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Medical Forum / General / Dentistry / January 2007

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resin or porcelain crowns?

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JimSocal - 29 Jan 2007 19:31 GMT
I'm getting my 4 lower front teeth fixed (23 through 26) because my
teeth there had big fillings which weakened the teeth and caused them
to chip, so they're all chipped and ugly.

Anyway, so I was asked if I wanted porcelain crowns or resin. (I hope
I am getting this right, I didn't write it down, but I hope you can
understand what I'm asking.) The dentist explained that if I get
porcelain, it might screw up my upper teeth because when I bite down
my upper teeth naturally slide down over (in front of) my lower teeth.
He said that the uppers and lowers slide so close together when I bite
down that the porcelain might cause my upper healthy teeth to
deteriorate due to the porcelain rubbing against them.

Therefore he suggests I get resin instead of porcelain, which as I
understand it is less aesthetically pleasing but will work better due
to the above scenario.

My question is, do you agree with this (I realize you cannot make an
accurate judgement without seeing the teeth; but I am asking, really,
if what he says makes sense as described) and how bad (or good) will
resin look as opposed to porcelain.

Of course, anything will look better than the chipped teeth I have
now, and the lowers are not seen that much behind my lips, and upper
teeth, anyway. But if I had my choice I'd go with the porcelain
because it would look better. The question I do not know is "How MUCH
better?" He indicated that they could do a good job with the resin and
it would look okay. I asked for some photos of the difference between
the porcelain and resin and he said he'd try to provide some for me to
see the difference. Can anyone refer me to any on the web? (I'll do a
search myself...)

So please give me any info on this issue that might help me decide
whether to go with porcelain or resin to fix my front 4 lower teeth.

Oh, also, the dentist seems to think I am grinding my teeth at night.
I'm not sure if I do or not, but this might be a factor in the
above... I'm starting another thread on grinding teeth...
Mark & Steven Bornfeld - 29 Jan 2007 19:49 GMT
> I'm getting my 4 lower front teeth fixed (23 through 26) because my
> teeth there had big fillings which weakened the teeth and caused them
[quoted text clipped - 34 lines]
> I'm not sure if I do or not, but this might be a factor in the
> above... I'm starting another thread on grinding teeth...

    I have more frequently seen damage to the lower front teeth from
porcelain crowns on the upper incisors, but no reason to assume you
couldn't have a problem with abrasion.
    Personally I think you have to deal with the parafunction (grinding and
clenching), or you may break your restorations.  I can hear the others
readying to recommend an NTI appliance, and this might be a good idea.
 Personally, I'd go with porcelain over resin.  Resin crowns are softer
and kinder to the opposing teeth.  Another way of looking at this is
that resin crowns are softer than the opposing teeth, and if you indeed
grind you may be looking at replacements for these crowns periodically,
which is a nice annuity for the dentist, but maybe not so nice for you.
 Of course the dentist will say "which would you rather wear, the
crowns or your own natural teeth"?  And he'd be right.  But controlling
parafunction should minimize wear.  Furthermore, there are newer
low-index porcelains that are less likely to wear the teeth.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

JimSocal - 30 Jan 2007 09:38 GMT
>    I have more frequently seen damage to the lower front teeth from
>porcelain crowns on the upper incisors, but no reason to assume you
[quoted text clipped - 13 lines]
>
>Steve
Thanks Dr. Bornfeld. I'll ask about the low index porcelain, and ask
more about the grinding, or parafunction.
As you may remember I am seeing a dentist at dental school and it was
the student (grad student) dentist who mentioned the grinding, not the
prof, so I'm not absolutely certain she knew what she was talking
about, concerning the grinding; though she probably did. But in any
case, I'll ask her to let me discuss this with the prof and see what
he says.

I don't think the dentist school would be looking for future crowns to
replace (i.e; profit motive) though they could be I suppose. The prof
seemed to genuinely think the resin would be better, to save my upper
real teeth from being damaged by the porcelain lower teeth.
Dartos - 30 Jan 2007 13:54 GMT
I agree Dr. B.

Yes, the resin crowns will not wear the natural teeth.  However, as
the resin wears, the bite will come closer together.  When the crowns
need replacement, it will not be a matter of just removing the old
crowns and making new ones.  The teeth will have to be cut down even
more.  If none of them needed root canals yet, this might cause them
to.  Get the porcelain.

BUT....

Controling the parafunction (clenching/grinding) is the only way to
get the maximum life out of the crowns and your natural teeth.
Some type of 'bite guard' is in order.  IME, the NTI device is the
easiest to wear and has the fewest side effects.  I've had one patient
out of hundreds who prefers a 'horseshoe' appliance over the NTI.

Pretty good odds.

JME,
D

>>    I have more frequently seen damage to the lower front teeth from
>>porcelain crowns on the upper incisors, but no reason to assume you
[quoted text clipped - 27 lines]
> seemed to genuinely think the resin would be better, to save my upper
> real teeth from being damaged by the porcelain lower teeth.
Le Huart - 30 Jan 2007 22:50 GMT
Do you charge less for the in office NTI than the lab fabricated horseshoe?
Dartos - 31 Jan 2007 16:24 GMT
I charge about the same.  The 'horseshoe' actually costs more to
make, but since the NTIs work so much better, they are worth
at least as much.

;-)
D

> Do you charge less for the in office NTI than the lab fabricated horseshoe?
Mark & Steven Bornfeld - 30 Jan 2007 14:59 GMT
>>    I have more frequently seen damage to the lower front teeth from
>>porcelain crowns on the upper incisors, but no reason to assume you
[quoted text clipped - 27 lines]
> seemed to genuinely think the resin would be better, to save my upper
> real teeth from being damaged by the porcelain lower teeth.

    This may certainly be true, and it's not necessarily inappropriate to
give up a bit of durability and esthetics for a more physiologically
kind situation.  The situation needs to be assessed on it's particular
merits.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

 
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