Dental Crown and Restoration Types: Benefits and Limitations
Classified in Biology
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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