Dental Crown and Restoration Types: Benefits and Limitations

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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

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