Zirconia Crowns

Where it may be suitable

• A tooth with a large loss of structure or a fracture that a filling cannot repair
• Back teeth, where chewing forces are high
• Replacing missing teeth with a bridge (a conventional bridge also needs the neighbouring supporting teeth to be reduced)
• Crowns on implants
• People who want a restoration without metal, or who are unhappy with a visible metal edge

Where it is not suitable, or another option should be considered first

• Healthy, well-shaped teeth. Crowning a healthy tooth only for its appearance means removing a large amount of tissue. Options that remove less should be considered first, such as teeth whitening, shaping with composite (bonding) or laminate veneers.
• Teeth that a filling or a partial restoration can repair. An inlay fills a cavity inside the tooth; an onlay also covers weakened cusps (the raised chewing points) where needed. If enough of the tooth remains, these can take the place of a full crown.
• Untreated decay or gum disease. These are treated first.

Where extra care is needed

• Clenching and grinding. Ceramic crowns can wear down the natural tooth they bite against; your dentist may recommend a night guard.
• Expectations about appearance on front teeth. Some types of zirconia are more opaque than glass ceramics. Where appearance matters most, lithium disilicate (often called e.max) is also considered.
• Veneers. A 2025 review found no long-term data¹ for zirconia veneers; options with better-documented long-term results should be considered.

The right option is decided at an examination, with X-rays assessed where needed.

• Doing nothing, or monitoring. For a tooth that causes no symptoms and has kept its structure, waiting is an option; your dentist will explain the risk to you.
• A filling or a partial restoration. An inlay fills a cavity inside the tooth; an onlay also covers weakened cusps where needed. Both keep more of the healthy tooth than a full crown.
• For a missing tooth, options other than a bridge. In suitable patients, an implant, a resin-bonded bridge (glued to the neighbouring teeth) or a removable denture is also considered. Leaving the gap and monitoring it is another option.
• Monolithic (single-piece) zirconia. Made entirely of zirconia, with no separate layer of porcelain on top.
• Layered zirconia. Porcelain is built up on a zirconia framework. The layer allows colour and surface detail to be tailored to the person; small fractures of the porcelain layer (chipping) are more common.
• Lithium disilicate glass ceramic (e.max). Used, where conditions suit, for single crowns on front and back teeth, veneers and partial restorations.
• Metal-ceramic (porcelain fused to metal). The option that has been used for decades for long bridges and under heavy loads.

How the result looks depends on more than the material: the colour of the tooth underneath, the laboratory's work and the clinical conditions matter too.

The steps below are for crowns on natural teeth and are usually completed in two or three appointments. Bridges and work on several teeth can take longer. A crown on an implant needs no natural tooth to be prepared. It is attached to the implant with a screw or with cement, and its care is specific to implants.

The risks below apply to crowns on natural teeth.

Risks and disadvantages

• It cannot be undone. Tissue is removed from every surface of the tooth for a crown; from then on, the crowned tooth will always need a restoration.
• Effect on the tooth's nerve. The pooled results of 37 studies cover teeth that were alive at the start. These teeth then received a crown or a partial restoration, or supported a bridge. In about 5 in every 100 of these teeth, the nerve lost its vitality². In studies with more than ten years of follow-up, the figure was about 7 in 100. The certainty of this evidence is low. If it happens, root canal treatment is needed to keep the tooth.
• New decay. A crown does not protect the tooth beneath it from decay. New decay can develop at its edge or underneath it.
• Wear of the opposing tooth. Ceramic crowns can wear down the natural tooth they bite against. In studies of monolithic zirconia lasting 6 to 24 months, the deepest wear measured on the opposing tooth averaged about 0.1 mm³. The review could not reliably say how this compares with the wear natural teeth cause on each other. Surface roughness, polishing and the bite all affect wear.
• Fracture. On layered zirconia, small fractures can occur in the porcelain layer on top⁴. Monolithic zirconia has no separate layer, so no layer can come away; but edge fractures or larger fractures can still occur in the zirconia itself.
• Sensitivity. Sensitivity to hot and cold may follow the procedure; it usually eases within weeks.
• Coming loose, and replacement. No crown stays in place for ever; when the time comes, it needs replacing.

Benefits

• It contains no metal, so no metal edge shows. The colour of the tooth underneath or a receding gum can still make the edge look darker.
• Its stronger types can be used on back teeth and in bridges. Whether it suits a bridge depends on the properties of the product used, the length of the gap and the design.

After the procedure, wait until the anaesthetic has worn off before eating or drinking. While the temporary crown is in place, avoid hard and sticky foods. Mild sensitivity and tender gums are normal in the first days.

Daily care

• Brush twice a day with a fluoride toothpaste.
• Clean every day where the crown meets the gum, and under bridges; use interdental brushes or bridge floss.
• If you clench or grind your teeth, wear the night guard your dentist recommends.
• Keep up regular check-ups.

It is a rate, not a number of years. The figures below describe crowns staying in the mouth; they do not mean that no problem or repair was needed during that time.

A 2026 review combined the results of earlier studies of single crowns on natural teeth. It estimated how many of every 100 would still be in place after five years. For monolithic zirconia it was about 97⁴, for layered zirconia 97 and for metal-ceramic 97. For monolithic lithium disilicate it was 98 to 99. According to the same review, fractures and chipping were significantly less common on single-piece crowns than on layered ones.

The material, the state of the tooth, the bite, oral hygiene and workmanship all affect how long a crown stays in place. These estimates are for single crowns on natural teeth and cannot be applied directly to bridges or implant crowns⁴.

Contact your dentist if any of the following happens:

• The crown feels loose or comes off (keep it, and do not glue it back yourself)
• The crown cracks or porcelain chips off
• Sensitivity that lasts more than a few weeks or keeps getting worse
• Pain that starts on its own, wakes you at night or gets worse when you bite
• Swelling, bleeding or discharge from the gum around the crown
• The crown feels high when you bite, or your jaw feels tired

Emergencies. If pain is increasing, or you have facial swelling or a fever, see a dentist where you are without waiting for the clinic's reply. If you have difficulty breathing or swallowing, or swelling in the mouth or neck that spreads quickly, go to an emergency department. The emergency number is 112.

Fees are not given on this page. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• How many teeth need crowns, or how many units a bridge has
• Monolithic or layered zirconia, and the laboratory work
• Treatment needed first: decay treatment, root canal treatment, gum treatment, rebuilding the tooth
• A night guard, if needed

Ask for the plan in writing, including what it covers and which procedures would be assessed separately.