Dental Experts Assess Zirconia Crowns Pros Cons and Alternatives

A bright, healthy smile not only boosts confidence but also enhances quality of life. However, tooth damage, discoloration, and other dental issues often pose challenges. Among various restorative solutions, dental crowns have emerged as an effective treatment, with zirconia crowns gaining particular attention for their exceptional properties.

Dental crowns, sometimes called caps, are prosthetic restorations that cover damaged teeth or implants. Dentists typically recommend crowns to support fractured, weakened, or misshapen teeth. They can also protect severely worn or discolored teeth, or serve as components in dental bridges for multi-tooth restoration.

Zirconia crowns have become increasingly popular due to several notable advantages:

Zirconia's most prominent advantage lies in its remarkable strength. Given the substantial chewing forces that molars endure, this material proves particularly suitable for posterior restorations. Its high strength also allows for more conservative tooth preparation, preserving healthy tooth structure.

A 2017 randomized controlled trial published in the Journal of Dentistry demonstrated comparable 5-year performance between zirconia and metal crowns. Monolithic zirconia crowns (single-material construction) showed especially impressive durability. A 2022 5-year study confirmed similar success rates for implant-supported zirconia crowns.

Many dental professionals prefer zirconia for its high biocompatibility, meaning it rarely triggers adverse biological reactions. A 2020 research review confirmed this property, noting zirconia crowns' favorable clinical performance across multiple studies.

With CEREC (Chairside Economical Restoration of Esthetic Ceramics) technology using CAD/CAM systems, dentists can design and mill zirconia crowns in-office during a single appointment. This eliminates the need for temporary crowns and multiple visits, though not all practices offer this technology.

Zirconia's natural opacity can sometimes create less natural-looking results compared to other materials, particularly for monolithic anterior crowns. Many clinicians address this by layering porcelain over the zirconia framework for enhanced aesthetics.

Some practitioners express concern about zirconia's hardness potentially causing wear on opposing natural teeth. However, a 2021 study found feldspathic porcelain actually causes more enamel wear than zirconia ceramics.

The layered approach combines zirconia's strength with porcelain's lifelike appearance. While this improves color matching, research indicates slightly higher risk of chipping or delamination compared to monolithic designs.

Zirconia crowns typically range from $1,000 to $2,500, often costing more than other crown types. Geographic location and specific case requirements affect pricing. Insurance coverage varies significantly—patients should verify their benefits beforehand.

Other common options include:

• All-ceramic crowns
• Porcelain-fused-to-metal (PFM)
• Full metal crowns
• Composite resin crowns

Material selection depends on multiple factors: remaining tooth structure, restoration location, gum visibility during speech/smile, and adjacent tooth color.

This conventional method involves:

1. Tooth preparation and impression taking
2. Temporary crown placement
3. Laboratory fabrication (1-2 weeks)
4. Permanent crown cementation at second visit

With in-office milling technology:

1. Digital scanning replaces physical impressions
2. Crown design and milling occurs during appointment
3. Final crown placement completes treatment

Proper care extends crown lifespan significantly:

• Maintain excellent oral hygiene with brushing and flossing
• Avoid chewing hard objects (ice, hard candy, etc.)
• Schedule regular dental checkups
• Address grinding/clenching habits with nightguards if needed

Zirconia crowns represent an excellent restorative option, particularly for patients prioritizing strength and longevity. While they present certain aesthetic considerations, technological advancements continue to improve their natural appearance. As with any dental treatment, consulting with a qualified professional ensures the best solution for individual needs and circumstances.