Materials

Why material choice matters

The material of a crown, veneer, filling, denture or implant affects how it looks and how strong it is. It also affects how it is fixed to the tooth and how it can be repaired. No single material suits every tooth. Each family trades something off, usually appearance against strength, or how much of the tooth has to be removed. The tissue removed does not grow back1.

A stronger material does not necessarily mean a longer-lasting crown. A 2026 review of single crowns on natural teeth found that five-year survival was close across lithium disilicate, zirconia and metal-ceramic2. Survival here means the crown was still in place, not that it never needed repair. The tooth, your bite, the design and your care at home matter as well.

This page gives an overview of the main families and links to a detailed page for each. When this page says "we", it means our clinic in Antalya, Turkey. This page does not say which materials, products or laboratory our clinic uses. Ask for them in writing (see "If you live in the UK").

  • The material affects how a crown, veneer, filling, denture or implant looks, how strong it is, and how it is fixed and repaired.
  • Glass-rich ceramics look more natural; zirconia is stronger but more opaque; metal-ceramic has metal under the porcelain.
  • Composite is easy to repair but stains and wears more than ceramic; acrylic is the usual material for dentures.
  • In published studies, five-year survival of single crowns on natural teeth was close across lithium disilicate, zirconia and metal-ceramic.
  • The dentist who treats you chooses the material with you after an examination; ask in writing for the material, product and manufacturer.

Dental ceramics

Dental ceramics are tooth-coloured materials used for veneers, inlays, onlays, crowns and bridges. "Porcelain" is the everyday word for them, but it covers several materials that differ in strength and appearance. In general, ceramics that are mostly glass, such as feldspathic porcelain, look more natural than the others but are weaker. Zirconia, which contains no glass, is stronger and tougher, but more opaque3.

Glass ceramics can be etched with acid and treated with silane, which allows a strong adhesive bond4 to the tooth. This makes thin veneers and partial restorations possible. Resin bonding to zirconia can be challenging4, so zirconia crowns are usually fixed with a cement. Ceramic resists staining better than composite1, but whitening does not lighten crowns or veneers5. If you plan to whiten your natural teeth, say so before the shade is chosen.

The main trade-off for you is appearance against strength. A thin, lifelike ceramic needs enough room and good support from the tooth beneath it. All ceramics are brittle and can fracture3, especially with clenching, grinding, knocks or biting hard objects. Ceramic can also wear down the natural teeth it bites against, more so if its surface is rough.

Our porcelain and dental ceramics page explains how the ceramic families differ, how they are made and bonded, and how they chip and wear.

Zirconium-based materials

Patients often say "zirconium", as in "zirconium crown". Zirconium is a metal. What goes in the mouth is its oxide, zirconia (zirconium dioxide): a white ceramic with no metal alloy or metal framework. A 2018 review describes zirconia as stronger than the other dental ceramics6. It is used for crowns, often on back teeth, for bridges, and for crowns on implants and the parts that connect them to the implant.

Its main trade-off is strength against translucency. Zirconia comes in several types. The more translucent types look more like a natural tooth, but their strength is reduced7. Even these still let less light through than glass ceramics8 such as lithium disilicate.

A single-piece (monolithic) zirconia crown has no porcelain layer to chip, though the zirconia itself can still fracture. A layered crown has porcelain built up on a zirconia framework: it can look more natural, but the porcelain can chip. In a 2026 review, single-piece crowns had significantly fewer fractures and chips than crowns with porcelain layered on top2.

Our zirconium (zirconia) page explains the types and where each one suits.

Lithium disilicate and e.max

Lithium disilicate is a glass ceramic: fine crystals of lithium disilicate held in a glass9, with no metal. It lets light through much like a natural tooth, and it can be etched and bonded to the tooth. It is used for veneers, inlays, onlays and single crowns.

Lithium disilicate is not as strong as zirconia, so it needs enough thickness, and heavy clenching or grinding raises the risk of fracture. As a bridge material it did less well in studies than metal-ceramic10.

e.max is a trade name, not a material. It is one manufacturer's product family. Its CAD and Press products are based on lithium disilicate glass-ceramic11, and the family also includes zirconia12. This is manufacturer information. Other manufacturers make lithium disilicate under their own names. So a plan that says only "e.max" does not tell you exactly which material or product you would receive.

Our lithium disilicate glass ceramic page explains the material, and our e.max page explains what the trade name covers.

