When considering dental crowns, the material you choose will have a huge impact on longevity. Learn about each material option and what it can mean for the lifespan of your dental crown
What Is the Average Lifespan of Porcelain Fused to Metal Crowns?
Porcelain fused to metal (PFM) crowns have an average lifespan of 8–15 years. The location of the tooth will significantly affect the porcelain fused to metal lifespan.
Molars, for example, which are subjected to the highest biting force, can cause the porcelain to chip more easily. Other patient risk factors, like bruxism, can reduce the PFM crown lifespan.
Recognizing PFM Crown Failure
What do the signs of crown failure look like for PFM crowns? One of the most common is chipping or fractures in the porcelain veneer. It will no longer offer the protection the tooth beneath it needs, allowing bacteria to enter. You will likely notice a change in appearance.
If your gums have receded, you can begin to see the metal margin of the crown. This can lead the crown to fail. Some signs that this has occurred include swollen or bleeding gums.
A crown’s failure can also become obvious if you develop a secondary caries (decay) at the crown’s margin, where the tooth and restoration meet. This comes down to the crown failing to protect against food particles and bacteria.
The most common sign of a PFM crown failure is the crown falling out. The cement can fail, and this requires immediate attention from a dental professional.
Additionally, the underlying tooth can fail. You can experience pain and even the feeling that the tooth is loose beneath the crown. Decay could have gotten to the root, destabilizing the tooth.
Survival Percentages
One thing to consider regarding the average lifespan of dental crowns is the Kaplan-Meier survival percentages based on the years you’ve had them. At five years, the survival rate is about 90%, while at 10, it drops to about 80%. At 15 years, the survival rate is about 70%.
These findings are from clinical trials, however, which are very different from real-life scenarios. Studies point to fractures in the ceramic materials and mobility of the crown as the two main factors that lead to the failure of the restoration.
Preventing PFM Crown Failure
Factors affecting crown longevity, whether for same-day crowns or PFM, include patients with bruxism or occlusal overload. Poor hygiene habits also contribute to this issue, as does not following all crown maintenance tips. If the tooth preparation for crowns was subpar, that, too, can result in failure.
Some strategies to extend crown longevity include:
- High-Quality Luting Cement: To avoid losing the crown completely
- Proper Tooth Reduction and Margin Placement: Prevents the crown from getting loose and protects the tooth from potential decay at the margin site
- Nightguard: Protects crowns if the patient has bruxism
- Occlusal Equilibration: Stabilizes the bite to avoid uneven pressure on teeth
- Professional Cleanings: Prevents the growth of bacteria
It’s also vital to remember that same-day crowns made with the use of CAD/CAM (CEREC) technology tend not to last as long as lab-fabricated ones.
CAD/CAM options are more convenient and look just as good as lab-made options, and crown procedure aftercare is similar for both options.
What Is the Average Lifespan Of All Ceramic Crowns?
A study by Pjetursson et al. shows that ceramic crowns have a five-year survival rate of 93-98% and a 10-year survival rate of 82-91%. Porcelain crown lifespans fall within this range.
Ceramic Dental Crown Lifespan by Material
Full-contour high-translucency zirconia crowns tend to last between 10 and 15 years. They are less sturdy than opaque zirconia options but provide better fracture resistance. Lithium disilicate (e.max) also has an average lifespan of about 10 to 15 years.
Glass-ceramic crowns have higher chipping risks, so they could last anywhere from five to 15 years.
Typical Failure Modes
Layered-ceramic crowns can chip more easily than other options, and they can also suffer from veneer delamination. This causes the top crown layer to separate from the one beneath it.
Monolithic zirconia can suffer bulk fractures, but it’s not a common problem.
At five years, glass-ceramic crowns have a survival rate of about 89%, while zirconia crowns have a survival rate of 94%.
Numerous factors can influence the longevity of the crown. People who grind their teeth or have bite misalignments can place a significant amount of force on their crowns, potentially damaging them.
Inadequate tooth preparation is a concern, too, since it can cause loose crowns. Not cementing the crown correctly can cause it to fall out, while having restoration on opposing teeth can lead to more friction.
