A Comparison of Dental Crowns - Front and Back Teeth

Most dentists would recommend a ceramic crown for a front tooth, like zirconia, E-max or Lava and either ceramic or porcelain fused to metal (PFM) for a back tooth (molar tooth). If esthetics is not that important to you, a gold crown can also be a great choice (usually for a molar tooth).

However it is important to know that there is no such thing as "the best dental crown material". Each case is different and your dentist should consider your particular condition to choose a crown material.

Some of the things your dentist considers when selecting a dental crown material:

• your general oral health: e.g. very hard materials might not be suitable for people who grind their teeth, PFM crowns are not recommended to people with receeding gums
• the type and amount of damage of the tooth: some materials require less trimming of the tooth
• the quality of the neighboring and opposing teeth: very hard material might wear out the opposing tooth
• the shade of your teeth: some crowns are just too translucent and won't look natural if your natural teeth have a darker shade
• your eating habits: some crowns might fracture when you are eating hard food
• allergies you might have: some people might be allergic to metals that certain crowns contain
• other conditions: e.g. very hard materials might not be suitable for people who grind their teeth

Another important thing to remember is that the skill and experience of the dentist and the dental technician is just as important as the material of the crown.

In most cases ceramic crowns are considered to be the best choice for front teeth. They are not only very durable but also highly esthetic, which is a very important factor for a front tooth, as the crown will always be visible when you smile.

Your front tooth crown will likely be some sort of zirconia crown or E-max.

Zirconia crowns are very durable and look natural. However they tend to wear out the opposing tooth and if there is a decay underneath the crown, it may go unnoticed (because of the strength of the crown). Single-sitting crowns are usually milled from a block of zirconia.

A zirconia crown is a great and common choice for a front tooth.

E-max crowns are less durable than zirconia, however they are even more esthetic. They are also somewhat more expensive than zirconia crowns.

If you can afford it and your dentist recommends, e-max is probably the best dental crown material for a front tooth.

Porcelain crowns are not as durable as ceramic crowns, but they are highly esthetic and might also be a great choic for front teeth. These come in three categories:

• Bonded all porcelain is the most preferred choice of the dentist. However, these materials are not very strong by itself. If the dentist is good at his job and can fix it well then the threat of it breaking can be minimized.
• Extra strong all porcelain is the second in this category which is made of new ceramics strong materials. Many dentists prefer these to the previously mentioned due to the fact that these do not need to be fixed in a special way as the bonded ones. They are strong and easy to fit.
• Porcelain fused to metal is the third in this category. Since this material has the tendency to get black near the gum line, it is less often used for front teeth.

Nowadays all ceramic crowns are often used for back teeth restorations, but metal, gold, porcelain fused to metal are also good options.

Esthetics is less important here, but the strength and durability of the crown is very important. A back tooth crown has to withstand much higher forces than a front tooth crown.

There is really no "best back tooth dental crown material", it all depends on your oral conditions and budget.

These are the most common materials:

Porcelain fused to metal used to be the go to material for back teeth restorations.

The underlying layer of the crown is metal, which makes the crown very strong and the surface of the crown is porcelain, which makes it look natural.

PFM crowns does not look as good as ceramic crowns, but they are more affordable.

It's good to know that cheaper PFM crowns usually contain base metals (like nickel or cobalt-chrome), which might cause allergic reactions in some patient. More expensive crowns usually contain gold, allergic reactions are very rare in this case.

PFM crowns are still widely used today and they can be a good choice for back teeth crowns.

Metal crowns are affordable and durable but very unesthetic and therefore they are seldom used. Gold crowns have many great properties, if esthetics is not a problem, you should mention gold as on option to your dentist.

All ceramic is also an often used material for back teeth crowns. They used to chip off easily but with some advancements in the manufacturing process, this is usually not a problem anymore. They are not only very strong but also look great. However they are usually more expensive than PFM crowns.

These are some of the pros and cons of the most commonly used dental crown materials:

Metal / Gold (back tooth)

• very unesthetic
• metal is affordable, gold is expensive
• metal might cause allergic reactions
• very strong
• long-lasting
• friendly to the surrounding teeth
• needs very little trimming of the tooth

Porcelain fused to metal (back tooth)

• improved esthetics, but might not look as your natural teeth
• the gum lines tend to get black, might be visible when smiling when used on front teeth
• usually more affordable than all ceramic
• a large part of the tooth needs to be trimmed
• tried and tested, used to be very popular, still often used
• contains metal, might cause allergic reactions

All ceramic (front and back tooth)

• strong and durable
• look very natural
• might wear out the opposing tooth
• requires less trimming
• a bit more expensive than PFM crowns
• metal-free, no allergic reactions

 Porcelain (front tooth)

• look like your natural teeth
• tends to crack and chip
• needs significant reduction of the tooth structure
• metal-free, no allergic reactions

It's hard to give an exact estimate as prices greatly depend on your geographical location, the experience of the dentist and the material of the crown.

Resin crowns are the most affordable, but they don't last very long, so you should really look for crowns made of some more advanced materials.

For back tooth, a porcelain fused to metal crown (PFM crown) is a good choice, in the US this costs around $1,000 - $1,200. You might see significantly higher prices in large metro areas, though.

For front tooth dentists usually recommend all ceramic solutions, like zirconia or emax. They are a few hundred dollars more expensive than PFM crowns, however due to their enhanced aesthetics, they usually worth the extra cost.