Dental materials have changed significantly over the past 2 decades. In the past, the only options we have to create beautiful cosmetic restorations were soft porcelain (feldspathic) or with porcelain to metal crowns (a metal coping with feldspathic porcelain stacked over the top. Both of these options were adequate, but lacked long term durability and great aesthetics. Maybe you’ve seen someone with a front tooth crown that looks “not quite natural”, and has a dark line right next to the gum line? These are usually older “porcelain/metal” crowns that lack translucency and have an exposed metal collar at the gum line. These crowns are often replaced with newer - more aesthetic - porcelain crowns, not because the old crowns are broken or defective, but rather because the old crown no longer look good. See the image below - and notice the dark line at the gum area of the crown and the dull/flat appearance of the front tooth crown when compared to the adjacent natural tooth.
Porcelain technology has improved significantly and we not have material like Lithium Disilicate and Zirconia - which have no metal coping, are super strong and durable as well as aesthetic. The challenge for any cosmetic dentist is to create restorations that mimic real life - meaning using porcelain that allows not only the correct color match; but also the right translucency, opalescence, characterization and surface texture. We want to create veneers and crowns that are truly lifelike and indistinguishable from natural teeth.
So, what do you do when your old crowns catch your eye in your most recent family photos? Maybe the dark line at the gingiva is driving you crazy, you have chips or fractures in your old crown or veneers or the old crowns no longer match your teeth? The first step is bring these concerns up at your next visit or cosmetic dental consult. Often we recommend replacement of the old materials with newer materials AFTER you have a chance to full whiten your smile. I always recommend using this time to get your natural teeth back to the color you always wanted with our take home professional whitening system - then we replace the old veneers or crowns to the new color of your adjacent teeth. Remember, teeth change color but porcelain is forever the same color. If you don’t take the time to first whiten - you’ll be stuck at that shade, unable to whiten your other teeth because it will create a contrast between your crown and natural teeth.
Here is a case where the patient presented with broken (soft porcelain) veneers that were also very gray in appearance. We recommended replacing the restorations with new "lithium disilicate” restorations that were brighter, a bit longer and more aesthetic and durable. The patient loved the result and the case was completed in 2 visits!
So, if your old crowns or veneers are not looking the best - mention it to your cosmetic dentist and learn about what options are out there to reguvinate your smile. It might be easier than you think!
~ Dr B
