Re: resin or porcelain crowns?

JimSocal wrote:

I'm getting my 4 lower front teeth fixed (23 through 26) because my
teeth there had big fillings which weakened the teeth and caused them
to chip, so they're all chipped and ugly.

Anyway, so I was asked if I wanted porcelain crowns or resin. (I hope
I am getting this right, I didn't write it down, but I hope you can
understand what I'm asking.) The dentist explained that if I get
porcelain, it might screw up my upper teeth because when I bite down
my upper teeth naturally slide down over (in front of) my lower teeth.
He said that the uppers and lowers slide so close together when I bite
down that the porcelain might cause my upper healthy teeth to
deteriorate due to the porcelain rubbing against them.

Therefore he suggests I get resin instead of porcelain, which as I
understand it is less aesthetically pleasing but will work better due
to the above scenario.

My question is, do you agree with this (I realize you cannot make an
accurate judgement without seeing the teeth; but I am asking, really,
if what he says makes sense as described) and how bad (or good) will
resin look as opposed to porcelain.

Of course, anything will look better than the chipped teeth I have
now, and the lowers are not seen that much behind my lips, and upper
teeth, anyway. But if I had my choice I'd go with the porcelain
because it would look better. The question I do not know is "How MUCH
better?" He indicated that they could do a good job with the resin and
it would look okay. I asked for some photos of the difference between
the porcelain and resin and he said he'd try to provide some for me to
see the difference. Can anyone refer me to any on the web? (I'll do a
search myself...)

So please give me any info on this issue that might help me decide
whether to go with porcelain or resin to fix my front 4 lower teeth.

Oh, also, the dentist seems to think I am grinding my teeth at night.
I'm not sure if I do or not, but this might be a factor in the
above... I'm starting another thread on grinding teeth...


I have more frequently seen damage to the lower front teeth from porcelain crowns on the upper incisors, but no reason to assume you couldn't have a problem with abrasion.
Personally I think you have to deal with the parafunction (grinding and clenching), or you may break your restorations. I can hear the others readying to recommend an NTI appliance, and this might be a good idea. Personally, I'd go with porcelain over resin. Resin crowns are softer and kinder to the opposing teeth. Another way of looking at this is that resin crowns are softer than the opposing teeth, and if you indeed grind you may be looking at replacements for these crowns periodically, which is a nice annuity for the dentist, but maybe not so nice for you. Of course the dentist will say "which would you rather wear, the crowns or your own natural teeth"? And he'd be right. But controlling parafunction should minimize wear. Furthermore, there are newer low-index porcelains that are less likely to wear the teeth.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

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