"All-Porcelain" Crowns
“I am a patient looking to have a front incisor replaced with an "all-porcelain" crown. I have spoken to several dentists and a lab and have been reading online and there seems to be a lot of use of the terms "all-porcelain" and "all-ceramic" and I am very confused what the terms mean. To me, the term all-porcelain would mean a monolithic porcelain crown but from the dentists and lab I have called they don't seem to know what I am talking about. They talk about e-max, zirconia, and pfms. They also mention crowns with either an Emax or zirconia coping and porcelain on top. The lab I spoke to said that the most aesthetic option would be an Emax coping with porcelain on top. Is there such a thing as a monolithic porcelain crown? The image below seems to indicate there is. I am trying to find the most aesthetic option for my front incisor and would appreciate clarity on this subject”
Porcelain needs to be fused to a framework material, it will not have any strength without a base material to which the porcelain sticks.so a zirconia framework or an Emax framework can be made that gives the porcelain an even thickness and room to generate shade.an all-porcelain crown cannot mean a porcelain crown minus its framework. in ye olden days porcelain jacketed crowns that wanted to avoid the use of metals used the precursor material to zirconia - "alumina" this is no longer done except by a handful of providers.
all-porcelain must mean porcelain on all aspects of the visible areas. this is a departure really, back to roughly 2008-2009 when porcelain bonded to zirconia became a big deal. nowadays people more use zirconia in all aspects except for a "window" area cut into the front of the crown, the part you can see. this saves porcelain and has a higher strength because the majority of the crown is now zirconia instead of porcelain.
Some patients may think front teeth that emax layered with porcelain is the best aesthetic option as it is more translucent in comparison to zirconia layered with porcelain, but actually more translucency isn’t always better even for the anterior especially if your underlying tooth is dark.
Let a skilled ceramist decide the best material choice for your situation. . All porcelain just means “ no metal substructure “. Each individual has a different way of chewing and biting so the material choice is about more than what looks pretty.