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Medical Forum / General / Dentistry / November 2008Problems with base metal crowns???
This morning I visited my regular dental practice and was told that they no longer fit porcelain-on-base-metal crowns. All of the ones I have are of porcelain on base metal and most of them are 25 years or older and have never given me problems. The dentist claimed that so many people had trouble with this kind of metal that they are now very rarely made. The diference between the prices of the base metal and noble metal crown is around $200. I have not seen any publicity about the porcelain-on-base-metal crowns. Has anyone? Info appreciated here. TIA > This morning I visited my regular dental practice and was told that they > no longer fit porcelain-on-base-metal crowns. All of the ones I have are [quoted text clipped - 11 lines] > > TIA Most of the base metals used in crowns contains nickel, which many people are sensitive to. Some contain beryllium, which is a serious occupational hazard to technicians or dentists that grind crowns containing beryllium. I have had many patients without problems with non-precious alloys, but a number have. I presume it's the nickel. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > I have had many patients without problems with non-precious alloys, but >a number have. I presume it's the nickel. > >Steve Simple to test for nickel allergy or reaction. Tape a US nickel to the insided of the forearm or upper arm. Look for a reaction in 3 - 5 days. >> I have had many patients without problems with non-precious alloys, but >> a number have. I presume it's the nickel. [quoted text clipped - 6 lines] > > Look for a reaction in 3 - 5 days. My daughter can't wear cheap earings--I presume that's why. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >This morning I visited my regular dental practice >and was told that they no longer fit [quoted text clipped - 11 lines] >I have not seen any publicity about the >porcelain-on-base-metal crowns. Has anyone? Nope, and have literally placed thousands of them. >Info appreciated here. > >TIA Nowdays I tend to place porcelain to high noble metal <Captek> and all porcelain crowns because they look better. I personally, have never placed a porcelain-to-BASE-metal crown. The lab fee was generally only about $8-$20 less. I never had any patients who refused a crown because it cost $20 too much. For the past ten years, I have not placed a crown with any metal in it (I think there were about 3-4 exceptions). Signature/ Amatus / > This morning I visited my regular dental practice and was told that they > no longer fit porcelain-on-base-metal crowns. All of the ones I have are [quoted text clipped - 11 lines] > > TIA >I personally, have never placed a porcelain-to-BASE-metal crown. Ditto. For the OP, the price difference today between base metal and noble is quite a bit more nowadays. John >For the OP, the price difference today between base metal and noble is quite >a bit more nowadays. > >John I can't see how the lab fee would be $200 more per crown. >>For the OP, the price difference today between base metal and noble is >>quite [quoted text clipped - 3 lines] > > I can't see how the lab fee would be $200 more per crown. Agreed, it does seem a bit high, but can't comment for sure on that given we don't know exactly which high noble alloy your dentist was referring to. Different high nobles cost different amounts depending on the proportions of gold, platinum, etc. John >>> For the OP, the price difference today between base metal and noble is >>> quite [quoted text clipped - 10 lines] > > John Not surprisingly, dental casting alloys are considerably more expensive (at least charged by the lab) than you would expect based on the amount of gold. $200 would be a bit high, but not much for high noble. Steve > Not surprisingly, dental casting alloys are considerably more expensive >(at least charged by the lab) than you would expect based on the amount >of gold. $200 would be a bit high, but not much for high noble. > >Steve I can't remember ever being charged anything like that for the total metal cost of any crown. >> Not surprisingly, dental casting alloys are considerably more expensive >> (at least charged by the lab) than you would expect based on the amount [quoted text clipped - 4 lines] > I can't remember ever being charged anything like that for the total > metal cost of any crown. I should elaborate--I think I've seen those metal fees for the combination of crown and custom implant abutments. I don't do a lot of high noble/porcelain crowns, but it is easy to imagine a large molar crown containing upwards of 5 pw or 1/4 oz. I think the price of gold has declined, but not too much. