Zirconium crowns

Zirconium and zirconia mean the same thing in a dental context: zirconium is the metal the ceramic is made from, and zirconia, or zirconium dioxide, is the ceramic itself. Dentists and lab technicians tend to say zirconia; patients and clinics abroad tend to say zirconium. This page uses both.

Below you will find what the material is and the types it comes in, how it compares with porcelain, E-max and metal-fused crowns, how long crowns last, the problems worth knowing about, what drives the price in the UK and abroad, and how a treatment trip actually runs. Use it alongside the clinic list above, where you can compare clinics and get matched to one that fits your case.

The short answer: zirconia is the strongest, E-max is the most lifelike for single front teeth, and porcelain fused to metal is the older compromise that is being replaced by both. Which one suits you depends on where the tooth is in your mouth and how hard you bite.

• Zirconia. The strongest of the three and the safest choice for molars, long bridges and people who grind. Modern multilayer grades look good enough for front teeth too, which is why it now dominates.
• E-max (lithium disilicate). The most translucent of the three, and usually the closest match for a single front tooth beside natural teeth. It is weaker than zirconia, so it is not the first choice for back teeth or long bridges.
• Porcelain fused to metal. A metal shell with porcelain baked over it. Strong and long proven, but the metal blocks light and a grey line can show at the gum as it recedes.
• All-porcelain and older all-ceramic. Good aesthetics, less strength, and rarely chosen now for anything but low-force front teeth.

In practice many clinics use both: zirconia at the back, E-max or high-translucency zirconia at the front. Ask which material your dentist proposes for each tooth and why, because a single material for the whole mouth is usually a laboratory decision rather than a clinical one.

There is no single price for a zirconium crown. What you pay per crown depends on the country, the grade of zirconia, whether the clinic has its own laboratory, and what else the tooth needs first. UK and US private prices sit at the top; Turkey is usually the lowest of the main destinations and has the most competition; Mexico suits North American patients on a short flight; Thailand sits in between with long-established international clinics. Current package prices and a personalised quote are in the clinic list above, and our guide to zirconium crowns in Turkey covers that destination in detail.

• How many crowns you need. Clinics quote per crown, and the per-crown price usually falls on a full set, so a single crown and a full arch are very different comparisons.
• The grade of zirconia. Monolithic zirconia for a molar costs less than a multilayer translucent block or a layered crown for a front tooth.
• What the tooth needs first. Root canal treatment, a post and core, a build-up or an extraction are separate line items, and a quote that ignores them is not comparable.
• Whether the laboratory is in house. Clinics with their own lab control turnaround and remakes, which shows up in both the price and how quickly a shade problem can be fixed.
• What the package includes. An all-inclusive package covers treatment, hotel and transfers; a treatment-only price does not. Check whether the temporary crowns, the final fitting visit and any remake are inside the number.

Zirconia is a very good crown material, but it is not perfect, and the honest drawbacks are the things patients most often ask about after the fact. Knowing them beforehand is how you avoid the disappointment.

• More tooth is removed than for a veneer. A crown covers the whole tooth, so healthy enamel has to be reduced all round. If the tooth is largely intact, ask whether a veneer, an onlay or a filling would do the job instead.
• Older opaque grades can look flat. First-generation monolithic zirconia was very white and very opaque. On a front tooth that reads as artificial. Multilayer and high-translucency blocks solve it, so ask which grade is being used.
• It can wear the opposing tooth. Zirconia is harder than enamel. A well-polished crown is kind to the tooth biting against it; a rough or adjusted-then-unpolished surface is not.
• Chipping on layered crowns. Monolithic zirconia rarely chips, but the porcelain layered over a zirconia core on front teeth can. This is one reason multilayer monolithic blocks have taken over.
• It is hard to remove. The same strength that makes zirconia last makes it slow to cut off if the tooth underneath needs treatment later.
• Colour is fixed once it is made. A crown cannot be whitened afterwards. If you plan to whiten your natural teeth, do that first and match the crowns to the final shade.

A handful of countries have built genuine depth in cosmetic and restorative dentistry for international patients. Where you go usually comes down to flight time, budget and how many units you need.

Patients also travel to Cyprus, Poland, Albania and Spain. What matters is the clinic and the dentist rather than the country, so start from the clinic list and our dentistry in Turkey guide rather than from a destination you have already picked.

The clinic and the dentist decide the result, so check both before you pay a deposit. A few questions tell you most of what you need to know.

1. 1

   Ask which zirconia they use

   There is a real difference between an opaque monolithic block and a multilayer translucent one. A clinic that answers precisely is a clinic that thinks about it.
2. 2

   Ask where the laboratory is

   An in-house or named local laboratory means faster remakes and tighter shade control than work sent out to whichever lab quotes lowest.
3. 3

   Check the dentist, not just the clinic

   Ask for the name and qualifications of the dentist who will do the work, and how much of their practice is crown and bridge.
4. 4

   Look at their own before and after photos

   Look for cases similar to yours, photographed under normal light rather than with heavy retouching, and ask to see front-tooth cases if that is what you need.
5. 5

   Agree the aftercare and the remake policy

   Find out who you contact if a crown debonds or the bite feels wrong once you are home, how long the clinic stands behind the work and who pays for a return trip.