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Until recently, crowns were commonly made with a core of metal for strength, and porcelain pressed over the top for appearance. What patients may not know is that some metal/ceramic crowns use nickel and beryllium, because they are cheaper to fabricate. Although not visible, these two elements can produce allergic and potentially toxic reactions. In addition, these metal/ceramic crowns do not transmit light in a natural way and, so, often have a flat and dead appearance, which does not blend well with natural teeth. Furthermore, the metal can irritate the gum around the tooth causing recession and exposing a black line at the tooth neck.

Today's technological advancements make it possible to eliminate the metal in most cases. The new metal-free crowns made of either porcelain or indirect composite have been available for over ten years. Compared with the metal/ceramic crowns, these metal-free crowns are biocompatible and look natural. With these crowns, patients will avoid black lines, opaque teeth, and mismatched crowns.

There may be rare cases, however, when metal-free crowns cannot completely substitute the metal/ceramic crowns. For example, in cases when back molars are very highly decayed or substantially broken-down, a metal-free, all-porcelain crown might actually crack or fracture during chewing.

Prioritizing biocompatibility and patient's health in his work, Dr. Vahan Grigoryan is a strong proponent for metal-free all-porcelain crowns or those made of indirect composite. And in cases, discussed above, when metal-ceramic crowns are needed, Dr. Vahan will ensure that only precious metals such as gold and palladium are used.

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