Dental Crown and Restoration Types: Benefits and Limitations

Full Crown Veneer

Indications:

• Extensive destruction from caries or trauma
• Endodontically treated teeth
• Existing restorations
• Correction for occlusal plane

Contraindications:

• Less than maximum retention
• Esthetics

Advantages:

• Strong
• High retentive quality
• Easy to obtain
• Adequate resistance form

Disadvantages:

• Removal of large amount of tooth structure
• Adverse effect on tissues
• Vitality testing not readily feasible
• Display of metal

Porcelain-Fused-to-Metal (PFM) Crown

Indications:

• Esthetics if all-ceramic is contraindicated
• Gingival involvement

Contraindications:

• Large pulp chamber
• Intact buccal wall

Advantages:

• Superior esthetics compared to complete cast crown

Disadvantages:

• Removal of substantial tooth structure
• Subject to fracture
• Difficult to obtain accurate occlusion
• Shade selection can be difficult
• Expensive

Partial Ceramic Crown (PCC)

Indications:

• Posterior teeth with moderately lost tooth structure
• Retainers for a fixed partial denture (FPD)
• Anterior teeth to establish anterior guidance
• To splint teeth
• Teeth with sufficient bulk

Contraindications:

• Short clinical crown
• Inadequate retention
• Retainers of long-span FPD
• Endodontically treated teeth
• Patients with active caries or periodontal disease
• Poorly aligned teeth
• Pulpos teeth

Advantages:

• Conservative
• Easy access to margins
• Less gingival involvement than complete cast crown
• Easy escape of cement and good seating
• Electric vitality test feasible

Disadvantages:

• Less retention
• Less resistance to displacement
• Need very careful preparation and limited adjustment can be made
• Esthetic concerns since some metals can be displayed

Pinledge

Indications:

• Undamaged anterior teeth in caries-free mouth
• Alteration of lingual contour of maxillary anterior teeth or alteration of occlusion
• Anterior splinting

Contraindications:

• Large pulp
• Thin teeth
• Non-vital teeth
• Carious involvement problems

Advantages:

• Minimal tooth reduction
• Minimal margin length
• Minimal gingival involvement
• Optimum access for margin access and hygiene
• Adequate retention

Disadvantages:

• Less retentive than complete coverage
• Alignment can prove difficult
• Technically demanding
• Not usable on non-vital teeth

Inlays

Indications:

• Small carious lesion on otherwise sound tooth
• Adequate dentinal support, low caries rate
• Patient request for gold instead of amalgam or composite resin

Contraindications:

• High caries index
• Poor plaque control
• Small teeth
• Adolescence
• Mesio-occluso-distal (MOD)
• Poor dentinal support requiring wide preparation

Advantages:

• Superior material properties, longevity
• No discoloration from corrosion
• Least complex cast restoration

Disadvantages:

• Less conservative than amalgam, may display metal
• Gingival extension beyond ideal
• Wedge retention

Ceramic Restorations

Advantages:

• Esthetic potential
• Potential translucency
• Good tissue response

Disadvantages:

• Reduced strength (no metal substructure and brittle in nature)
• Substantial tooth reduction required
• Technique sensitive
• Opposing tooth wear
• Zirconia used for posterior teeth

Indications:

• High esthetic requirement
• More conservative preparation not indicated
• Optimal tooth preparation possible
• Favorable distribution of occlusal load