Are CEREC Crowns Better Than Traditional Crowns?
(Dentist’s Perspective)

Category: Adult Dentistry, Common Questions, Dr. Advocate's Insights

Dr Advocate Avatar IconBy: Dr. Advocate
Updated: August 25, 2022

CEREC vs. Traditional Crowns Pros/Cons | My Dental Advocate

If you are like most people, you probably dread going to the dentist. However, thanks to modern technology, many dental procedures are now more efficient and less painful. One such procedure is the placement of a crown. Traditional crowns are made of metal and must be fitted over several appointments. Now, CEREC crowns can be placed in just one visit! This article will explore the benefits of CEREC crowns and discuss the pros and cons of CEREC and traditional crowns.

Recommended Reading: CEREC Crowns | The Ultimate Guide

What are CEREC crowns?

CEREC crowns are made of ceramic, a strong, aesthetically-pleasing material. The pre-shaded blocks come in many different shades to match the color of your natural teeth. CEREC crowns are fabricated in-office using sophisticated design and mill technology.

CEREC crowns are made using CAD/CAM technology. CAD/CAM technology consists of an intraoral digital scanner (rather than a gooey impression) that takes a video of the prepared tooth and adjacent teeth.

The scan is then sent to a computer using state-of-the-art software to design and customize the crown digitally. The dentist has complete control over the entire process and can make modifications that will improve the overall fit of the crown, including shape, contact with adjacent teeth, and contact with opposing teeth.

Recommended Reading: Same-day CEREC Crown Process (Step-by-step Guide)

In addition, the CAD/CAM software analyzes the adjacent and opposing teeth to accurately and precisely fit the crown within all parameters, so minimal adjustments are necessary. For example, suppose you have a partial denture that anchors around a tooth needing a crown. In that case, the intraoral camera can scan the tooth, which is then sent to the computer to allow the software to replicate the shape tooth into the new crown design.

After the dentist approves the design, the dentist will digitally send it to the CEREC milling unit for crown fabrication. The milling unit uses two diamond burs to carefully trim the crown from a pre-formed, shaded ceramic block. The milling process takes six to twelve minutes, depending on what restoration is being milled.

CEREC crowns are not the only restorations that the dentist can fabricate. Inlays, onlays, and veneers can also be designed and milled in-office within a single visit. The entire process from start to finish usually takes less than two hours, which is a considerable improvement over traditional crowns.

Recommended Reading: What Are CEREC Crowns? (Advantages & Disadvantages)

CEREC Crown Block | My Dental Advocate

What are CEREC blue-block crowns?

CEREC blue-block crown refers to Ivoclar’s IPS e.max CAD block that is blue before firing. After firing the material in a specialized oven for about 20 minutes, it transitions into a natural tooth color shade. The CEREC blue-block crown is one of many materials available.

CEREC crown materials

Dentsply Sirona and Ivoclar are the two leading manufacturers of CEREC blocks, and each material has advantages and disadvantages. For example, Dentsply Sirona manufactures three types of ceramic, feldspar ceramic, glass-ceramic, and zirconia ceramic. Ivoclar is well-known for the IPS e.max CAD block, constructed from lithium disilicate glass-ceramic (LS2). It’s the “world’s best-selling glass-ceramic” and is known for its high strength and esthetics.

Let’s take a closer look at these different crown materials.

CEREC Crown Ceramic | My Dental Advocate

Feldspar ceramics – With enamel-like properties, feldspar ceramics provide an excellent color integration with adjacent teeth. Feldspar ceramics are indicated for inlays, onlays, and anterior and posterior crowns. Some blocks have three different layers based on varying degrees of color saturation. Feldspar ceramics are high esthetic and can be cemented immediately after milling (they don’t require a “firing phase”). Lastly, studies show they have a 90% survival rate after ten years.

Glass ceramics – Can be processed by milling and polishing followed by cementation in the mouth or milling and firing (in a specialized oven) to increase overall strength. CEREC Tessera high-strength crown is an exceptional option and can be milled in 4 minutes and 30 seconds with CEREC SpeedFire.