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>>> For the OP, the price difference today between base metal and noble is >>>> quite [quoted text clipped - 16 lines] > >Steve For Captek, it's not so much the gold amount, it's the special equipment required to form the coping. The wax materials ain't cheap neither. Really nice strong posteriors, have made many anteriors too. Looks great, fit is exceptional, and tough as nails. Have place many hundreds of these. >>I personally, have never placed a porcelain-to-BASE-metal crown. > [quoted text clipped - 4 lines] > >John Indeed. > I personally, have never placed a porcelain-to-BASE-metal crown. The lab > fee was generally only about $8-$20 less. I never had any patients who > refused a crown because it cost $20 too much. For the past ten years, I > have not placed a crown with any metal in it (I think there were about 3-4 > exceptions). My thanks to all for your enlightening comments. Amatus, are your crowns porcelain only and, if so, are they brittle? Have any of your patients returned to you with one of those crowns broken? I'd prefer no metal at all. >> I personally, have never placed a porcelain-to-BASE-metal crown. The >> lab fee was generally only about $8-$20 less. I never had any [quoted text clipped - 7 lines] > Have any of your patients returned to you with one of those crowns > broken? I'd prefer no metal at all. Most all-ceramic crowns, particularly the stronger ones hold up to normal biting pressure quite well. I'm not personally ready to do fixed bridges with them, but other dentists may disagree. Amatus uses CEREC, a proprietary CAD/CAM system, and has for many years. I'll let him sing it's praises. But he's an excellent dentist and would probably get optimal results no matter what material he used (within reason). Steve >>> I personally, have never placed a porcelain-to-BASE-metal crown. The >>> lab fee was generally only about $8-$20 less. I never had any [quoted text clipped - 11 lines] >normal biting pressure quite well. I'm not personally ready to do fixed >bridges with them, but other dentists may disagree. Placed a Lava bridge in my younger daughter. Nice ! Good single units too. Have placed posterior 3-units too, if bonded correctly or cemented with Fugi G-Cem, really tough stuff. Lava looks great too. For bonding all ceramics am using Calibra. > Amatus uses CEREC, a proprietary CAD/CAM system, and has for many >years. I'll let him sing it's praises. But he's an excellent dentist >and would probably get optimal results no matter what material he used >(within reason). Amatus could make a great crown out of petrified wood. >Steve >>>> I personally, have never placed a porcelain-to-BASE-metal crown. The >>>> lab fee was generally only about $8-$20 less. I never had any [quoted text clipped - 29 lines] > >> Steve Agree on all points. Thanks for the report on the Lava bridge. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 We now have a CEREC block that is basically very similar to LAVA. We mill it in its bisque stage, adjust it to fit, then fire it to get the final hardness. You virtually cannot grind on these with a high speed and diamond after sintering it in the oven. Signature/ Amatus / > >>>> I personally, have never placed a porcelain-to-BASE-metal crown. The [quoted text clipped - 30 lines] > >>Steve > We now have a CEREC block that is basically very similar to LAVA. We mill > it in its bisque stage, adjust it to fit, then fire it to get the final > hardness. You virtually cannot grind on these with a high speed and diamond > after sintering it in the oven. You have a furnace in the office? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 yup Signature/ Amatus / >> We now have a CEREC block that is basically very similar to LAVA. We >> mill it in its bisque stage, adjust it to fit, then fire it to get the [quoted text clipped - 4 lines] > > Steve The same percentage of failures as with full gold. Signature/ Amatus / >> I personally, have never placed a porcelain-to-BASE-metal crown. The lab >> fee was generally only about $8-$20 less. I never had any patients who [quoted text clipped - 7 lines] > any of your patients returned to you with one of those crowns broken? I'd > prefer no metal at all. I think he means: Slim and None ! >The same percentage of failures as with full gold. > [quoted text clipped - 9 lines] >> any of your patients returned to you with one of those crowns broken? I'd >> prefer no metal at all. Studies show the statistics to be almost the same. At 15 years, the machine milled ceramic actually have fewer failures than gold. Signature/ Amatus / > > I think he means: Slim and None ! [quoted text clipped - 16 lines] >>> I'd >>> prefer no metal at all. >I personally, have never placed a porcelain-to-BASE-metal crown. Not even in school ? >The lab >fee was generally only about $8-$20 less. I never had any patients who >refused a crown because it cost $20 too much. For the past ten years, I >have not placed a crown with any metal in it (I think there were about 3-4 >exceptions). School used porcelain to semi-precious. We did some full metal --non-precious-- crowns. We used NEY-76 which is really classified as semi as it is mostly silver. We had to cast these ourselves (no lab fee), and we could deliver these crowns for about $75 each back in 1981 Signature/ Amatus / > >>I personally, have never placed a porcelain-to-BASE-metal crown. [quoted text clipped - 6 lines] >>have not placed a crown with any metal in it (I think there were about 3-4 >>exceptions). |
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