Dental Crowns in San Mateo: Zirconia, Lithium Disilicate or 3D-Printed?

For a permanent crown, milled zirconia and milled lithium disilicate are still the materials with a long track record in published research, and they show comparable survival over the first several years in published reviews. 3D-printed resin crowns are an active area of research. Early results look acceptable in the short term, but the long-term data isn't there yet, so printed crowns are best suited to temporary or low-stress situations. Same-day crowns are most often milled from a ceramic block in the office; some practices also use printed permanent-grade resins, which have less long-term data.

What are the main crown materials, and how are they made?

Most crowns today are designed on a computer from a digital scan of the prepared tooth. After that, the path splits depending on the material.

• Zirconia: a very strong ceramic, milled from a block and then fired in a special oven (sintered) to reach full strength. It's a common choice for back teeth and for people who clench or grind.
• Lithium disilicate: a glass-ceramic that is also milled and is often crystallized in an oven after milling, depending on the block. It is popular because it combines good strength with a natural, light-handling appearance.
• 3D-printed resin: a resin loaded with ceramic particles, built up layer by layer in a printer and then cured. It is a newer approach, and it is not the same thing as milling.

This distinction matters for same-day dentistry. When a dentist makes a crown in a single visit, the crown is almost always milled from a ceramic block in the office. The printer plays a different role, typically for models, surgical guides and temporary crowns.

How do zirconia and lithium disilicate compare?

Reviews of clinical studies have found that both materials hold up well on natural teeth, with comparable survival and similar kinds of complications. The most common problems are a fracture, a chip in a porcelain layer, or a crown coming loose, and these have become less common with modern one-material (monolithic) designs than with older layered crowns.

The studies that have been pooled so far followed crowns for a few years on average, so we know less about performance past a decade. Dentists usually decide between the two based on the individual tooth:

• Zirconia is often favored when strength matters most, such as a molar with limited remaining structure or a patient who grinds their teeth.
• Lithium disilicate is often favored when appearance matters most, such as a visible premolar or a tooth that needs to blend with its neighbors.

What do the newest 3D-printed crown studies show?

Researchers are now testing printed permanent-grade resins in real patients. Here is what the early picture looks like, and what it does not tell us.

Short-term results look acceptable in adults

Small, short-term studies in adults have reported that printed ceramic-filled resin restorations, such as overlays and one-piece endodontic crowns on premolars and molars, performed acceptably overall, though edge discoloration tended to increase over time. That is encouraging, but these studies involved small groups and short follow-up periods.

Wear and staining were a concern in a children's study

In a short-term split-mouth study in children, a printed resin crown on one baby molar was compared with a prefabricated zirconia crown on the matching tooth on the other side. The printed resin wore down more and discolored progressively, while the zirconia stayed stable. This was on baby teeth, so it can't be applied directly to adult crowns. It does show how printed resin can behave under chewing forces.

Head-to-head trials are still under way

Randomized trials comparing printed resin with milled zirconia, including on dental implants, are under way, with follow-up planned over a couple of years. Until results like these come in and are repeated, the current evidence suggests that printed definitive crowns are promising but unproven for the long haul.

Where do printed crowns make sense today?

Printed resin works well for temporary crowns worn while a permanent one is being made. A dentist may also consider it in lower-load situations when the plan is to monitor the crown or replace it later. For a long-term restoration on a molar, dentists generally still recommend milled zirconia or lithium disilicate because their track record is far longer.

Crown questions come up often from San Mateo families, whether they live in Hillsdale, Baywood or San Mateo Park. Some of them ask whether a newer, printed option is worth trying. A reasonable answer is that newer is not automatically better for a restoration you expect to keep for many years. If you're comparing options, a good starting point is to read about how to find the best dentist in San Mateo, CA and ask any practice how it decides on materials.

What should you ask before getting a crown?

• Is the crown milled or printed, and is it intended as temporary or permanent?
• Why is this material right for this tooth, given my bite and any grinding habit?
• How much tooth structure will need to be removed?
• What is the plan if the crown chips, loosens or needs replacement?
• What is the written estimate, and what does my insurance cover?

Investment varies with the material, the tooth and whether other treatment, such as a root canal or build-up, is needed. We provide a written estimate after your consultation. We accept most PPO plans (check with our office to confirm your specific plan), offer in-house membership plans starting at $30 per month, and offer 0% APR financing through CareCredit and Proceed Finance, subject to credit approval and promotional terms.

This article is general education, not a substitute for an exam and individualized advice from a dentist. The choice of crown material should be made with a dentist after an exam.

Common questions about dental crowns

Q: Is a 3D-printed crown as strong as zirconia?

Not enough evidence exists to say so. Early studies show acceptable short-term performance in some adult cases, but a children's study found more wear and staining with printed resin than with zirconia, and long-term adult data is still limited.

Q: Are same-day crowns 3D-printed?

Usually not. Same-day crowns are typically milled from a ceramic block in the office, though some practices now use printed permanent-grade resins, which have less long-term data. Printing is more often used for temporaries, models and guides.

Q: Which lasts longer, zirconia or lithium disilicate?

Published reviews show comparable survival for the two. The better choice depends on the tooth's location, how much force it takes, and how important appearance is.

Q: How far is Belmont from San Mateo?

It is roughly a 12 to 20 minute drive south, using El Camino Real or 101 and Ralston Avenue, depending on traffic.

Talk through your options

If you have a cracked, worn or heavily filled tooth, a consultation can help you compare materials for your situation. We're at 2100 Carlmont Drive, Suite 8 in Belmont, serving patients in San Mateo and nearby cities. Call (650) 591-1984 or visit carlmontdentalcare.com to schedule.