Zirconia ceramicsConsidered the strongest all-ceramic dental restoration material on the market. Zirconia crowns are available in 10 different shades and provide the highest strength (+900 MPa). Zirconia ceramics are not as esthetic as glass ceramics or feldspar ceramics but make up for their lack of esthetics with high flexural strength and hardness. Zirconia ceramic crowns require a milling and firing phase before crown cementation. Other blocks such as Celtra Duo (ZLS) crowns are reinforced with zirconia resulting in impressive strength.

Lithium disilicate ceramics – With more than ten years of clinical experience and maximum versatility (used for crowns, veneers, and implant abutments), lithium disilicate glass-ceramic crowns are a quality material of choice. In addition, it has a 97.2% survival rate over ten years. Unlike other materials, it requires an additional firing phase that hardens the ceramic material and allows the color to transition from blue to white. IPS e. max crowns are considered “the world’s best-selling glass-ceramic crown.”

Recommended Reading: How Do CEREC Crowns Stay On? (Top 8 Reasons Crowns Fall Off)

Are CEREC crowns stronger than traditional crowns?

This is a loaded question; it’s debatable. Some dentists believe that CEREC crowns are less likely to chip or break than other porcelain crowns but more likely to chip or break than traditional gold or zirconia crowns.

Glass-ceramic CEREC crowns are the weakest type of crown; however, it’s the most esthetically pleasing. Zirconia ceramic crowns are the strongest CEREC crown, but they are not the most esthetic because of their opacity. Lithium disilicate (e.max/blue-block) provides an outstanding balance between durability and esthetics.

Traditional gold crowns are stronger than CEREC crowns and won’t fracture under heavy loads, including teeth grinding or clenching. Therefore, gold or Zirconia crowns are an excellent choice for these patients.

But, first, let’s compare the CEREC crown with other crown materials.

CEREC vs. PFM Crown Pros/Cons | My Dental Advocate

CEREC crown vs. PFM crown

PFM (porcelain-fused-to-metal) crowns have been around for many years and consist of a metal coping with porcelain fused for esthetics. The significant differences between PFM and CEREC crowns are that PFM crowns require fabrication in the dental laboratory. In addition, it contains metal that can be unsightly and is not biocompatible with oral tissue (unlike CEREC crowns). For example, tissue irritation may occur where the metal portion of a PFM crown interacts with the gums.

Because PFM crowns are sent to the dental lab, they require multiple visits to the dentist and possibly multiple injections (sometimes injections are not needed for the crown delivery appointment). In addition, a gooey impression is required, and a temporary crown is placed for 1 to 3 weeks. On the other hand, CEREC crowns can be completed in a single visit within two hours, and no gooey impression or temporary crown is needed!

The main advantage of a PFM crown is the cost. They are much less expensive than CEREC crowns, but they come with many tradeoffs, as previously mentioned.

CEREC vs. Gold Crown Pros/Cons | My Dental Advocate

CEREC crown vs. Gold crown

Gold crowns have been used for many years and are very strong. They can last 20+ years with proper maintenance and oral hygiene care. The main advantage of gold crowns is that they are highly durable and will not chip or break like other materials. Gold crowns are fabricated with varying amounts of actual gold. The higher the gold content, the softer the crown. Gold crowns are never pure gold and contain other alloys or non-precious metals.

The tradeoff is that they are not as esthetic as CEREC crowns and can discolor the surrounding teeth or irritate the gum tissue. In addition, gold crowns, like PFM crowns, require a gooey impression, a temporary crown, and multiple visits.

CEREC crowns are highly versatile, and the CEREC crown process allows for milling errors or design mistakes. For example, if a CEREC crown is milled and fits poorly, the dentist can mill another crown within six to twelve minutes. If a traditional crown does not work, a new impression is taken, the temporary crown is recemented (for 1 to 3 more weeks), and another visit is needed (another injection is possible as well).

CEREC vs. Zirconia Crown Pros/Cons | My Dental Advocate

CEREC crown vs. Zirconia crown

Zirconia is a newer crown material compared to other traditional crowns. They are extremely strong and recommended for patients that grind or clench their teeth. In addition, zirconia and gold crowns can be fabricated with a minimal thickness (0.5-1 mm) and is an excellent choice for molars (particularly second molars). Second molars receive high bite force and are shorter teeth, so removing less tooth structure for a zirconia crown is superior.

Zirconia tops CEREC with strength and durability; however, CEREC crowns are more esthetic and can be chemically bonded to the tooth. Crowns can either be cemented or bonded, depending on the crown material. Short teeth are better suited for crowns that can be chemically bonded to prevent the crown from falling off.