All of these factors can shave years off the crown’s lifespan.
Preventing Ceramic Dental Crown Failure
Zirconia options are better for high load placements, like molars, while lithium disilicate can be better suited for front, visible teeth because of their aesthetic look. Consider whether CAD/CAM options like CEREC are better than lab-fabricated crowns.
CEREC crowns offer faster results and provide crowns that look excellent, but they are not as durable. Although their lifespan has improved over the years, lab-fabricated crowns are still sturdier.
What Is the Average Lifespan of Zirconia Crowns?
Zirconia crowns tend to have a 95-99% survival rate in the first three to five years and an 85-95% survival rate after 10 years. Factors that negatively influence zirconia crown longevity include improper hygiene and grinding your teeth.
Types of Zirconia Crowns
Monolithic zirconia is a high-strength material milled from a single block of zirconium dioxide. It has a lower veneer chipping risk and is highly durable. Layered or high-translucency zirconia is more aesthetically pleasing but carries more chipping risks.
Thinner crowns are more likely to fail than thicker ones. When used in bridges, monolithic zirconia crowns can be more durable if they are designed with the correct connectors.
Common Failure Patterns
For layered restorations, veneer chipping is a common problem, while bulk fracture is the main issue with monolithic crowns. If tooth preparation for crowns wasn’t done correctly, secondary caries can develop on the tooth.
Another problem is failed cementation, which occurs if the cement is not appropriate for the process or if it wasn’t applied properly.
Clinical Placement Guidance
For posterior crowns or long-span bridges, a monolithic zirconia crown can be the right option because of its durability even under high amounts of pressure. Layered or high-translucency options are less expensive, but they are also less durable.
Lifespan-Preserving Tips
Adequate tooth preparation is essential for preserving zirconia crowns. The crown must have the proper occlusal clearance to avoid stress concentrations that can cause chipping. Cementation must be handled correctly, as well, to prevent the crown from loosening.
Nightguards for bruxism prevent grinding that can damage the crowns. Having regular dental appointments can make it easier to spot early signs of crown failure.
What Is the Average Lifespan of Gold and Metal Alloy Crowns?
The average lifespan of dental crowns made of gold or metal alloys tends to be longer than that of other options. Gold crown longevity can be between 15 and 30 years or more, while crowns made of base metal alloys like cobalt-chromium or nickel-chromium can last between 10 and 20 years.
Studies show lower fracture rates, as well as marginally lower failure rates, for gold and high-noble alloys as opposed to all-ceramic crown options. This is because metal can withstand wear better, even under a heavy occlusal load.
Clinical Indications Favoring Metal Crowns
Who can benefit most from metal crown durability? People with bruxism, a misaligned bite, and those with molars that have limited remaining enamel can all benefit from metal crowns. The same is true for those needing short crowns and conservative reduction, as well as maximum protection against catastrophic crown fractures.
There are trade-offs when choosing these crowns, however. Crown aesthetics come into play because metal is visible and doesn’t blend into your natural teeth. On front teeth, they can be very noticeable, though that is less of an issue on back teeth. One option is to choose porcelain-fused-to-metal layering, but this means additional costs.
Tooth Conservation and Biological Considerations
Gold crowns require less tooth preparation, which is important for people who don’t have enough enamel or who need very conservative procedures. It’s vital to consider nickel allergy risks, too, since this is an issue that impacts many people.
Signs of metal crown failure include tooth sensitivity, a crown that moves or feels loose, and further decay on the tooth. All of these signs require fast action to preserve the crown and avoid tooth deterioration.
To help prevent crown damage, maintain strict flossing and brushing habits, and avoid chewing on hard objects, like pen caps, or sticky foods. For bruxism, wear a nightguard.
What Patient and Oral Factors Affect Crown Longevity?
There are a few patient factors affecting crown longevity.
Bruxism
Bruxism can cause chips in crowns, along with cement failure. Assessment steps for bruxism include:
- Detailed history of symptoms
- Bite-splint trial or polysomnography
- Wear facet examination
Wearing nightguards, choosing the right materials for the crown, and utilizing the best possible cement options can all help preserve restorations.
