My Journey to Find the Best Zirconia Crown

(MIS) Steps along the way and a final satisfying discovery

My Journey to Find the Best Zirconia Crown 1

I graduated from my pediatric dental residency in 2007. At the time there were very limited choices when it came to “white” pediatric crowns. To be honest, we didn’t have much demand for these types of crowns in my residency program in Rhode Island. 

That soon changed when I moved back to Northern Virginia and started my own practice. We all know that the standard SSC is functional, but, for obvious reasons, it’s not always the most esthetic option. After realizing that parents were not going to just always accept SSC as the only option, I began my hunt for a crown that was functional, esthetic, durable, and easy to place. 

My first candidate was the esthetic-coated stainless steel crown. These crowns had been on the market for a long time and did satisfy some of the criteria I was looking for. Quite frankly, they were my only choice at the time. The thick esthetic coating required me to prepare the tooth to fit the crown rather than adjust the crown to fit the tooth. This process took considerably more time and effort. 

While these crowns did prove to be a nice aesthetic option at initial placement, I soon learned that they did not hold up to the wear and tear that is seen in a child’s mouth. I found myself only offering these to parents that were strongly opposed to the dreaded “silver crowns.” I even went so far as to have them sign a waiver stating they understood I could not guarantee that the white coating would not chip. 

Obviously, I wanted something better to offer my patients. So, the search continued. 

The wear and tear of the esthetic-coated stainless steel crown. 

After hearing a rumor of a new “porcelain pediatric crown” option from some of my colleagues, I thought I might give them a try. Later, I opened one of my pediatric dental magazines, noticed an ad for Tuff Kids Crowns, and placed an order for a starter kit. Zirconia crowns were new on the scene, and not much information was available on how to prepare the tooth for crown placement. After some trial and error, I was able to complete my first Tuff Kids crown. The crowns did look much nicer than any other option I had tried up to that point, but when I went to reorder some replacement crowns, the company had disappeared. My search suddenly came to a dead end. 

In 2012, I visited a booth (Kinder Krowns) at the AAPD annual meeting in San Diego and was excited to see that prefabricated Zirconia crowns were now an option. I was very impressed with the overall esthetics of these new crowns and was anxious to start using them. I soon found that placing these crowns was not as easy as I would have liked. Given the rigid nature of Zirconia, a crown could not be crimped and was not adaptable to the tooth. This often required excessive reduction of tooth structure, and fitting crowns on teeth with space loss was almost impossible. These crowns also seemed very thin, and I fractured more than I would have liked trying to achieve an acceptable fit. 

The manufacturer of these crowns also recommended that I use a resin cement—one that I did not commonly use in my practice. This resin required the tooth to be isolated and dry during cementation. While isolation is not impossible, it proved to be a challenge, and I had cement failures requiring patients to return to my office. These crowns proved to be a step up from the esthetic coated stainless steel crowns I previously used, but I was not completely satisfied. 

Fast forward to 2014. I had received an email prior to the AAPD annual meeting from Sprig stating they were going to present small mini-clinics at the meeting in Boston. Not being completely satisfied with the crowns I had been using, I decided to give this a shot. I went through the 30-minute mini clinic which presented a very simple step-by-step process of how to prepare a tooth to fit an EZCrown. I liked what I saw and decided to make the investment and try out these new crowns. I went all in, purchasing the anterior, posterior, and space-loss crown sets. 

My Journey to Find the Best Zirconia Crown 2
My Journey to Find the Best Zirconia Crown 3
My Journey to Find the Best Zirconia Crown 4

The next week after the meeting, I had a patient that wanted a “white crown.” I was excited to try out these new EZCrowns. I followed the steps exactly as I had been shown. When I tried on my first EZCrown, it fit like a glove. Needless to say, I was excited with the idea that these new crowns could save me a lot of time and frustration. 

I cemented the crown with Ketac Cem, the cement that Sprig recommends, and which also happens to be my cement of choice in my office. 

I was so happy that I emailed Sprig at the end of the day (we all love positive feedback, right?) and told them how delighted I was with these new crowns and expressed my overall satisfaction with my Sprig experience. I received an email back from Dr. John Hansen thanking me for the feedback and giving me his contact information to use if I had any further questions or comments. 

Why was I so excited? After multiple missteps on my journey searching for an ideal esthetic crown, I had discovered Sprig to be the best option out there by far. The aspect that is most valuable to me is the ease of placement. The engineering that has gone into fabricating a design that allows frustration-free placement as well as long-term retention does not go unnoticed. The fact that these crowns are also the most natural looking I have tried is just icing on the cake. 

Thanks to the natural look of EZCrowns, I have no problem placing just one crown in an anterior region, where in the past, if I had done so, it would have been extremely obvious. Using these crowns to restore anterior teeth in children with heavy grinding has also saved a tremendous amount of chair time (fewer “re-dos” of composites) and made parents happier with the outcome. Even with hard cases involving noticeable space loss, I have been able to find the right fit with the Sprig’s Space Loss crowns. 

Adding Zirconia crowns to my practice has changed how I practice dentistry. I now have been using EZCrowns for two years and can say they check all the boxes I was looking for—they are esthetic, durable, functional, and easy to place. I have completely phased out the use of all anterior esthetic coated SSCs. The introduction of EZCrowns to my practice has allowed me to step out of the past and into a bright new future. Thanks Sprig! 

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