Are CEREC or porcelain crowns better?

CEREC and porcelain crowns have both advantages and disadvantages. It ultimately depends on the patient’s individual needs and preferences. For example, lab-made porcelain crowns can be custom-shaded and will be more esthetically pleasing than most CEREC crowns.

The esthetic gap is closing as CEREC crown technology is improving. Crown translucency and color shading are two significant improvements in recent years. In addition, some CEREC crown materials, such as lithium disilicate glass-ceramic (e.max CAD), can be custom-shaded with color dyes before firing.

Aside from esthetic differences, a porcelain crown can not match the efficiency of a CEREC crown as the dentist can complete it within two hours without a temporary crown and a gooey impression.

What is the best type of crown?

It depends, so let’s take a closer look at ALL scenarios.

Most esthetic traditional crown – Dental laboratory-designed porcelain crowns with custom shading will provide the most esthetic results and the best opportunity to match adjacent teeth. This is because the dental lab techs are highly trained. In addition, if the dentist provides quality photos, they can apply different shades to some tooth regions, including incisal translucency, gingival shading, or enamel texturing.

Fastest crown w/esthetics – CEREC glass-ceramic crowns, without firing (firing adds 20 minutes but adds strength for the crown), are the fastest esthetic crowns available from start to finish. It’s routine for CEREC-trained dentists to complete a crown from start to finish within 2 hours; some can complete it within 1 hour! Vita Mark II glass-ceramic crowns are the crowns of choice for this category.

Fastest crown w/strength – CEREC lithium disilicate (e.max CAD) crowns are fast, durable, and esthetic. This material is called a “blue-block” crown because of its blue color. After milling, it requires a firing step in a specialized oven to strengthen the crown and change the color from blue to a natural tooth shade. The firing step more than doubles the overall strength of the crown.

Strongest CEREC crown – The CEREC zirconia ceramic crown is reinforced with highly durable zirconia particles. However, zirconia ceramic crowns require a specialized milling unit and firing kiln (different from typical units) and only recently have been able to be fabricated in-office. In addition, Zirconia ceramic crowns lack esthetic qualities, so they are recommended for molar teeth and for patients who grind or clench their teeth.

Strongest traditional crown – Dental lab-created zirconia crowns are the strongest and most durable crowns available. They can even be hammered into a 2X4! Check out the video HERE. Similar to CEREC zirconia ceramic crowns, they do lack esthetic qualities and are thus commonly recommended for molar teeth.

Best longevity – Gold crowns provide the best longevity because of many years of clinical research and durability. It’s not uncommon for patients to have gold crowns for 20+ years that still have a glowing sheen. However, gold crowns can be unsightly, so they are most commonly placed on molar teeth (mandibular molars preferably) to prevent gold from showing when smiling.

Recommended Reading: When Are CEREC Crowns NOT Recommended (Top 6 Reasons)

What type of crown lasts the longest?

This is another loaded question; it depends.

Most dentists will say gold crowns have the best longevity; however, others would disagree. Along with gold crowns, CEREC crowns are another great option because they are chemically bonded to the teeth. Time will tell which crown material is best, but CEREC technology is steadily improving using clinical trials and research.

Final thoughts

Crowns are essential to restoring a tooth to its original function and appearance. When a tooth is damaged or decayed, a crown can be used to cover the damaged portion of the tooth and protect it from further damage. Crowns can also be used for cosmetic purposes to improve the appearance of teeth that are discolored, misshapen, or have gaps between them. CEREC and traditional crowns have pros and cons, so talk to your dentist about what crown material is best for you. If you’re interested in learning more about CEREC crowns, visit the content hub HERE.

The more you know, the more healthy habits you can develop, saving you and your family from avoidable and potentially expensive dental procedures. Talk to your dental professional for more suggestions on improving oral health and check back for more blog posts and relevant information. Please share this site and let us know what else you’d like to know!

Dr Advocate Avatar IconAbout the Author

Dr. Advocate is an actual board-certified dentist with clinical practice experience and a mission to provide accurate dental patient education. He believes everyone should access easy-to-read dental resources presented in layman’s terms with relevant, up-to-date dental research and insight to improve their oral health.