Which materials stand out in dental crowns?
Modern dentistry offers constantly evolving materials to meet both the aesthetic and functional expectations of patients. Today, traditional metal-supported porcelains have largely been replaced by all-ceramic systems such as zirconium and Emax. These materials have revolutionized the imitation of natural tooth structure thanks to their light transmission properties and excellent compatibility with the gums. When making a choice, the position of the tooth, the chewing habits of the patient, and the targeted aesthetic results are evaluated as a whole.
What is zirconium coating and how is it applied?
Zirconium crowns are durable restorations produced from a white metal ceramic called zirconium dioxide. This material is known for its high mechanical resistance and tissue-friendly structure. During the application process, after the teeth are slightly abraded, digital impressions are taken and designed in a computer environment using CAD/CAM technology. Zirconium blocks are shaped in special milling devices to be fully compatible with the patient's mouth structure. It is strong enough to withstand the chewing load on the posterior teeth and elegant enough to look aesthetic on the anterior teeth.
What is Emax coating and what are its advantages?
Emax is one of the types of coatings with the highest aesthetic success, produced from lithium disilicate material, which is a special glass ceramic. The biggest advantage of this material is that it has the light transmittance and color depth closest to natural tooth enamel. Emax coatings are preferred especially to provide a flawless appearance in the anterior teeth. Despite its thin structure, it is quite durable and since it is chemically bonded to the tooth, the risk of falling or coming out is minimum. Since it does not contain metal, it does not cause bruising at the gum line.
What are the main differences between Zirconium and Emax?
The most fundamental difference between Zirconium and Emax lies in the balance between durability and aesthetics. Zirconium is a structurally more robust and hard material, so it is generally preferred for posterior teeth and long bridges. Emax, on the other hand, has a more transparent and glass-like structure, making it unrivaled in meeting aesthetic expectations in the front teeth. While zirconium has an opaque sub-structure, Emax is in a structure that completely transmits light; this allows Emax to offer a much more natural depth.
Which one looks more natural from an aesthetic perspective?
In aesthetic comparison, Emax coatings are usually one step ahead. Natural tooth enamel transmits and reflects light at a certain rate; Emax is the material that best imitates this optical property. Zirconium is also very aesthetic, but due to its structure, it can look a bit more "opaque" or "white". If it is necessary to mask very dark or discolored lower tooth structures, zirconium may be a better option. However, if transparency and a vibrant smile design are targeted, the natural look offered by Emax coatings usually satisfies patients more.
Which material is superior in terms of light transmittance?
Light transmittance is the most critical factor for a dental crown not to look "lifeless". Emax coatings create a perception of depth by allowing light to pass through the coating thanks to its lithium disilicate structure. This situation makes it almost impossible to distinguish the coating from your own tooth. Zirconium, on the other hand, has a structure that reflects light more. Although "translucent zirconiums" produced in recent years have closed this gap, Emax is still accepted as the gold standard when pure light transmittance is concerned.
Should zirconium be preferred when durability is the issue?
If your priority is durability and resistance to high chewing pressure, zirconium is definitely a better choice. The fracture resistance of zirconium (MPa value) is about twice as high as that of Emax material. Thanks to this feature, it exhibits an excellent performance against the grinding movements in the back teeth. Emax is also durable, but it may carry a risk of breaking under very high pressure or in very long bridges. For this reason, physicians generally prefer zirconium in areas where the functional load is heavy.
Which coating type is safer for back teeth?
The back molars are the area that receives the highest pressure in our mouth, and the "biomechanical resistance" of the coatings here must be very high. Zirconium coatings can carry this load for years without cracking or breaking. Although Emax coatings can be used for single tooth restorations in the posterior region, zirconium is a much safer harbor especially in patients with teeth grinding problems or in cases where a bridge is needed. The hard texture of zirconium shows superior resistance against wear in the posterior teeth.
Why is Emax popular in anterior tooth restorations?
When a smile design is made, the form, color, and surface texture of the teeth in the front region reflect the character of the person. Since Emax coatings can be processed in very thin layers in the laboratory environment, they can imitate even the smallest details of the tooth. The softness of the transitions in the areas close to the gums and the color transitions within the material itself make Emax indispensable for the front teeth. Patients keep Emax popular in this region because they get such a natural result that they will not realize that a coating has been made when they look in the mirror.
Which material is more successful in terms of gum harmony?
