Has anyone had any experience of the latest in all-porcelain crowns, i.e. the e.max crown. I have recently had one placed over a root canal in an upper tooth and the opposing bottom teeth are very heavily filled with old amalgam fillings. Until I had this root canal and crown, I was largely unaware of these old fillings. Since the crown, I have felt hitting on the opposing fillings, i.e. the amalgam, every time I bite down, even very gently.The crown has been filed down 3 times but stil feels like it's "hitting". I have read that some of the new all-porcelain crowns are extremely hard (therefore more durable). I am wondering if the hardness of this new crown is too hard for the amalgam opposite or having some kind . Has anyone had this experience or something similar? I don't think it's the root canal: the temporary crown was far too large, and the new crown has been trimmed 3 times but it's making the wrong contact
Any feedback would be most appreciated
And eMax crown is "Lithium Disilicate". Unlike a traditional porcelain crown, eMax does not have the metal substructure, and therefore requires more tooth reduction. An eMax crown is harder than a natural tooth, therefore it is very important that your "bite" is adjusted properly. If you're hitting, biting up and down, or sliding from side to side, on this crown prematurely, you need to continue to bug your dentist until it's dealt with. Worst-case scenario, is that you could give the opposing tooth a toothache. Be persistent, don't "just live with it".
Thank you for your reply. My problem seemed a little less for a while, after about 4 adjustments, but now I'm back to the pain on hitting. The amalgam fillings, which are opposing the crown, are very old, but have never given me any trouble before. I also have an earache on that side, which has been called TMJ and any number of things, but which predated the crown and root canal treatment by many years. I was wondering if the amalgam fillings could be part of the problem. This crown seems extremely hard and hits metal, but I suppose if there is a weakness in the fillings, there could also be a problem. Has anyone any ideas about this.
The way our teeth function together is very complex. Is this tooth that has the e.max crown, the very last one? If so, sometimes there is a condition called "pivoting molar" that may be causing some of the problems. I probably will do a very poor job of explaining the mechanics of this but: when you slide your jaw from side to side, instead of sliding up lower eye tooth against upper eye tooth and all back teeth disengage, this back molar stays in contact. The new crown is not shaped exactly like your old tooth, so this pivoting function may no longer be there. Or, on the other hand, this new crown may have a part of it stays in function when you slide from side to side. When your dentist rechecked how your teeth fit together, I am assuming that these side to side movements were checked also.
Or, your old tooth was not fully hitting against the opposing amalgam filling, and this new crown is.
I would be very surprised if your old amalgam fillings are part of the problem. Amalgam fillings, done properly, are far gentler on your natural teeth than porcelain crown is.
Most porcelain crowns are harder than your natural teeth. If the aesthetics-meaning tooth colored-isn't important, having gold on your molars-In My Opinion-is the better option.
I hope this helps!
please remember that I am not a dentist, these are just my thoughts on this particular issue.
Sylbia, I've also had problems with this material and I've been finding it really hard to get used to some emax crowns. I've had bite problems too and have been in pain trying to get used to them. I've had to have a set replaced because of bite issues so it's not as though it's just a one off. I also think older types of crown look more natural. Dentists seem to really like this material but maybe their patients, not so much...
Thanks for replying followill. This whole thing cost me a fortune and it's still very uncomfortable. It basically feels like a "concrete" tooth. If you have any other feedback I'd love to hear. Thanks also for replying to my other comment
Thanks a lot for replying. The tooth is not the back molar: I think they call it a pre-molar, but it's been identified as T15 i.e. its 4 from the front, and about 3 from the back. Having had 2 perfectly satisfactory crowns made with the porcelain fused over metal, which I don't notice at all, I'm most unhappy with this "concrete tooth", which doesn't even really show. Have you any further advice, or ideas?
Sylbia, my only advice would be to change the crown to another material if you are still unhappy. It's a pain and can have some risks due to trauma (although anyone skilled should be able to minimise this), but maybe it's the only way for you to accept the crown.
I too have some sort of bite adjustment issues. The crowns seemed ok at first but I don't know if it's my teeth being worn or the crowns being worn, but my bite keeps changing. Now to top it all off I have what seems to be a root problem with a molar totally unconnected to the crowns, but which has suffered as a result of the change in bite (which seems to put more pressure on back teeth). I am really fed up with the emax myth and am currently in pain awaiting a dental appointment this weekend. I am likely to need a root treatment, the first I have had on a back tooth and I blame it all on poor dentistry and emax myths. This material seems to mess up your bite and my crowns don't feel like real teeth any more.
I wish dentists would stop obsessing with this material. It's not so great for patients and requires expert technical experience. I think it has placed too much strain on my teeth. Yet they don't feel stronger.
Well, its amazing that someone else is having the same problem. I have raised this issue with the original dentist who did the emax crwon and 2 others and they all think emax is the best thing ever. I reckon it's because it's so extremely hard that it's unlikely to ever break and therefore they won't have to replace it under warranty. I've actually thought of getting the whole tooth pulled out. Whatever this ridiculous new material is, I think it is totally foreign to the mouth, and just creates more problems. I hope you get your problem sorted out: my root canal and emax crown together cost the best part of (australian) $4,000 . Money down the drain. Like you, I'll probably have to replace it in the not too distant future.
thanks I now have to go to a bite specialist as I seem to have developed tmd. There was no sign of root failure, but my jaw joint was sore when touched and I realise that when I relax it the pain stops. I hope you get your problem sorted too. This really is stopping me from enjoying life. The emax is the best thing ever must be a mass delusion. Dentists who are highly ethical believe this too. However, there must be other patients who have these problems. I think perhaps the material itself is good, but some technicians using it are not sufficiently experienced to ensure it works and feels the way it is supposed to. I have been reading technician forums on the subject and there seems to be a lot of uncertainty on how to cast well using the stuff.
