Materials

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 back: a veneer, for example, may require enamel removal, which is not reversible¹.

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. Study findings quoted here come from published research, not from our own records. When this page says "we", it means our clinic in Antalya, Turkey. Your dentist will tell you which material, product and laboratory will be used for your teeth. You can ask for this in writing (see "Before you travel").

Dental ceramics are tooth-coloured materials used for veneers, inlays, onlays, crowns and bridges. All of these are restorations: they repair or replace teeth. "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, are the most aesthetic, but also the weakest³. Zirconia, which contains no glass, is stronger and more resistant to cracking, but more opaque³.

Glass ceramics can be etched with acid and treated with a chemical called 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. Which method suits a crown depends on the product and on the tooth. 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 ceramic that lets light through 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. It also sets out how a material is chosen for each tooth.

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 the strongest of the 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. Those that let more light through (the more translucent types) have reduced strength⁷. 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. The outer porcelain gives the final shape, shade and appearance³, but it can chip. For single crowns on natural teeth, the 2026 review found a difference by design. Single-piece lithium disilicate and zirconia crowns had significantly fewer fractures and chips than crowns with porcelain layered on top².

Our zirconium (zirconia) page explains the types of zirconia and where each one suits. It also covers single-piece and layered restorations, zirconia implants and implant parts, how zirconia compares with other ceramics, and care.

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 where the material is used and how it is made, bonded and cared for. It also compares it with other ceramics. Our e.max page explains what the trade name covers and how to find out which ceramic you received. It also compares e.max with zirconia and metal-ceramic.

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. In dentistry, the noble metals are gold and the platinum-group metals¹⁴.

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 how these restorations are made and fitted. It also covers what is known about metal sensitivity, and the metal-free alternatives.

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. A bonding system is applied to the tooth first. The composite is then shaped on the tooth and hardened, in most products by a light¹⁶. Bonding can be done with very little tissue removed from the tooth, or none. Even then, the tooth surface is treated so that the composite can bond. 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 what it is made of and how it is placed and repaired. It also covers what is known about allergy and its use in pregnancy.

Acrylic

Acrylic, mostly polymethyl methacrylate (PMMA), is the usual material for dentures. A patient leaflet on complete dentures from a hospital in Leeds, in the UK, 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 its types, how dentures are made and cleaned, and the alternatives.

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. Most of the research is on one-piece implants; the evidence for two-piece implants is limited²⁰. Our titanium page explains the grades and alloys used for implants, implant surfaces, what is known about sensitivity, and the care implants need. It also covers the alternatives, including ceramic implants.

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. It is not tooth-coloured.

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. A hospital in Cambridge, in the UK, wrote a leaflet for its own patients. It says bone 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 what they do, how they are chosen, what is known about sensitivities, and the records to keep.

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. Preparing a living tooth for a crown, a partial crown or a bridge can also affect its nerve²². If the nerve dies, root canal treatment is needed to keep the tooth. Our pages on the ceramics and on metal-ceramic say how often this happened in published studies.

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. Turkey's medical device regulation defines a custom-made device as one made for a particular patient. It is made to a written prescription that gives specific design characteristics under the prescriber's responsibility²³. In the UK, General Dental Council guidance also says dental technicians construct custom-made dental devices to the prescription of a dentist²⁴ 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.

This is a general comparison; which material suits your tooth is decided at an examination.

• 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: lets more light through than zirconia or metal-ceramic; can be bonded. Main trade-off: not as strong as zirconia; 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.

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, including after you are home;
• who pays for the repair and for any extra trip.

Take home for your own 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 (batch) numbers. Ask also for your aftercare plan in writing: the follow-up you need, who provides it and how to reach the clinic. In Turkey, patients may examine their file and records and obtain a copy²⁵. Under the health tourism regulation, international patients who ask are given copies of the records of the materials used, tests and imaging, without charge²⁶. In private dental facilities in Turkey, a consent form is required for every intervention²⁷. Two copies of the form are signed, and one is given to you²⁵. Ask for your copy.

Aftercare. Problems after you return are usually first seen by your own dentist near your home, who will need these records. If you do not have a dentist where you live, it helps to find one before you travel. If a restoration chips, cracks or comes off, or pain starts, see a dentist and tell the clinic. If pain keeps increasing, or you have facial swelling or a high temperature, see a dentist where you are without waiting for the clinic's reply. What a health service or an insurer covers after treatment abroad differs from country to country. Before you go, ask the health service or your insurer where you live what they would cover.

Emergencies. With a suspected dental abscess, the following need urgent medical help²⁸. Do not wait for a dental appointment or for the clinic's reply. Go to the nearest emergency department or call the emergency number where you are.

• It is hard to breathe, speak, swallow or open your mouth
• A swollen or painful eye, or sudden problems with your eyesight
• A lot of swelling inside your mouth

Your choice. A second opinion from a dentist near your home gives you a point of comparison, and having treatment there remains an option. You can say no, or ask to stop, at any stage. Once a tooth has been prepared (shaped) for a restoration, that step cannot be undone.

More questions to ask before treatment abroad are on our page on dental treatment abroad.