Both zirconium and Emax are biocompatible materials and are gum-friendly. The "purple line at the gum edge" problem, which is frequently seen in metal-supported coatings, does not occur in these two materials. However, Emax coatings can exhibit a more marginally integrated harmony with the gums thanks to the tooth bonding (cementation) method. The perception of the coating by the gum not as a foreign substance but as a part of the tooth protects the tissue health. Both materials minimize the risk of gum recession.
Is there a risk of allergic reaction with these coatings?
Metals such as nickel, chrome, or cobalt used in classic dental crowns can cause allergic reactions or a metallic taste in the mouth in some patients. Zirconium and Emax, on the other hand, are ceramic structures that are completely metal-free. Thanks to these features, they are classified as "biocompatible", meaning tissue-friendly. There is no serious allergic case reported against these materials in the literature. Therefore, both options are extremely safe and healthy for patients who have metal allergies or sensitive gums.
How much tooth cutting is required before coating?
Minimal invasive dentistry aims to protect the natural tooth structure as much as possible. Since Emax coatings can be produced very thin (sometimes 0.3 - 0.5 mm), they require very little abrasion from the tooth. Even in "Lumineers" or "Non-prep" techniques, tooth cutting may not be done at all. Zirconium coatings generally require a bit more tooth cutting (about 1-1.5 mm) due to material thickness and infrastructure requirements. The current condition of your tooth is the main factor determining how much cutting each material will require.
Is there a risk of color change or yellowing?
One of the biggest fears of many patients is that the coatings will change color over time due to coffee, tea, or smoking. Both zirconium and Emax are materials with very high surface smoothness and have a non-porous structure. In this way, plaque accumulation on them is minimal and external coloring agents cannot penetrate into the material. A coating whose polishing (glaze) process has been done correctly maintains its color of the first day even after years. With regular tooth brushing and professional cleaning, yellowing of these coatings is out of the question.
How is their resistance to chewing forces measured?
In dentistry, the resistance of materials is measured with the "Megapascal" (MPa) unit. While the resistance of zirconium is usually between 900 and 1200 MPa, the resistance of Emax (lithium disilicate) is around 360 to 500 MPa. These figures prove that zirconium is physically much harder. However, it should not be forgotten that the success of a coating in the mouth depends not only on its hardness but also on how it is bonded to the tooth. Emax is quite resistant and long-lasting in the mouth despite its low MPa value because it adheres to the tooth with a chemical bond (adhesive).
How long is the lifespan of zirconium coatings?
Zirconium coatings can generally be used without problems for 10 to 15 years, or even longer, with correct oral care and regular physician checks. Since the material itself is extremely resistant to wear and breakage, it does not show signs of "aging". The main factor determining the life of the coating is the health of the tooth under it and the condition of the gums. If gum health is protected and decay formation around the tooth is prevented, zirconium coatings can accompany the patient for a lifetime.
How long can Emax coatings be used?
Emax coatings are also long-lasting restorations just like zirconium. Clinical studies show that the 10-year success rate of Emax restorations is over 90%. The most important factor extending the life of Emax is the quality of "bonding" to the tooth. Thanks to the chemical bond, the coating and the tooth move like a single piece, which prevents micro-leaks and secondary decays. As long as bad habits such as breaking hard foods with teeth or biting pens are avoided, Emax coatings maintain their aesthetics for years.
What is the result when breaking and cracking risks are compared?
In terms of breaking risk, zirconium is more advantageous; because it shows a very "tough" resistance against impacts due to its structure. Emax, on the other hand, is more fragile (brittle structure) against sudden and very hard impacts because it is a glass ceramic. However, today, breaking rates have been reduced considerably in both materials thanks to "monolithic zirconiums" or reinforced porcelain layers. If the patient has an uncontrolled night teeth grinding, zirconium or zirconium-based porcelains are preferred instead of Emax to minimize the risk of breaking.
How do computer-aided design processes work?
Both types of coatings are generally prepared with CAD/CAM (Computer-Aided Design / Computer-Aided Manufacturing) technology. In the first stage, after the teeth are prepared, 3D digital impressions are taken with intraoral scanners. This digital data is transferred to the computer and the dental technician designs the teeth in a virtual environment. After the design is finished, zirconium or Emax blocks are placed in the milling device and cut with micro-level precision. This technology makes it possible for the coating to adapt to the tooth at the micron level and to reduce the margin of error to zero.
Is the use of temporary crowns necessary in this process?