Is Emax the same thing as Cerec? Just wondering, as I have been having trouble with an all-porcelain Cerec crown on a molar that required a root canal and also seems to have messed up my bite (and given me TMJ). New dentist says extra cement used to put in these types of crowns could make tooth unstable (and also requires more prep on tooth itself). I am trying to figure out whether to get new crown made (with risk that my tooth is already fractured below the root and therefore unsalvageable- although it looks ok on x-ray) or to just have the tooth extracted (after spending the last 3 months trying to fix this). I am starting to suspect that the all-porcelain crowns are very profitable for the dentist, but not so beneficial to the patient.
Hi Sadie, they are not the same. Cerec is a crown usually made in one hour and designed and milled by a dentist using computer technology rather than being made by a technician. The machinery to make this is expensive is usually owned and operated by the dentist. Emax is something else, it's a type of material/process which is supposed to make really strong crowns with really nice aesthetics using a particular material mixture which is the material of the moment. ( Unfortunately it's created a really nice bite problem for Sybia and I). With cerec the dentist will have special machinery to make crowns on site in one day (or one hour). I haven't heard that it means extra cement. With a root canal filled molar there is always the potential for a dentist to explain they have tried to save a tooth and it was not successful. It's hard to prove whether the crown is at fault. Your best bet is to have a couple of second opinions to check whether the fit is good and whether they would have recommended porcelain for that tooth. Another dentist will be able to confirm whether it is acceptable to use crowns which require additional cement and increase the instability of a root -filled tooth.
One of the big reasons why dentists are pushing the "all porcelain" crown is primarily driven by the consumers push for the "Hollywood Smile", and the skyrocketing price of gold.(How many ads do we see for teeth whitening products?) I would say roughly 15 years ago majority of crowns being done would be gold, but needless to say that has changed. I don't mean this statement to be taken as defending Dentists prescribing the all porcelain crown, but more as a statement that the American population's attitude towards vanity may be driving it.
A Cerec or Emax crown, or the traditional porcelain fused to metal crown require at least double the amount of tooth reduction that a gold crown does. In my humble opinion, a gold crown is the way to go as long as you aren't hung up on "aesthetics". Less tooth reduction, along with a wear factor similar to your natural teeth, a properly made gold crown could last 30 years plus.
A Cerec crown has the color painted on the outside, then fused. Depending upon how your hygienist cleans your teeth, eventually this color can be polished off. Emax crowns on your back teeth, are generally made similarly with the color painted on the outside then fused on, and can also be eventually polished off. There are two types of emax crowns: one as mentioned above, for back teeth, and the second method for the front teeth, have the color on the inside with porcelain layered over the emax core. This layered type of emax crown is not as strong as the painted or stained method, but aesthetically speaking are so much superior in looks.
Okay, maybe a bit too much information: I love gold, and just a reminder, that even with a gold crown, things may not go right regarding bite, etc.
Thanks followill and WW2er. I wish I had all this information before I got the crown (and then the subsequent root canal)! My crown is on a back molar (#18) and it has never felt right in my mouth. I was also concerned about it opposing another crown of the gold fused to porcelain type above it, although the Cerec dentist assured me that it would never present a problem. In any case, I now have a (Cerec) crown with a big hole in it from the root canal, and have had both pain in the tooth and swelling around the gum for over three months now. I feel like infections keep getting in to the tooth, though I can't tell if it's from the crown (poor fit?) or perhaps because of a root fracture that no one has been able to see. I think followill answered this on my other thread about this (and thank you, followill), but if anyone else has any advice I would love to hear (as my friends/family are so tired of my tooth problems they all think I should just have the thing extracted at this point). Should I spend the time and money required to attempt to have another crown made out of some other material to see if that's the problem? Or should I just give up on this tooth completely and have it pulled? it's driving me crazy.
I just had 5 of these put on last week. They replaced a 23 yr old metal/porcelain bridge. I don't know if I would have believe it if I had read your msg before but I do now. These e.max crowns are TERRIBLE! And they look bad.
Dentists have no idea how to place them. I was told they were easier on the opposing teeth. They are not! I was told they could be reshaped after installed. They are hard, brittle glass and cannot be modified They have to be chipped off and will likely cause trauma to the underlying teeth. My idiot dentist pawned the whole thing off on an assistant and did not even check the bite. Now she wants to grind down all my lower teeth to get them to work with these incredibly bad looking teeth.
My 23 yr old bridge looked great. These look awful! The pics. on-line look good. And I can take pics of mine that look pretty good. But they do not in person. Maybe there are some labs out there that know how to work with the material but the one my dentist used did not. My new teeth are grey/yellow and absorb light. In some lights they look green.
My lips that touch the e.max are swollen. The roof of my mouth near the material is irritated. I think I might be allergic to the stuff.
If anyone is considering these do not use a general dentist, even one you have used for years and think is qualified. Find a prosthodontist. The procedure appears to not be reversible if they are bonded on. You need to be sure it is done right. My old metal/porcelain bridge was placed by a good general dentist and was an A. These are an F.
I have an appt. with a prosthodontist to get a 2nd opinion to see if we can get a decent bite out of these or need to try to get them taken off. In the mean time I'm grinding all my food to baby food in the blender.