CEREC crown fell off Archives

I had a same day crown done. There was no temporary crown, which was very convenient. I don’t know exactly what the material that was used for the crown. But it can’t be good, because it has come off three times already. This has all taken place in less than a year. Well, when it came off again, I finally wised up and went to a new dentist. The new dentist said that the setting wasn’t done properly. He used zirconcia porcelain for the new crown. Well, all of this sounded good to me. But, it has already fallen off twice in only a month. Now, he is saying I need a full porcelain crown with a new setting because the bonding isn’t happening on my tooth. I’m so sick of this. Any advice?

– Beth in Flordia

Beth,

The original crown you had placed is called a CEREC crown, which is prepped, fitted, and placed all in the same day. When this type of dental crown (well any type of crown) is placed properly, it should stay on permanently. It doesn’t matter whether it’s porcelain, CEREC, gold, or zicronia. If it is done correctly, it should stay in place.

Therefore, it sounds like there is an issue with the dental bonding and the shape of the tooth when it was prepared. This must be the “setting” that your second dentist is referencing. The tooth should have a slight taper when it is initially prepared so that the cement will properly adhere to the tooth. If it was not prepared properly, it doesn’t matter how strong the cement is. It will continue to fail.

Although, the strength of the cement can be a factor, the bond needs to be sufficient. It is difficult to provide more specific recommendations without having seen your case. The best conclusion is that the tooth was not prepared properly. So, now what?

You need to find an experience dentist, likely a cosmetic dentist that truly understand the bonding techniques and materials required to successfully place a crown. It is not normal for a crown to fall off multiple times. Many dentists go the length of their entire career without this happening. It’s time to have a consultation with a dentist that better understands cosmetic dentistry. Best of luck. Sorry that you are dealing with this situation.

Bottom line is that it’s not the CEREC same-day crown or material used that is causing your crown to fall off.

I am starting to doubt my dentist that placed a CEREC crown on my front tooth. I was sold when I heard that by choosing CEREC, I wouldn’t have to deal with the inconvenience of a temporary crown. Having the crown done in only one office visit was very appealing. Well, I left town the day after I had the crown placed. I was shocked when the crown came off the next day. I was freaking out and so my friend referred me to her personal dentist. Her dentist seemed comfortable with CEREC and reattached the crown for me. I don’t love the look of the new crown. The color doesn’t look quite right and I think it appears a little longer than the neighboring tooth. The following week when I returned home, I called my dentist to explain what had happened. My dentist offered to have the crown redone. But now I’m starting to wonder if CEREC was a bad choice to replace a broken front tooth? Maybe I should move forward with the traditional crown placement method and go through with the temporary and permanent crown. And I’m even beginning to doubt that having my dentist redo it is the right call either. I’m feeling overwhelmed and don’t know what to do. Can you give me some advice?

-Jen in New York

It is always difficult to provide specific recommendations without having seen your case in person. That said, I’m sorry that you are having to go through this. The bottom line is that a front tooth, single crown is very difficult to get right. Not just any dentist can pull this off. Cosmetic dentistry is an art. Most dentists come from a functional mindset of fixing a problem. Very few (less than two percent) actually have the artistic beauty to deliver beautiful, natural-looking results, especially on a front tooth.

The color may not be right because of the milling machine that was used to fabricate the CEREC crown. Typically, there is a lot of communicator and collaboration on the color of a crown between the cosmetic dentist and the ceramist. But the machine short cuts that process and the CEREC machine will result in a factory color for the crown. A CEREC crown is milled form a single ceramic block, which is provided from the factory. Often times, dentists like using CEREC technology, but agree that they may not be the best fit for a front tooth crown. But there are some highly skilled cosmetic dentists that may be able to deliver a beautiful front tooth CEREC crown. Most excellent cosmetic dentists would choose a traditional porcelain crown so they could perfectly match the surrounding translucency, color and exact shape.

Another cautionary sign is that the crown should not have come off in the first place. So, it is quite possible that the dental bonding wasn’t done properly to begin with. Therefore, you may be correct in questioning your dentist’s ability with cosmetic dentistry. It is nice that he is offering to redo the crown, but you have to wonder if he will successful bond it in place this time around. This may be beyond his personal skill set.

All this to be said, it may be time to seek a second opinion from an expert cosmetic dentist before moving forward with the crown replacement. Meet with another dentist, one that has experience and training in cosmetic dentistry. Specifically ask if they have done front tooth crowns and ask to see examples of the work. Then, you can better assess what may be the best way to go.

Again, it is hard to tell you exactly what to do without having seen your case. Hopefully this gives you some things to consider before moving forward in getting the porcelain crown replaced.

My crown keeps falling off!

Was CEREC the wrong choice for a front tooth?