Zirconia Crowns

Zirconia crowns and bridges: which teeth they suit, how they are made, what can go wrong, how long they last, and how the appointments fit a trip to Antalya.

Written by: Dt. Dilek AKSU GÜLER

What is a zirconia crown?

A zirconia crown covers the whole tooth and is made of zirconia, a ceramic that contains no metal. It is used most often on back teeth, in bridges and on implants. People often call it a "zirconium crown", but zirconium is a metal; what goes in the mouth is its oxide, zirconia. There are several types of zirconia, and they differ in strength and in how much light passes through them.

Every full crown on a natural tooth needs tissue removed from all of the tooth's surfaces, and that tissue does not grow back. A crown is for a tooth that has lost much of its structure and cannot be protected another way. It is not the first choice for changing how a healthy tooth looks.

This page is written for readers who live outside Turkey and are considering treatment at our clinic in Antalya, Turkey. On this page, "we" means that clinic. The section "If you are coming from abroad" covers appointments, flying and aftercare at home.

  • Zirconia is a strong ceramic that contains no metal; it is used most often on back teeth and in bridges.
  • Like every full crown, it needs tissue removed from all surfaces of the tooth, and that cannot be undone.
  • Its five-year survival is close to that of other crown materials; a strong material does not mean the crown will stay in the mouth longer.
Two people side by side giving thumbs up

Who it suits, and who it does not

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.

Alternatives to a crown, and the crown materials

  • 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 than on monolithic zirconia.
  • 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.

Monolithic zirconiaLayered zirconiaLithium disilicate (e.max)Metal-ceramic
Contains metal?NoNoNoYes
Where it is often usedBack teeth, bridges, implant crownsCrowns and bridgesSingle crowns, veneers, partial restorationsBack teeth and long bridges
Separate porcelain layer on topNoYesNot on single-piece typesYes
Visible metal edgeNoNoNoMay show if the gum recedes

How the treatment works

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. How the appointments fit a trip is covered in "If you are coming from abroad".

  1. Examination and planning

    An examination, with X-rays where needed, decides whether the tooth needs a crown or a smaller restoration. Any decay or gum problems are treated first.

  2. Preparing the tooth

    Under local anaesthetic, all surfaces of the tooth are reduced just enough for the crown to fit. An impression or a digital scan is taken, the shade is chosen and a temporary crown is fitted.

  3. Laboratory

    The crown is shaped from a zirconia block by a computer-controlled machine (CAD/CAM) and fired in a furnace. On layered crowns, porcelain is then built up on top.

  4. Try-in and cementing

    Fit, bite and shade are checked in the mouth. The surfaces that meet the opposing teeth are polished. Once you agree, the crown is cemented permanently.

  5. Review

    The bite and the fit at the gum are checked again, and you are given advice on care.

Patient waiting area at the dental clinic

Risks and benefits

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. These figures are from published studies, not from our own records, and 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.

Recovery and daily care

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.

How long does it last?

Studies do not give a lifespan in years. They report how many crowns are still in place after a period of time. The figures below come from published studies, not from our own records. They 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.

When to contact a dentist

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. In an emergency, call the emergency number of the country you are in; in Turkey it is 112.

Before you fly home

Make sure your bite has been checked and that you have written care instructions. Take the written record of your treatment with you for your dentist at home.

Once you are home

If a problem comes up that is not urgent, write to the clinic and send photographs. Photographs do not replace an examination, so see your dentist at home as well. In the emergencies above, do not wait for a reply.

If you are coming from abroad

A crown on a natural tooth usually needs two or three appointments. The crown is made in a laboratory between preparing the tooth and fitting it, and you wear a temporary crown in between. The number of days in Antalya depends on how many teeth are treated and whether a bridge is involved. It also depends on whether decay, root canal or gum problems need treating first. Before you book, you receive a written preliminary plan with the appointments and how many days they need. It is based on your photographs, so the examination confirms or changes it, and with it the days and the cost.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment5, and longer after surgical procedures. The authors note that the research is limited and comes mainly from military aviation. These times assume there is no pain, swelling or bleeding where you were treated. Treat it as a starting point for your dentist's advice, not as a rule.