Metal-ceramic options

A metal-ceramic restoration, also called porcelain fused to metal (PFM), has porcelain fused onto a thin metal framework. The metal gives strength, and the porcelain gives a tooth-coloured surface. It is used for crowns and bridges, not for veneers. Metal-ceramic crowns have been in use for decades, and their results have been followed for up to 25 years13.

The metal is an alloy. The American Dental Association (ADA) classification, published in 2003, groups dental alloys by how much noble metal they contain14. The groups are high-noble (gold-based), noble, and predominantly base-metal alloys such as cobalt-chromium or nickel-chromium.

The trade-offs: light cannot pass through the metal. A layer of opaque porcelain is needed to hide the colour of the metal3, and the crown may look darker3. If the gum recedes, a dark line may show at the edge. The porcelain layer can chip. Allergic reactions to the alloys in metal-ceramic crowns and bridges are reported, but few studies document them15, so how often they happen is not known. Tell your dentist about any metal allergy.

Our metal-ceramic and dental alloys page explains the alloy groups and what is known about sensitivity.

Resin and acrylic materials

Composite resin

Composite is the tooth-coloured material used for white fillings, composite bonding and composite veneers. A 2015 opinion of a European Commission scientific committee (SCENIHR) describes it as a polymerisable resin base containing a ceramic filler16. It is shaped on the tooth, hardened and bonded to it. Bonding can be done with very little tissue removed from the tooth, or none. Its trade-off is that it is easier to fix if damaged, but not as stain- or wear-resistant1 as porcelain. Over time it may need polishing, repair or replacement. Our composite resin page explains it, including what is known about allergy and its use in pregnancy.

Acrylic

Acrylic, mostly polymethyl methacrylate (PMMA), is the usual material for dentures. An NHS hospital leaflet from Leeds says dentures will most commonly be constructed of acrylic17. It forms the pink base and often the teeth, and is also used for temporary crowns and bridges. A partial denture can instead have a cobalt-chromium plate, which is thinner and stronger18 than an all-acrylic one but not suitable in all cases. Acrylic can be adjusted and relined, and many breaks can be repaired, but it wears, stains and can crack. Our acrylic in dentures and temporary teeth page explains it.

Titanium and other materials

Titanium is the standard material for dental implants, the screws placed in the jawbone to replace the roots of missing teeth. They are made of commercially pure titanium or a titanium alloy19. An international expert consensus states that ceramic (zirconia) implants can be an alternative to titanium in selected cases20. Our titanium page explains implant materials and what is known about sensitivity.

Fillings can also be made of glass ionomer or silver-coloured amalgam, which our composite resin page compares with composite. A full-metal (gold alloy) crown is still an option for back teeth that do not show, and for bites with very little space.

Many other materials are used along the way: temporary crowns and fillings, cements and bonding agents, impression materials, bone and gum grafts, and root fillings. An NHS hospital leaflet from Cambridge says graft material can come from yourself, another person, an animal or a synthetic source21. If the source matters to you, say so before you consent. Our other dental materials page describes them.

How clinicians and laboratories select materials

The first decision is whether a tooth needs a restoration at all, and which kind; the material comes second. If the only concern is colour or shape, whitening, composite bonding or tooth straightening may be considered before a crown or veneer. Decay and gum disease are treated first.

The material is then chosen for each tooth after an examination, with X-rays where needed. The main questions are:

  • Where the tooth is, and how much of it shows when you smile.
  • Your bite, and whether you clench or grind your teeth.
  • How much of the tooth and its enamel remain, and how much room there is for the material.
  • Whether it needs adhesive bonding, as thin veneers do, or can be fixed with a conventional cement.
  • Whether it is a filling, veneer, inlay or onlay, crown, bridge, denture or implant crown.
  • The colour of the tooth underneath (thin, translucent ceramic may not hide a dark tooth), and what you expect of the appearance.
  • Your medical history, including any allergy to metals or dental materials you know of.

Who does what

The dentist examines you, plans the treatment with you, prepares the teeth, records them and writes the prescription. The laboratory makes the restoration to that prescription. The dentist then checks it in your mouth and fits it. In the UK, General Dental Council guidance says dental technicians construct custom-made dental devices to the prescription of a dentist22 or clinical dental technician. That guidance is written for dental professionals registered in the UK. Our dental laboratory page explains what the laboratory does and the documents that should come with a custom-made restoration.