Caries Risk
People who tend to experience tooth decay more easily can struggle with crown longevity. This risk can increase the chances of caries at crown margins. To assess if this is an issue, professionals will:
- Test pH levels and salivary flow
- Provide a caries risk form to fill out
- Perform bitewing radiographs
To prevent these issues, dentists can recommend making dietary adjustments, applying fluoride varnishes, choosing margin placements away from the sulcus, and having a glass ionomer base under the margins.
Periodontitis
Periodontitis, which is advanced gum disease, creates pockets in the gums and can expose margins. This compromises retention and makes decay more likely. Risk can be assessed by:
- Periodontal charting
- Bleeding on probing
- Full-mouth radiographs
To extend crown longevity, it’s helpful to undergo periodontal therapy and crown lengthening.
Malocclusion and Tooth-Level Biomechanics
Malocclusion can result in pressure being placed on certain teeth more than others, leading to uneven wear. This can result in serious stress to crowns. Assessments of this problem include:
Occlusal analysis
Articulating paper and digital occlusion tools
Mounted models
Pre-cementation corrections can be the best way of protecting restorations.
Health and Hygiene
Age, systemic health, and oral hygiene all impact crowns. Uncontrolled diabetes can lead to frequent tooth decay issues, as can poor hygiene, putting crowns at risk. Assessments will include:
- Salivary flow test
- Oral hygiene indices
- Medical history
Getting information on improving oral hygiene, as well as getting underlying medical issues under control and performing basic crown maintenance, can increase the restoration’s longevity.
How Do Clinical Studies Measure Crown Survival Rates?
Studies that focus on crown longevity use survival analysis instead of simple averages because survival analysis accounts for study subjects who may stop participating before the end of the study or for when the crown fails after the study is done.
The Kaplan-Meier Estimator, for example, is very useful for predicting the probability of a crown surviving up to a certain point in time.
Kaplan-Meier displays failures of restorations in these studies via stepwise drops. When using the Kaplan-Meier curve, the Y-axis on the chart plots survival probability, while the X-axis plots the point in time. To find the median, look for 0.5% on the Y-axis, draw a horizontal line to the curve, and then drop to the X-axis.
To find the survival probability at specific points in time, look for the time on the X-axis, move vertically up to the curve, and read the probability on the Y-axis.
Crown loss, recurring caries, fractured crowns, and gum complications are all considered failures in these studies.
Keep in mind that longer follow-up times in studies will offer more accurate answers if you’re looking for how long a crown lasts. Short-term studies can overestimate crown longevity.
What Is the Evidence-Backed Lifespan Matrix by Material?
How long do crowns last? The answer will depend on the dental crown materials used.
The lifespan matrix is used to analyze and project the dental crown lifespan by materials. It relies on numerous columns, like the typical lifespan range in years and common failure modes, and peer-reviewed clinical survival analyses, field performance reports, manufacturer warranties, and longevity data.
Gold Alloy
Gold crown longevity is between 15 and 30 years, according to studies reliant on the Kaplan-Meier method. Maintenance, hygiene, and other factors impact longevity. Corrosion can be a concern for these crowns.
Porcelain-Fused-to-Metal
The average for porcelain-fused-to-metal crowns is 10 to 20 years, calculated with a Kaplan-Meier method. Margin failure and recurrent decay are the biggest issues with these crowns.
Zirconia
Zirconia crowns can last between 15 and 20 years, according to studies reliant on manufacturer data and Kaplan-Meier methods. Chipping and other breaks are the most common issues with these crowns.
Lithium Disilicate
The average lifespan of dental crowns made of lithium disilicate is between five and about eight years, according to studies that rely on Kaplan-Meier methods. As with other ceramic options, chipping can cause these crowns to fail.
Composite Resin
The resin crown lifespan is between five and 10 years, though they can last longer if the materials are applied correctly. Studies rely on manufacturer data and Kaplan-Meier methods.
Composite resin crown durability is impacted by fracture and wear.
Esthetic and Functional Outcomes Over Time
Over several years after the crown has been in place, saliva and chemicals start dissolving the cement, making the bond weaker. The crown can begin to show signs of wear, including thinning, and the glazing can start looking less shiny. There could be stains, too.
