Crowns, porcelain veneers, or composite veneers?

نشر في: {name} at {date} 25/08/2017

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Crowns and veneers are equally good solutions in dentistry. Both provide the patient with excellent aesthetic results and allow them to eat as they normally would have done before. Deciding which to have done depends on several factors, but first it’s important to know that veneers can come in two types: porcelain or composite.

The difference between veneers and crowns

Porcelain veneers and crowns (which are usually made of porcelain too), are very similar: both are made in a laboratory and the dentist simply fits them into place, cementing them with the appropriate adhesive. Composite veneers, on the other hand, are totally different because they are made directly on the tooth by the dentist themselves.

Let’s take a look at the three options and their advantages and disadvantages:

Crowns

Crowns completely cover the tooth. To fit a crown, the tooth has to be carved and filed to form a stump. The crown is made to measure in a laboratory and is fitted to the tooth stump with cement.

They are usually made from porcelain, and come with or without a metal frame.

The advantages of crowns:

Crowns are a tried and tested solution and have been used for more than a century
Porcelain never changes colour and is very resistant to wear
They can break, but this happens very rarely
The dentist does not need to be a specialist in aesthetics, since the final appearance of the crown depends on the work of the laboratory, and is simply cemented into place

Disadvantages of crowns:

The technique to place crowns is quite aggressive, because it forces the original tooth to be permanently and irreversibly carved, enabling the crown to be fitted
The aesthetic aspect is reliant on the quality of the laboratory’s work. If the crown does not fit, or meet the expectations of the dentist or patient, reworking and revisions are required, which multiplies the number of appointments needed
A porcelain crown cannot be repaired or renovated. With any deterioration or fracture, modification is not possible and the only option is to fit a new replacement crown

Porcelain veneers

Unlike crowns, which are designed to replicate the whole tooth, a veneer covers just the front. It is an aesthetic improvement. Like crowns however, the tooth needs to be prepared (carved and shaped) for the veneers – which are made in a laboratory - to be appled and fixed with cement.

Advantages of porcelain veneers:

The tooth is not worn down so much or altered with veneers as it is with crowns
Porcelain is very resistant to wear, although veneers are more fragile than crowns and fractures are possible
The dentist does not have to be an specialist aesthetic dentist since the result depends on the quality of the veneers from the laboratory. However, the cementing of veneers is a thorough technique that requires a competent dentist

Disadvantages of porcelain veneers:

Fitting veneers is less aggressive than fitting crowns, but carving the tooth is still necessary, and is irreversible
A veneer can peel. A peeling veneer can usually be re-cemented. .
Over time the edges of the veneer can change colour affecting the aesthetic
As the porcelain cannot be repaired or renovated, any repair or modification necessarily involves removing the veneer and ordering another

Composite veneers

Composite veneers are made from powdered porcelain bonded with a synthetic resin. They adhere to the tooth without needing to make any alteration to it. The dentist models and applies the material, which comes in the form of paste, in different layers until the desired shape, colour and form are obtained.

Advantages of composite veneers:

The main advantage of composite veneers is that the tooth doesn’t have to be altered. In most cases, anaesthesia is not required. The veneer is simply adhered to the tooth, which, under the composite, remains as it was before the procedure
Unlike porcelain, composite veneers can be retouched or repaired, directly in the mouth and without having to redo all the work. Any deterioration, defect or modification can be solved, usually, in a short time, and in a simple way
With proper maintenance and occasional retouching, composite restorations can last in good condition indefinitely – generally it has been seen that composite veneers last over 30 years.

Disadvantages of composite veneers:

The colour stability of the composites is less than that of porcelain and, over the years, they may darken
Like porcelain veneers, they can suffer a fracture or cracking, but this can be solved without having to completely redo the restoration
As the veneers are not made by a laboratory, the dentist must have solid dental aesthetic training and artistry, as the result depends entirely on their skills

When to choose crowns, porcelain veneers, or composite veneers:

Crowns: Because of their resilience, crowns are advised for people with aggressive oral habits: sportspeople, people who grind their teeth, people who chew pens, etc. They are also the best option when teeth have been destroyed or severely broken.

Porcelain veneers: These are a good solution for those who want a low maintenance restoration option. The average duration of porcelain veneers is ten to fifteen years. After that time, margin degradation, possible fractures, changes in gum position and other factors often make it necessary for them to be replaced.

Composite veneers: Composite veneers are the best solution for those

who want to improve their smile without having to have their teeth altered
for patients who are undecided about modification
for young patients who are still growing and need a semi-permanent solution
For those who prefer a reversible treatment, that allows a change of mind in the future

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