All about dental crowns – treatment procedure, variants, costs

What are dental crowns?

A dental crown refers to a crowning of the natural tooth crown. The natural tooth crown is the upper, visible part of the tooth. The aim of an artificial dental crown is to preserve the natural tooth. An artificial dental crown is often used when the root of a tooth is still intact, or alternatively as an attachment for an implant.

Dental crown is a fixed tooth replacement and is considered one of the most commonly performed dental treatments.

When is a dental crown necessary?

Artificial dental crowns are often used to replace an injured or missing tooth for functional and aesthetic reasons, this may be necessary in different situations:

• If the natural crown of the tooth has been destroyed by caries or accident to such an extent that it can no longer be restored by a simple filling or inlay
• When teeth are discolored or loose
• When an implant has been anchored in the jaw after the complete loss of a tooth, on which a crown is anchored
• As anchorage for (removable) dentures

The most important condition for a dental crown is that there is a tooth root from the original tooth or an implant as a base for the crown.

What are the differences in dental crowns?

Basically, several types of dental crowns can be distinguished:

Function:

• Replacement crown: Replacement crowns, as the name suggests, replace the natural tooth crown. This may be necessary, for example, in case of major damage to the natural teeth
• Protective crown: The protective crown is used when the hard and solid enamel of the tooth has been lost in order to protect the soft dentin.
• Anchoring crown: An anchoring crown is primarily used to anchor a dental prosthesis (e.g. for the removable part of a combined denture).

Size and extension:

• Partial crown: A partial crown covers only a part of the damaged natural crown, i.e. when there is still enough healthy tooth structure left
• Full crown: A full crown covers the entire tooth crown and mimics the natural tooth as closely as possible

Material used:

When it comes to the material used, both the durability of the material and the desired aesthetics should play a role, as well as possible allergic reactions. Various materials are available here:

• Veneered crown: A veneered crown is made of metal, but the visible part is partially or completely covered with a tooth-colored material, e.g. ceramic or plastic. Veneered crowns are often used in the visible area of the dentition (e.g. on the incisor)
• Metal and full-cast crown: Metal or full-cast crowns are made of metal or a gold alloy and are particularly durable and fracture-resistant. They are mostly used in the non-visible area of the dentition (e.g. for a molar tooth)
• Mantle and all-ceramic crowns: A mantle crown or all-ceramic crown encloses the tooth in the shape of a mantle, is made exclusively of ceramic and can hardly be distinguished from the natural tooth. The disadvantage is that these crowns are not as fracture resistant, therefore more material must be used and possibly more of the still healthy part of the tooth must be ground off.
• All-resin crown: These serve as a longer-term temporary crown rather than a permanent tooth replacement. Prefabricated blanks can often be used here or a dental laboratory mills a custom crown

Anchorage to the tooth:

• Cemented or bonded crowns: Here, an abutment is screwed onto the implant, to which the crown is then attached with a medical cement.
• Pin tooth (pin crown): If the tooth is severely damaged, a post may need to be implanted in the tooth stump in order to place a dental crown on it.

What is the course of treatment?

Step 1: Preparation and impression taking

Before a crown can be placed, the dentist must remove any decay or damage to ensure that the crown fits properly.

Then the dentist takes impressions of the tooth and neighboring teeth, which are used to make a custom artificial crown in the dental laboratory.

In addition, the dentist inserts a temporary dental crown.

Step 2: Fabrication, Insertion and gluing

The fabrication of a dental crown varies depending on the material. The fabrication of a crown can take up to two weeks. A ceramic crown usually takes 5-7 business days to fabricate, but in some practices a CEREC (CEramic REConstruction) device can be used to complete a dental crown in as little as a single visit and place it directly.

Once the crown is fabricated, it is placed in the patient’s mouth in another session. During this procedure, the dentist checks the fit and appearance of the artificial crown and makes adjustments, if necessary, to ensure that the crown fits properly and matches the surrounding teeth. Several adjustment appointments may be necessary.

After the crown is placed and adjusted on the prepared tooth stump, the dentist permanently attaches it to the prepared tooth with dental cement (a special cement).

Step 3: Oral hygiene and follow-up visits

The patient must practice good oral hygiene to keep the crowned tooth healthy and usually must return regularly for follow-up visits to ensure that the crown is in good condition.

What are advantages of artificial crowns?

Saving teeth: Often, even severely damaged teeth can still be preserved by crowns.

Protection of teeth: In addition, artificial crowns can protect teeth from new caries formation.

Durability depends on material and care: The durability of an artificial crown is strongly dependent on the material used and the individual dental care.

Ceramic crowns, for example, can last 10 to 15 years, and a full metal dental crown can even last up to 25 years if the patient takes good care of it. Crowns made of metal and veneered with plastic may no longer look beautiful after only 5-7 years.

What are disadvantages of artificial crowns?

Grinding down part of the natural tooth substance: In the case of crowns, the natural tooth substance must be ground down, this can rarely lead to damage to the tooth nerve.

Risks associated with poor fit: If the fit is poor, crowns can contribute to the reformation of caries or inflammation of the gums or tooth nerve after a long period of wear.

What costs should I expect?

In Switzerland

The cost of a finished crown is highly dependent on the material.In Switzerland, the following costs can be expected:

• Veneer crown: Veneer crowns made of metal and ceramic cost approx. CHF 300 in Switzerland; for a crown with gold, the current gold price must be addedx
• Shell and all-ceramic crown: approx. CHF 1,200 to CHF 2,500 per tooth depending on the stress, localization and necessity of a post build-up. The cost of a CEREC ceramic crown ranges from approx. CHF 1,000 to CHF 1,600.
• All-resin crown: Temporary all-resin crowns are relatively inexpensive and range from CHF 40 to CHF 90

In European foreign countries

Generally, as with most medical treatments, Switzerland is among the European countries with the highest costs for dental crowns, but Germany and Austria also have relatively high costs for ceramic crowns, with typical cost levels of EUR 700 to EUR 1,000 for mantle and all-ceramic crowns and EUR 500-2,000 for zirconia crowns.

For crowns, patients can save significant money by traveling to Southern or Eastern Europe, for example, the cost of shell and all-ceramic crowns in Hungary, the Czech Republic and Greece are each between EUR 300 and EUR 500, both for shell and all-ceramic crowns, and for zirconia all-ceramic crowns.

The following table provides an overview of the typical price levels for ceramic dental crowns in the countries mentioned:

Country	Cost of shell and all-ceramic crowns	Costs for zircon crowns
Switzerland	CHF 1’200 – 2’500	CHF 1’100 – 2’500
Germany	EUR 700 – 1’000	EUR 500 – 2’000
Austria	EUR 700 – 1’000	EUR 500 – 2’000
Greece	EUR 300 – 500	EUR 300 – 500
Hungary	EUR 300 – 400	EUR 300 – 400
Czech Republic	EUR 300 – 500	EUR 300 – 500

Source: Various dental practices

Who covers the cost of dental crowns?

In Switzerland, the basic insurance usually does not cover dental treatment costs, normally 100% of dental costs have to be paid by the patient. An exception exists if certain serious diseases of the masticatory system are present or if the consequences of serious diseases make dental treatment necessary.

Private supplementary dental insurance in Switzerland usually covers the costs when damaged teeth are fitted with artificial dental crowns. Most insurance companies offer different rates with reimbursements between 50% and 80%, but often there is a maximum reimbursement in one year.

After clarification, the accident insurance covers the treatment costs for artificial crowns if destroyed teeth are the consequences of an accident.

Last update: December 12, 2022