Products differ, even within one material. In a review of laboratory tests, lithium-based blocks from different manufacturers differed in composition and strength9. So ask which product is proposed, not only which material, and why it suits that tooth better than the alternatives.

The main families at a glance

The main materials side by side

  • Glass-based ceramics. What it is: contains glass, with or without crystals such as lithium disilicate; no metal. Often used for: veneers, inlays, onlays, single crowns. Main advantage: in general, very lifelike; can be bonded. Main trade-off: weaker; needs enough room and support.
  • Zirconia. What it is: crystalline ceramic with no glass and no metal. Often used for: back teeth, bridges, implant crowns. Main advantage: strong; no metal alloy. Main trade-off: more opaque; the translucent types are weaker.
  • Metal-ceramic. What it is: porcelain fused to a metal framework. Often used for: back teeth and long bridges. Main advantage: long record; strength from the metal. Main trade-off: the metal blocks light and may show at the gum line; the porcelain can chip.
  • Composite resin. What it is: resin filled with fine glass or ceramic particles. Often used for: fillings, bonding, composite veneers. Main advantage: little or no drilling for bonding; easier to repair. Main trade-off: stains and wears more than ceramic.
  • Acrylic. What it is: hard plastic resin, mostly PMMA. Often used for: dentures, temporary crowns and bridges. Main advantage: can be adjusted, relined and often repaired. Main trade-off: wears, stains and can crack.

If you live in the UK: questions and records

Before treatment, ask in writing:

  • which material each tooth will get and, for a ceramic, whether it is layered or a single piece;
  • the product name and manufacturer, not only "porcelain", "zirconium" or a trade name;
  • for metal-ceramic work, which alloy; for an implant, the system and what each part is made of;
  • where each restoration will be made: at the clinic or in a laboratory, and which one;
  • what the clinic's written terms say if a restoration chips, breaks or comes off after you return, and who pays for the repair and any extra trip.

Bring home for your UK dentist a written record of each restoration: the tooth, the material, product and manufacturer, the shade and the laboratory. For implants, add the system, part and lot numbers. On request, Turkey's health tourism regulation entitles international patients to free copies of the records of the materials used, the tests and the imaging23.

Aftercare. Problems after you return are usually first seen by your UK dentist. The General Dental Council suggests speaking to your own dentist24 before you consider treatment abroad. Ask too whether they will see you afterwards. The NHS website for England says the NHS is not liable for negligence or failure of treatment25 when you have treatment abroad. It also says most travel insurance policies will not cover you for planned treatment abroad25. Scotland, Wales and Northern Ireland run their own health services, with their own rules, which this page does not cover; if you live there, ask your dentist.

Your choice. All of these materials are also available from dentists in the UK, and a UK opinion lets you compare. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.

Our dental crowns page lists the questions the General Dental Council and the NHS suggest asking before treatment abroad.

Questions about which material suits your teeth?

Send your question, with photographs of your teeth and an X-ray if you have one. A reply is not a diagnosis and promises nothing: which material suits a tooth, if any, is decided at an examination.

Is there one material that suits every tooth?

No. Glass-rich ceramics can look very natural, zirconia is stronger, metal-ceramic has a long record and composite is easier to repair. The choice depends on the tooth, your bite, the room available and the appearance you want.

Is zirconium the same as zirconia?

Not quite. Zirconium is a metal. Crowns and bridges are made from its oxide, zirconia (zirconium dioxide), which is a ceramic. "Zirconium crown" is the everyday name for a zirconia crown.

Is e.max a material?

No. e.max is one manufacturer's trade name for a family of ceramics. Its CAD and Press products are lithium disilicate, and its ZirCAD products are zirconia. Ask for the material and the product name, not only "e.max".

Does a stronger material last longer?

Not necessarily. For single crowns on natural teeth, survival in published studies was close across lithium disilicate, zirconia and metal-ceramic. The design, your bite, the way the crown is fixed and your care at home matter too.

Can I avoid metal in my mouth?

For veneers, crowns and many bridges, ceramics such as lithium disilicate and zirconia have no metal alloy or framework. Implants are usually titanium; ceramic implants are an alternative in selected cases. Ask what each part is made of, and mention any metal allergy.

Who chooses the material: the dentist or the laboratory?

The dentist examines you, chooses the material with you and writes a prescription. The laboratory makes the restoration to that prescription, and a technician can advise on its design.