In the period between the cutting of the teeth and the fitting of the permanent crowns (usually 3-7 days), temporary crowns are used to prevent sensitivity of the teeth and to protect aesthetics. Temporary crowns are made of acrylic material and allow the patient to continue their social life. Regardless of zirconium or Emax, these temporaries are fitted immediately after the tooth preparation is done. In this process, the patient can fulfill the chewing function, even if limited, until the rehearsal of the permanent crowns is made and begins to get used to the new form of their teeth.
What do cost differences mean for patients?
The costs of zirconium and Emax coatings vary according to the quality of the material used, laboratory workmanship, and the experience of the physician. In general, Emax coatings may be slightly higher priced than zirconium due to both material cost and the requirement for delicate workmanship. However, this difference is considered reasonable for many patients when the superior aesthetic value it provides is considered. Zirconium, on the other hand, may appear as a slightly more economical option because it has a wider usage area and the production line is more common.
Are there risks of making bad breath?
The bad breath problem seen in old-style metal-supported coatings was usually caused by the incompatibility of the coating with the gums and the corrosion created by the metal. Zirconium and Emax coatings do not cause bad breath on their own because they are completely biocompatible and provide a perfect fit to the tooth. If bad breath occurs after coating, this is usually due to inadequate oral hygiene, gum inflammation, or food residues accumulating at the edge of the coating. When correct cleaning is done, these materials provide a fresh oral environment.
Does tooth sensitivity occur after coating?
It is normal to see a slight cold-hot sensitivity for a few days after the coating treatment. However, zirconium and Emax are materials with low thermal conductivity; that is, they are much more successful than metal coatings in transmitting the external heat to the nerves (pulp) of the tooth. This also means that thermal sensitivity decreases in the long term. Especially in Emax laminate applications, the risk of sensitivity is minimum because very little cutting is done from the tooth. If there is a permanent sensitivity, this situation is usually caused by the height of the coating or the neural state of the tooth.
Which material should be preferred in bridge treatments?
In bridge prostheses used for the elimination of tooth deficiencies, "carrying force" is very important. The bridge body, which fills the gap created by the missing tooth, should not stretch or break during chewing. Emax coatings are usually not recommended for bridges of more than 3 members due to their fragile structures. Zirconium, on the other hand, is the most ideal material for long bridges thanks to its high durability. In deficiencies in the posterior region, zirconium-based bridges are the most preferred solution because they offer both strength and aesthetics together.
Which one is more suitable for over-implant prostheses?
In implant treatments, the material of the prosthesis to be attached onto the implant affects long-term success. Generally, zirconium is preferred for over-implant restorations; because the opaque structure of zirconium masks the metallic gray color of the implant very well. Also, since the forces on the implant are transmitted directly to the bone, using zirconium, which is a more resistant material, is advantageous. However, in single tooth implants in the anterior region, the most natural result can be obtained by making an Emax coating on a zirconium abutment (support) to ensure aesthetic integrity.
What should those with teeth grinding problems choose?
In patients with bruksizm (teeth grinding) problems, the forces to which the coatings are exposed are many times more than normal. Emax coatings may face the risk of cracking in such patients (if protective measures are not taken). Zirconium is a much more resistant shield against these forces. However, in both cases, the use of a night guard (protective plaque) is mandatory to protect the life of the coatings. Using monolithic (solid) zirconium in a patient who grinds their teeth will be a smart choice in terms of both durability and preventing the wear of the opposing teeth.
Which one gives the closest feeling to natural tooth structure?
When looked at from the perspective of the sensation in the mouth, Emax coatings usually make you feel "as if it were your own tooth". Thanks to its thin structure and lightness, it does not create a feeling of foreign substance on the tongue or lips. Zirconium is also quite light, but when combined with porcelain layers, it can give a slightly more voluminous feeling. Since both materials eliminate the metallic taste and their thermal conductivity is close to the natural tooth, the adaptation process of the patients is very fast. It is an expected situation that you will forget the presence of the coatings within a few days.
Is there a difference between laboratory preparation times?
Since both types of coatings are produced with technological methods, their preparation times are close to each other. However, the process of "sintering" of zirconium, which is the process of being baked in high-temperature furnaces, is a bit longer. Emax coatings, on the other hand, can be ready in a shorter time in crystallization furnaces after milling. Generally, in a dental clinic, these treatments are completed within 3 to 7 business days. Some clinics can even deliver these coatings within a few hours with the concept of "same day dentistry" thanks to the CAD/CAM devices within their structure.
Is it more logical to whiten teeth or to coat them?
