e.max Crowns: What They Are and What Decides the Cost

Does the tooth need a full crown?

A crown may be recommended for a tooth that is badly damaged or broken, weakened by a large filling, root-treated, worn or cracked, or badly discoloured or misshapen⁴. For a sound tooth whose only problem is colour or shape, gentler options come first. The tooth is reduced on every surface to make room for the crown, which is cemented in place: you cannot take it out, though it may need repair or replacement later.

That shaping is the part that cannot be undone. In a laboratory study on plastic model teeth, a full crown preparation removed about 67.5 to 75.6 per cent of the tooth's crown, while bonded preparations and inlays removed about 5.5 to 27.2 per cent⁵. These are laboratory values; how much comes off a real tooth depends on the damage and the old fillings already there.

• Back teeth. An onlay covers one or more cusps, the raised points of the biting surface, and keeps more of the tooth's outer walls than a crown. Studies comparing onlays or partial crowns with full crowns found no statistically significant difference in survival at one and three years⁶, but most were not randomised and follow-up was short, so neither can be said to last longer over decades. Onlays can also be made of glass-ceramic such as e.max. See inlay, onlay or crown.
• Front teeth. If most of the tooth is sound and the concern is colour or shape, a veneer, bonding or whitening may be enough. See crowns or veneers.

Every crown also carries a risk to the nerve. In pooled studies of teeth that were alive before they received crowns, partial restorations or bridge supports, the nerve lost its vitality in about 5 in every 100⁷, over follow-up periods that varied between studies, on low-certainty evidence. The tooth then needs root canal treatment to be kept. A crown that was not needed is the most expensive kind, for the tooth and for you.

e.max or zirconia?

Both are ceramics with no metal. The differences that matter are strength, how light passes through them, and whether the crown is in one piece.

• Strength. In independent laboratory tests, the bending strength of lithium disilicate (IPS e.max CAD) measured about 210 to 470 MPa in three-point bending tests, varying between studies¹; the manufacturer reports 530 MPa in its own biaxial test⁸. The two figures come from different tests and cannot be compared directly. Zirconia is stronger. A stronger material in the laboratory is not the same as a longer-lasting crown in the mouth.
• How long they stay. A 2026 review of single crowns on natural teeth found about 98 to 99 in 100 monolithic lithium disilicate crowns still in the mouth after five years, against about 97 in 100 for layered zirconia, metal-ceramic and monolithic zirconia². Crowns made in one piece had fewer fractures and chips than layered crowns. These figures do not apply to bridges or implant crowns.
• The tooth opposite. Ceramic crowns can wear the natural tooth they bite against; the pooled studies measured this for monolithic zirconia⁹. Surface roughness, polishing and the bite affect it.

So the choice follows the tooth: where it is, how you bite, whether you grind, whether it is part of a bridge, and how much it has to match its neighbours. Our zirconia crowns page and zirconia or porcelain crowns compare the materials in more detail.

What goes into the cost of a crown

• Work before the crown. Decay and gum disease are treated first. A tooth may need root canal treatment or a build-up (a core that replaces lost tooth inside the crown). These can matter as much to the total as the crown itself.
• How it is made. A laboratory-made crown usually needs one visit to prepare the tooth and another to fit the crown, with a temporary crown in between; more visits may be needed. Ask how many visits your crown needs.
• One piece or layered. A layer of porcelain lets the laboratory tailor the colour and surface, at the cost of a layer that can chip.
• Matching the shade. A single front crown next to natural teeth is the hardest to match. Two reviews found that choosing the shade with standard photographs or an instrument¹⁰ often came closer to the target colour than choosing by eye¹¹, although the studies were few and small and the reviews disagreed about spectrophotometers. More steps at the shade stage can be worth it on a front tooth. See how the shade of a crown is chosen.
• How many teeth. Each tooth is its own decision. A plan for several e.max crowns on healthy front teeth needs a reason for each one.
• Your bite. If you clench or grind your teeth, say so before the material is chosen: it is part of the assessment, not only of the aftercare.
• Afterwards. Adjustments, check-ups, and what happens if the crown breaks or comes off: ask what the quote includes, in writing.

If you want your natural teeth whiter as well, tell your dentist before the shade is chosen. Whitening does not lighten crowns the way it lightens natural teeth¹², so a crown matched to unwhitened teeth may look darker later.

A crown does not protect the tooth from decay: new decay can start at its edge. Brush twice a day with fluoride toothpaste, clean between your teeth daily and keep your check-ups. What a written plan should contain is set out in our consultation checklist, and how to compare two quotes in what decides the cost of dental treatment.

When to see a dentist

If you have an e.max crown, contact your dentist if any of these happens.

• Sensitivity that lasts more than a week or gets worse; pain that starts with heat and lingers
• Pain when you bite, or a bite that feels high
• A crack, chip or movement in the crown
• Bleeding, receding gum or a dark line at its edge
• It comes off: keep it, and do not glue it back yourself

Emergencies. Throbbing pain, facial swelling or a fever is not an expected result; see a dentist without waiting. Difficulty breathing or swallowing, fast-spreading swelling in the mouth or neck, or swelling around the eye: go to an emergency department or call 112.

Frequently asked questions