Gaps can then begin appearing at the margin, allowing bacteria in. Over time, this can result in tooth issues that could lead the crown to fall out.
Regular check-ups can help you understand whether the crown can be repaired with new cement or refinishing. If not, it will have to be replaced.
How Should I Care for My Crown to Maximize Lifespan?
Crown maintenance tips include brushing your teeth at least twice a day and flossing once a day. Rely on low-abrasive fluoride toothpaste. If you grind your teeth at night, you will need a nightguard. Keep up with crown procedure aftercare, too.
Preventive care for crowns also includes limiting your intake of acidic and sugary foods and drinks, as well as avoiding sticky foods. Be sure to get professional checkups every six months (or every three months if you have risk factors for decay).
When Should a Crown Be Repaired or Replaced?
Recognizing signs of crown failure is essential. You will know the crown needs to be replaced if you notice:
- Loss of ferrule
- Extensive fracture
- <2 mm remaining tooth structure
- Margin separation
- Recurrent decay
- Some scenarios, however, could allow for repairs. These include:
- Minor cement washout
- Localized porcelain chipping
- Surface defects
- Small margins without decay
The dental crown replacement timeframe will depend on the problem.
How Does Cost Compare to Expected Crown Longevity?
Cost should be considered with regard to longevity, too. Keep in mind the following:
- Porcelain-Fused-to-Metal: $800-$1,500, lifespan of 8-15 years
- All Ceramic/Zirconia: $1,000-$5,000, lifespan of 10-20+ years
- Full Gold: $1,000-$2,000, lifespan of 15-30 years
To understand what is the better option, it can help to take the total cost and divide it by the expected lifespan. For example, if you pay $1,000 for a gold crown and it lasts 20 years, you’d be paying just $50 a year.
This doesn’t include repairs or crown replacement timeframes.
How Do I Choose the Right Provider for Long-Lasting Crowns?
The provider you choose has to have appropriate qualifications, including a valid license. Research their education and read patient reviews and testimonials.
Ensure their dental practice offers CAD/CAM and CEREC options, as well as other same-day crowns. It’s helpful to review their follow-up care policies and warranties. Ask about the kinds of outcomes they have had with the various crown materials.
How Can I Use Warranties, Insurance, and Guarantees Effectively?
Dental warranties, insurance, and guarantees cover dental restorations, including crowns. They also address workmanship (repairs and replacements). There are some exclusions, however, including damage related to wear and tear and misuse.
Crown procedure aftercare is recommended, as is following all preventive care for crowns. Not doing so could create problems if you attempt to rely on the warranty or insurance.
If your crown gets damaged, you should:
- Notify the clinic
- Obtain a repair or replacement estimate
- Submit a claim to the insurer
If the claim is denied, you can escalate the issue by turning to the clinic manager, the crown manufacturer, or an ombudsman.
Crown FAQs
How long do crowns last? That’s one of the most common questions people have, and the answer will depend on dental crown materials. Here’s a breakdown:
- Porcelain Crown Lifespan: 8-15 years
- Zirconia Crown Longevity: 5-10 years
- Metal Crown Durability: 10-30+ years
- Resin Crown Lifespan: 3-10 years
- Composite Resin Crown Durability: 3-10 years
If you would like to learn more about dental crowns and how they can restore your smile, we invite you to speak with our specialists at our office or visit our page to explore your options.
1. Can Crowns Cause Allergic Reactions?
Yes, dental crowns can cause allergic reactions. That’s especially true with metal ones. Allergic reactions are less likely to happen with zirconia, gold, or high-purity ceramics.
2. Can I Whiten a Tooth With a Crown?
Tooth whitening only affects natural tooth structures, not crowns.
3. Will My Dental Crown Set Off Airport Metal Detectors?
Most modern crowns will not set off metal detectors. There could be some sensitivity if you have metal crowns, but it will depend on the sensor.
4. How Long Do Temporary Crowns Typically Last?
Temporary crown duration is typically between two and four weeks.
If you want to learn more about dental crowns and which material is best for your smile, schedule a consultation with Dr. Brett Langston today.
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