If the shape of your teeth is smooth and you only complain about its color, the first option should always be teeth whitening (bleaching). However, if there is excessive wear, large fillings, distortion on the teeth, or internal stains that do not go away with whitening (such as tetracycline stain), coating treatment is more logical. Emax coatings or laminates are a great way to completely change aesthetics without damaging the tooth. Zirconium, on the other hand, offers a permanent solution for teeth that have more serious structural problems and expect both shape and resistance.
Is a special routine required for the maintenance of coatings?
The maintenance of zirconium and Emax coatings is not much different from the maintenance of natural teeth. Brushing teeth at least twice a day and using dental floss every day is the golden rule. It is recommended to use an interface brush or oral irrigator to prevent plaque accumulation in the areas where the coatings join the gums. It is necessary to avoid breaking hard objects (shelled nuts, bottle caps, etc.) with teeth. Going to a regular dentist check every six months is of vital importance in terms of following the health of the teeth and gums under the coatings.
How does the age factor affect the choice of coating?
In young patients, the pulp (nerve) chambers of the teeth are wider, so Emax or laminates, which require minimal cutting, are more preferred. As age progresses, since wear and gum recession on the teeth increase, zirconium coatings, which provide more comprehensive protection and have high resistance, may come to the fore. Also, since tooth deficiencies are more common in elderly patients, the use of zirconium in bridge treatments is common. However, if "natural appearance" is a priority at any age, the physician decides according to the needs of the patient's teeth, not their biological age.
How is material selection made during the smile design process?
Smile design is a process in which many parameters such as the patient's face shape, lip structure, and skin color are evaluated. Your physician first shows you the finished version of the teeth with a temporary rehearsal called "mock-up". If a very bright and opaque whiteness like "Hollywood Smile" is desired, zirconium can give good results. However, if a more natural, "non-noticeable" smile is targeted, Emax laminates or coatings are preferred. In the decision-making stage, the clinical experience of the physician and the aesthetic vision of the patient should meet at a common denominator.
What is the difference of zirconium from metal-supported porcelains?
There is a gray metal sub-structure inside classic metal-supported porcelains. Since this structure blocks the light, the teeth look dull and lifeless. Over time, a black/purple shadow forms as a result of the oxidation of the metal at the gum border. Zirconium, on the other hand, is completely white; its sub-structure and its porcelain transmit light. In this way, it is both healthier and superior in terms of aesthetics by many folds. Thanks to its biological compatibility with the gums, it ensures that the gums remain healthy and pink around the coating, and it does not cause allergies like metal porcelains.
What are the differences between Emax laminate and full crown?
Emax material can be used both as "laminate" (leaf porcelain) and as "full crown". In laminate applications, only the front surface of the tooth is abraded around 0.3-0.7 mm; this protects the integrity of the tooth. In full crown, on the other hand, the tooth is cut 360 degrees. If there is no large decay or filling on the back surface of the tooth, laminate is always a more protective choice. However, if the tooth is very damaged or will carry a large force, making an Emax full crown creates a more durable structure in terms of surrounding the entire tooth.
Does smoking affect the color of the coatings?
In people who smoke, the surface of natural teeth yellows rapidly and stains form. Zirconium and Emax coatings are very resistant to staining thanks to their smooth glazed surfaces. Cigarette smoke does not change the color of the coating like a natural tooth. However, smoking can damage the gums and cause gum recession. When the gum recedes, a gap may form between the border of the coating and the tooth root, and this root surface may darken due to smoking. This situation spoils the aesthetics of the tooth under the coating, not the coating itself.
Which investment is considered more profitable in the long term?
Although dental treatments seem costly initially, they are a long-term investment in health and self-confidence. While Emax coatings give a "priceless" result with the self-confidence they offer from an aesthetic point of view, zirconium coatings provide an economic benefit by not requiring replacement for years thanks to their durability. Coatings made with cheap and low-quality materials can cause gum problems or breakages within a few years, causing larger expenses. Therefore, choosing the highest quality material and an experienced physician as much as the budget allows is the most profitable investment.
In which case does the dentist recommend zirconium?
If the patient has a tooth deficiency in the posterior region and a bridge will be made, if the patient has a severe teeth grinding habit, or if the color of the tooth to be restored is very dark and needs to be closed, your physician will recommend zirconium. Also, zirconium is more successful in masking the infrastructure in teeth that have had root canal treatment and whose color has completely changed. The structural support offered by zirconium allows for the protection of the remaining tissue of the tooth and the continuation of the chewing function in the healthiest way.
Hiç yorum yok:
Yorum Gönder