Are Same-day Crowns Worth the "No-Wait"??

Digital Technology Lets Dentists Make a Crown While a Patient Waits...

The Ache: Getting a crown for a weak or damaged tooth can be a big pain - and not just in the tooth. The process typically requires at least two dentist visits and a one-to-three-week wait for the crown to be made.

The Claim: Dentists say, with digital technology, they can make a crown in the office while a patient waits. The process takes only an hour or two.

The Verdict: Dentists claim one-day crown technology is convenient and produces durable ceramic crowns. But there are "aesthetic limitations" to the one-day crown procedure making it a less appealing option for front teeth.

The crown is a cap made to cover a damaged tooth. Preparing for the crown, your dentist drills to remove the decayed portion and shape the tooth for the crown. Depending on the dentist and location, the cost of a traditional crown runs between $800 to $2,000 or more, and may take at least two visits and a wait in between while a lab makes the crown.

The same-day crown systems sold by Sirona Dental Systems Inc. of Long Island City, N.Y., and D4D Technologies LLC of Richardson, Texas, which does business as E4D Technologies are now available in about 30% to 35% of U.S. dentists' offices, the companies say.

The systems cost dentists about $100,000 to $130,000 and include a computer that takes digital images of the damaged tooth, software to design the crown and a milling machine to create the crown.

Dentists say they don't charge more for a one-day crown than a traditional crown partly because the machine saves on lab costs. D4D and Sirona both say their crowns are generally covered by dental insurance that covers traditional crowns.

The process begins with the dentist using a wand with a camera on the end that uses reflected light to create a three-dimensional picture of the tooth and adjacent teeth. The software suggests a design for the crown, which the dentist can tweak if necessary. A click-of-the-mouse sends the design to the milling machine, which sculpts the tooth from a small block of ceramic.

Several studies show restorations made using the computer-assisted systems fit well and have good longevity, but more research is needed, particularly comparing lab-made crowns to those made in dentists' offices, scientists say.

And if cosmetic appearance is paramount—particularly on the front teeth—a patient may prefer going the traditional route as the artistry is just a little better.

Teeth aren't a single color, but yellowish at the gumline with gradually changing color until they become nearly translucent. In the one-day process, dentists can simulate this effect by painting on colors with tiny brushes.

But in the lab, a technician called a ceramist can achieve an even better result by layering different colors of ceramic.

Lab-made crowns may also be better for people who clench their teeth. Clenching puts a patient at higher risk of breakage, so they might prefer a gold crown—the strongest kind—which can't currently be made with the small mills in dentists' office.

If your dental office is interested in a new Sirona Cerec system #weshouldtalk