Dental Crowns or Veneers for Two Front Teeth?

Question

I have two veneers on my two front teeth. I need the veneers replaced. My dentist wants to crown one of my teeth as I had a root canal a few years back. The other tooth is perfectly healthy but needs a new veneer. My dentist also wants to do a crown on this tooth as he says it will be easier for the dental lab to match two crowns than match a crown and a veneer. These are my two very front top teeth. Does this sound right?

Scott Young, DDS · Answer

This is difficult to say for sure without pictures, but typically we could do a crown and veneer and make them match perfectly. We always want to be as conservative as possible without sacrificing aesthetics. Hope this helps.

James Asaf, DDS · Answer

To fully and appropriately assess your best option, I would have to make a full exam of your particular circumstance. Your dentist has very likely made the appropriate suggestion, but a porcelain veneer can definitely be matched with an adjacent crown (depending on the skill and experience of you cosmetic specialist).It can't hurt to get a second opinion.Best of luck. James Asaf, DDS

Amanda Canto, DDS · Answer

So the question is do I do dental
veneers or crowns on my two front teeth to repair them. That certainly depends on the severity of any
fractures or if the tooth has had a root canal.If the toot has had a root canal the more indicated treatment would be a
full porcelain crown. That just goes all
the way around…the material is the same and will look just as lifelike and just
as beautiful as these days we don’t have to do those crowns with metals or any
of the darkness therefore it depends on what it is that is needed by the tooth
and that needs to be evaluated by your dentist.

Norman Huefner, DDS · Answer

I don't think I can give an accurate answer without knowing more, seeing a photo of the tooth in question and the radiograph (x-ray).  However, there is a changing consensus in dentistry on whether or not to place a veneer or crown on a root canal tooth.  The old thinking was to always place a crown on a root canal tooth.  The newer thinking is to preserve as much of the tooth as possible, meaning place a veneer rather than a full crown restoration.  One thing happens when the dentist prepares a tooth for a full crown, he removes the bump on the backside (tongue side) of the tooth, called a cingulum.  Some studies have show that when this is drilled away for full crown preparation that the tooth becomes 50% weaker compared to a tooth that had a porcelain veneer and did not have the cingulum drilled off.

	I have done many cases where one of the front tooth is a porcelain veneer and the other is a porcelain crown.  However, you get the best match in color, shape and contour when both front teeth are prepared the same way (i.e. either for full crown or porcelain veneers).

	So, saying all of this, but not having the opportunity to actually evaluate your teeth, all I can say is that if you consulted ten cosmetic dentists my bet is that you would get three different answers.  Several would agree with your dentist and do one crown and one veneer.  Several would want to do full crowns on both teeth.  And the remaining, like me, would prefer, if possible, to do two porcelain veneers.

	One last thought.  Your dentist might recommend placing a post in the top 2/3 of the root canal tooth.  This is a good idea, as it will strengthen the root canal tooth considerably.  However, make sure he uses a bonded fiber post (it's like kevlar fiber, strong as metal, often used in bullet proof vests), and does not use a metal post.  A metal post can't effectively be bonded into the root canal space and also may case a dark shadow that will make that tooth, and veneer or crown, look darker than the non-root canal tooth.

Sylvan Fain, DDS · Answer

The dentist is correct that it will be easier to match the two teeth if they are both crowns. This comes at the expense of removing healthy tooth structure. 

	I would base my decision on the darkness of the teeth. If the tooth with the root canal is very dark then I would recommend a crown to block out the discoloration. If the tooth is not discolored then you might be able to get away with another veneer. What you do with the other tooth depends on the skill of the dental technician. Some labs are very good at getting a veneer to match a crown, some not so much.

Steve Alper, DMD · Answer

This is a very good question.  Unfortunately it simply cant be answered definitively without an exam.

	 

	Although some of the other doctors have given you definitive answers, there are just too many variables.  Indeed it is quite possible that you would have a superior esthetic result if you chose 2 crowns of the exact same material. 

	 

	If you are interested in two veneers rather than two crowns, I would recommend a in person consult with an experienced cosmetic dentist.

Abraham Hoellrich, DDS · Answer

With the newer materials we have today there should not be a problem matching crowns and veneers on front teeth since they can be made with the same materials without metal underneath the porcelain. Whether or not a root-canaled front tooth needs a crown depends on how much strong tooth structure is remaining. I prefer to preserve as much tooth structure as I can, so I lean toward a veneer if possible.

Joseph W. Worthington, DDS · Answer

In dental school, dentists were taught to automatically crown a root canal tooth. With advances in adhesive esthetic dentistry we no longer have to follow that rule with anterior teeth.
The root canal tooth should be fit with a fiber post to give it added strength without compromising esthetics and both teeth prepared for porcelain veneers. The veneers should be designed in such a way so they look much like 3/4 porcelain crowns for added strength and longevity. 
I have done this many times over the years with great success.

Robert Fields, DDS · Answer

I would do a crowm on the tooth that had the root canal. The tooth that had the veneer would receive a new veneer. I would use an Empress Crown and it would be easy to match the porcelain crown to the procelain veneer.

Susan Goode Estep, DMD · Answer

If you were my patient, I would do the crown and the veneer almost without fail.  Recent improvements in materials give us to the ability to do this procedure:
1.  Without a need for metal substructure, and;
2.  And very closely match a ceramic/porcelain crown with a porcelain veneer.

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