Crowns, porcelain veneers or composite veneers

Both solutions are equally good. Both give excellent esthetic results and can be used to eat snacks and bite apples without risk of mishap.

The choice of one solution or the other will depend on several factors that we will try to analyze here, but first of all it must be said that veneers can be of two types: porcelain or composite.

Porcelain veneers and crowns, which are usually also made of porcelain, are very similar: both are made in a laboratory and the dentist simply places them in place, cementing them with the appropriate adhesive. Composite veneers, on the other hand, are something completely different, because they are made directly on the tooth by the dentist himself, without the laboratory intervening at all in the process.

Let’s take a look at each of these three solutions, with their advantages and disadvantages:

CROWNS (OR CAPS)

These are restorations that completely cover the tooth. In order to place them, the tooth has to be ground and worn down to give it the shape of a die.

The laboratory is in charge of manufacturing the crown to the size of the die and, when it is ready, it is cemented over it. They are usually made of porcelain, with or without metal framework.

Advantages:

– They are very experienced restorations since, although they have been evolving, they have been in use for more than a century.

– Porcelain never changes color and is very resistant to wear.

– It can break, but it is not very frequent.

– The dentist does not need to be a great specialist in esthetics, since the final appearance of the crown depends on the laboratory work, and the clinician is limited to cementing it in place. If the lab is good, the crown will be good.

Disadvantages:

– It is a very aggressive technique, as it obliges severe grinding of the tooth, which, as it is not capable of regenerating the lost portions, remains ground for life.

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– The esthetic aspect is entirely in the hands of the laboratory. If, once received, it does not meet the patient’s expectations, it has to be returned for a repeat treatment, which multiplies the number of sessions required.

– Porcelain cannot be repaired or retouched. Any deterioration or fracture, or modification that, for whatever reason, is desired, necessarily involves removing the crown and ordering a new one.

PORCELAIN VENEERS

A veneer is like a half crown, since it does not completely surround the tooth, but only covers the front side, that is to say, the visible side. As in the case of crowns, the tooth must be milled, then the veneer is fabricated by the laboratory and cemented in place by the dentist.

Advantages:

– It is necessary to grind the tooth less than to place a crown, being, therefore, a less mutilating technique.

– Porcelain does not change color and is very resistant to wear, although veneers are more fragile than crowns and fractures are possible.

– The dentist also does not require a great deal of preparation in esthetics, since the result depends mainly on the laboratory. However, the cementing of veneers is a meticulous technique that cannot be left in the hands of just anyone.

Disadvantages:

– It is a less aggressive technique than crowns, but grinding is still necessary, and it is irreversible. Even the “no-milling veneers” that have been proposed lately require more or less wear on the tooth.

– A veneer can either peel off or break. In the first case, it can usually be re-cemented. In the second case, it will have to be removed and a new one made.

– Although porcelain does not change color, the margins tend to stain over the years, affecting esthetics.

– Since porcelain cannot be repaired or retouched, any repair or modification necessarily involves removing the veneer and ordering another one.

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COMPOSITE VENEERS

Composites for dental use are materials made of pulverized porcelain bonded with a synthetic resin, which allows them to be set directly in the mouth with the help of a special light. They adhere to the tooth without the need for grinding, and the dentist applies and models the material, which comes in paste form, in different layers until the desired shape, color and naturalness are obtained.

Advantages:

– The main advantage of this technique is its innocuousness. The tooth does not suffer any damage and does not have to experience a permanent loss of its integrity. In fact, in most cases anesthesia is not even required. The restoration is simply bonded onto the tooth, which, under the composite, remains as it was before it was started.

– Unlike porcelains, composites can be touched up or repaired directly in the mouth without the need to redo the whole job. Any deterioration, or damage or any modification can be solved, normally, in a short time and in a simple way.

– With proper maintenance and occasional touch-up, composite restorations can last in good condition for an indefinite period of time. In our experience, older restorations have long since exceeded thirty years of permanence in the mouth.

Disadvantages:

– The color stability of composites is less than that of porcelains and, over the years, they may tend to darken.

– Also, like porcelain veneers, they can suffer some fracture. Of course, this can easily be solved without the need to completely change the restoration.

– Since the veneers are not made by the laboratory, but by the dentist, the dentist must have a solid background in dental esthetics and a minimum of artistic skills, since everything depends on him.

WHAT WOULD BE BEST FOR ME?

Crowns: Due to their resistance, crowns are indicated for people with aggressive oral habits: bruxers, clenchers, pen biters, sportsmen… And they will also be a valid option for teeth that have already been ground for crowns, or for teeth that have been badly destroyed or restored, in which the grinding will not aggravate the situation.

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Porcelain veneers: These are a good solution for those who want restorations that they can forget about until they need to be changed, since they do not need maintenance, or rather, they do not require it. Their average duration is ten to fifteen years; after that time, the degradation of the margins, possible fractures, changes in the position of the gum and other factors usually make it convenient to replace them.

Composite veneers: Composite veneers are the best solution for those who wish to improve their smile without seeing their teeth ground down, for undecided patients who may want modifications or touch-ups a posteriori, for young patients whose growth makes it necessary to keep adapting the restorations instead of changing them completely several times until development is complete, for those who prefer to receive a reversible treatment, which allows them to return to the previous situation if one fine day they decide to have something else done….

CONCLUSION:

All solutions are therefore equally valid. The choice of one or the other will depend on the patient’s priorities and preferences and, naturally, on his or her dentist, who will prefer to use the technique that he or she masters best and that, in his or her hands, can offer the best results. Of course, it is advisable to put yourself in the hands of someone whose training is known to you, and to be wary of the balance. Clumsy or rushed work, no matter how cheap, always costs more than it is worth.