Should I give up on getting crowns and veneers that match? In 2010, a dentist performed a root canal on one of my teeth that wasn’t needed. I only learned it was unnecessary a year later when I switched to a different dentist. Since then, that tooth has gone through two PFM crowns. About two years ago, I agreed to have a zirconia crown placed. At the same time, the dentist suggested placing a veneer on the adjacent tooth because my crown tooth had been made wider to close a gap. I hesitated but accepted, since the dentist assured me that my smile would look more uniform.
The outcome wasn’t what I hoped for. The tooth under the crown is very dark gray, and when the zirconia crown was done without a metal backing, the light made the gray show through. Now I have three colors in my smile: the crown looks gray, the veneer looks different, and my other teeth don’t match either. My dentist added material inside the crown to help, but it didn’t make much difference.
I find it hard to believe that, with modern materials, nothing can hide the darkness under a crown. Am I a rare case that can’t be fixed, or could this be something my dentist can’t handle? Much appreciated. Simeon from AZ
Simeon,
Your situation highlights the gap between general dentistry and advanced cosmetic dentistry. Where a general dentist may struggle with shade issues in crowns or other restorations, a cosmetic dentist addresses them with experience and specialized training.
What Is the Role of Zirconia?
Dr. LeSage placed ceramic crowns on the patient’s front teeth for beautiful results
Zirconia provides strength, but it cannot match the appearance of natural teeth on its own. For aesthetics, the crown must include porcelain layered over zirconia. In your case, the challenge is to block the dark underlying tooth without losing translucency.
The best results come from close cooperation between the dentist and the ceramist. The dentist provides accurate information about the tooth, while the ceramist determines how to mask discoloration while still producing natural variation. Master ceramists are rare, but skilled cosmetic dentists know how to find and work with them.
How to Make a Dental Crown Look Natural
Overuse of opaquer creates an opaque, flat white crown. To achieve a realistic look:
- Place opaquer in deeper layers of the crown.
- Apply translucent porcelain over it for lifelike depth and variation.
Your dentist recommended a veneer rather than another crown on the neighboring tooth, which was wise. However, matching a veneer to a crown is highly complex, and only those with advanced cosmetic expertise should attempt it.
Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.