What is the best process and material for a crown for a bruxer? Gold, zirconium, ceramic, a combination, etc?

Tooth is a bottom right molar and has a root canal, defective crown, & multiple cavities under crown. Cannot afford to lose this tooth because it's on the main side of the mouth I chew on. I am a bruxer and seriously grind teeth at night (the crown on the root canal tooth has the enamel worn down, it's just metal). I am about to treat severe osteoporosis with bisphosphonates & need something with very tight margins on the gum line, extremely durable, will last & not get worn down or break, etc.

Doctor Answers 4

What is the best process and material for a crown for a bruxer? Gold, zirconium, ceramic, a combination, etc?

I would recommend either zirconia or full gold. However, more important is that the material of the new crown matches the material of the teeth that it opposes (bruxes against). If you are a severe bruxer, and you used zirconia on your new crown, and had natural tooth or a gold crown opposing it, the zirconia would wear down the opposing tooth. Your dentist should be able to make the best recommendations for what material he will use that best serves you.

However, very important, is that if you are a bruxer, you should wear a night guard dental appliance to protect against the harmful habit of bruxing.

Laguna Niguel Dentist

Best crown for a bruxer

The best crown that a bruxer can have are PFM (porcelain fused to metal) or Zirconia Crowns.

The difference between them , PFM is opaque have a metalic core , zirconia doesnt have a metal core so its traslucent, and its suppose that haves the same strenght that the metal ones but are susceptible to break in some situations, it depends on the dept of prepparation, if you have enought remaining tissue to have the crown, etc.

If your molar have cavities, maybe you wont have enought remaining tooth when the cavities get removed, so you will need a custom post core inside the root canal and a crown over it, in that situation your only solution its having the PFM one.

Also i recommend a muscle relaxing mouthguard (miorelax mouth guard) to avoid more damage to your teeth, this device works giving you a position on your mouth that your mastication muscles, will be relaxed and wont transmit the forces to the bruxism habit while you are sleeping.

Jose Alonso, MD, DDS
Dominican Republic Dentist
4.8 out of 5 stars 35 reviews

Crown for Severe Bruxer

I would suggest an all zirconium crown if you have the severe wear and load factors on the tooth you describe.

Donald L. Wilcox, DDS
Glendale Dentist
5.0 out of 5 stars 6 reviews

The gold standard

I usually give long-winded answers but this is simple: GOLD

Gold is literally the gold standard in dentistry, but almost no one wants a gold crown anymore. This is obviously due to aesthetics, and the recent advancements in porcelain/zirconia crowns (not to mention the rise of gold prices over the last 20 years and what that did to the price of gold crowns). That being said, if you don't care what the crown looks like (blasphemy coming from an aesthetic dentist) then gold is the way to go.

Your second option is to get what's called a BruxZir crown. This is an all white crown made from Zirconia. It isn't the most aesthetic white crown out there (definitely more aesthetic than gold), but it's the next best choice.

Victor Khatchaturian, DDS
West Hollywood Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.