Zirconia or E.max crown: which is better?

The useful question is not which material wins, but which one suits this tooth. E.max is a lithium disilicate glass-ceramic that transmits light much like natural enamel, so it tends to look alive on the front teeth you show when you smile. Zirconia crowns are a high-strength ceramic that copes with chewing forces on back teeth and is widely used for bridges and implant crowns. Both are metal-free, so neither produces the dark line at the gum that old porcelain-fused-to-metal crowns often show.

Zirconia is no longer a single product. Monolithic zirconia is extremely strong but more opaque; newer high-translucency zirconia can work on some front teeth; and layered zirconia has porcelain on top for better aesthetics. So you will see attractive front-tooth zirconia, but E.max usually remains closest to a natural tooth when the bite allows. On the other hand, if the bite is very heavy or you grind at night, zirconia may be the safer choice even on some visible teeth, together with a night guard.

At his clinic in Duhok, Dr. Khalid Saeed starts with an examination and X-rays: does the tooth really need a crown, or would a veneer or filling do? The written plan then lists the material for each tooth and why, the number of units, alternatives and the price. In full-smile cases he may combine zirconia on molars with E.max at the front and match the shades carefully. Restorations can be made at Creative Art Dental Lab in Dubai, the same lab that makes his veneers, and he also treats patients at Creative Arts in Jumeirah, Dubai.

For a detailed side-by-side table, read E.max vs zirconia. If you live abroad or elsewhere in Iraq, send photos and any X-rays on WhatsApp for an initial opinion before travelling. Remember that a crown's lifespan depends more on accurate margins, a balanced bite and daily cleaning than on the material's brand name.

• Visible front teeth: usually E.max
• Molars, bridges and implant crowns: usually zirconia
• Grinding or heavy bite: zirconia plus a night guard
• Healthy tooth needing only cosmetics: maybe a veneer instead
• Material per tooth is written in the plan with the reason