What should I keep for my dentist in the UK?

A written record of each restoration: the tooth, the material, the product name, the manufacturer, the shade and the laboratory. For implants, the system and the part and lot numbers. Ask for copies of your X-rays too.

Sources

  1. Veneers. American Dental Association, MouthHealthy.↩
    mouthhealthy.org
  2. Survival of monolithic lithium disilicate, monolithic zirconia and metal-ceramic single crowns: systematic review. International Journal of Prosthodontics 2026;39(3):308-324. 2026.↩
    doi.org
  3. All-ceramic restorations: a review of the literature (classification by composition, layered and monolithic restorations, fabrication methods). Saudi Dental Journal 2020;32(8):365-372 (Warreth A, Elkareimi Y). 2020.↩
    doi.org
  4. Survival and complication rates of ceramic laminate veneers by material: systematic review and meta-analysis (29 studies). Journal of Esthetic and Restorative Dentistry 2025;37(3):601-619. 2025.↩
    doi.org
  5. Teeth Whitening (patient information). American Dental Association, MouthHealthy.↩
    mouthhealthy.org
  6. Novel zirconia materials in dentistry (narrative review). Journal of Dental Research 2018;97(2):140-147 (Zhang Y, Lawn BR). 2018.↩
    doi.org
  7. Flexural strength of translucent zirconia for single crowns and fixed dental prostheses: a systematic review (78 laboratory studies). Journal of Prosthodontic Research 2026;70(2):173-182 (Bernauer SA, Lirgg NM, Ioannidis A, Zitzmann NU, Rohr N). 2026.↩
    doi.org
  8. Flexural strength and translucency characterization of aesthetic monolithic zirconia and relevance to clinical indications: a systematic review. Dental Materials 2021;37(4):711-730 (Fathy SM, Al-Zordk W, E Grawish M, V Swain M). 2021.↩
    doi.org
  9. Lithium silicate-based glass ceramics in dentistry: a narrative review of composition and strength. Materials 2023;16(12):4398. 2023.↩
    doi.org
  10. Survival, failure and complication rates of metal-ceramic, veneered and monolithic all-ceramic tooth-supported multiple-unit FDPs - Part 2. Int J Prosthodont 2026;39(4):444-462. 2026.↩
    doi.org
  11. IPS e.max CAD product information. Ivoclar.↩
    ivoclar.com
  12. IPS e.max ZirCAD product information. Ivoclar (Ivoclar Vivadent AG), product page, en_us.↩
    ivoclar.com
  13. High-gold metal-ceramic single crowns in one practice: up to 25 years (2,340 crowns). International Journal of Prosthodontics 2013;26(2):151-160. 2013.↩
    pubmed.ncbi.nlm.nih.gov
  14. Oral Health Topics: Materials for Indirect Restorations. American Dental Association (ADA Library & Archives, Research Services and Scientific Information), topic last updated 11 November 2025. 2025.↩
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  15. Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices: a systematic review. Quintessence International 2012;43(10):871-7 (Levi L, Barak S, Katz J). 2012.↩
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  16. Opinion on the safety of dental amalgam and alternative dental restoration materials for patients and users (update). European Commission, Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR); adopted at the 10th plenary, 29 April 2015. 2015.↩
    health.ec.europa.eu
  17. Complete Dentures: information for patients (leaflet LN002837). Leeds Teaching Hospitals NHS Trust, Department of Restorative Dentistry, Leeds Dental Institute (UK); 4th edition, publication date 02/2025, review date 02/2028. 2025.↩
    flipbooks.leedsth.nhs.uk
  18. Removable partial dentures: information for patients (leaflet LN002839). Leeds Teaching Hospitals NHS Trust, Department of Restorative Dentistry, Leeds Dental Institute (UK); 4th edition, publication date 02/2025, review date 02/2028. 2025.↩
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  19. A critical review of dental implant materials with an emphasis on titanium versus zirconia. Materials (Basel) 2015;8(3):932-958 (Osman RB, Swain MV). 2015.↩
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  20. Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry. Clinical Oral Implants Research 2023;34 Suppl 26:169-176. 2023.↩
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  21. Sinus lift procedures (patient information leaflet, document 101925, version 3). Cambridge University Hospitals NHS Foundation Trust (UK), Oral and Maxillofacial Surgery, approved 15 July 2024, accessed 2 October 2026. 2024.↩
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