Your dentist at home. Talk to your own dentist before you go. They need to know the plan in case problems come up later. If you do not have a dentist where you live, it helps to find one before you travel. Ask for a written record of the treatment, including the materials used, to take back to them. A crown needs regular check-ups for as long as it is in the mouth. UK guidance (NICE) says the interval between check-ups should be set for each person according to their risk6; agree it with your dentist at home. Before you travel, check the rules of the health service or your insurer in the country where you live about care after treatment abroad.

Questions to ask before you commit. Before treatment abroad, ask:

  1. Who will carry out my treatment, and what are their qualifications?
  2. Are you regulated by a professional body and registered with it?
  3. Are the remake and correction terms in writing, and for how long do they apply?
  4. What aftercare do you provide, and who can I contact after the treatment?
  5. If there are complications, who pays for further treatment, extra flights and the hotel?
  6. Do you have a complaints system, and can I see a copy?

Before treatment, we give you in writing how complications are handled and the terms for remaking a crown or bridge. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone. A longer list, with our answer to each question, is on our page about dental treatment abroad.

What determines the cost?

This page does not show prices. 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
  • The number of trips the appointments need

Ask for the plan in writing, including what it covers and which procedures would be assessed separately. Ask too who pays for further treatment and extra travel if there is a complication.

Which option is right for your tooth?

Send a photograph of your teeth, and an X-ray if you have one. Our dentists will write back on whether you need a crown or a smaller restoration, and which material suits the tooth; the definitive plan follows an examination.

Frequently Asked Questions

Zirconia, e.max or metal-ceramic: what is the difference?

For single crowns on natural teeth, their five-year survival figures are close to one another4. The choice depends on where the tooth is, how much of it remains, your bite and what you expect of its appearance. Your dentist will explain the pros and cons of each option to you.

What do "monolithic" and "translucent" zirconia mean?

Monolithic means the whole crown is made from a single piece of zirconia. It has no separate porcelain layer, so no layer can come away; but the zirconia itself can still fracture. "Translucent" is the name used for types of zirconia that let more light through. Zirconia types differ in strength and translucency. The type is chosen for the tooth's position and the bite, and for whether it is a single crown or a bridge.

Does a zirconia crown damage the tooth?

Like every full crown on a natural tooth, it needs tissue removed from all surfaces of the tooth, and this cannot be undone. Pooled results from 37 published studies cover teeth that were alive before such a restoration. The nerve lost its vitality in about 5 in every 1002. The certainty of this evidence is low. So a crown should be made only when it is really needed.

Can the tooth under a zirconia crown decay?

Yes. A crown does not protect the tooth from decay; decay can develop, especially at the edge where the crown meets the gum. That is why daily cleaning and regular check-ups matter. If decay progresses, the crown may need to be removed and the tooth treated again.

Do zirconia crowns stain or turn yellow?

The surface of zirconia and of glazed porcelain picks up less colour than a natural tooth. A colour difference that appears over time usually shows at the edge of the crown, or comes from the neighbouring natural teeth changing colour.

Can a zirconia crown fall off?

It can come loose. If a crown comes off, keep it, do not glue it back yourself, and see a dentist. Do not delay, because the tooth underneath is left unprotected.

Does it hurt?

The tooth is prepared under local anaesthetic. Once the anaesthetic wears off, there may be sensitivity and tender gums for a few days. Pain that increases or wakes you at night is not normal; let your dentist know.

How many days do I need to be in Antalya?

Crowns on natural teeth usually take two or three appointments, with laboratory time between preparing the tooth and fitting the crown. The number of days depends on how many teeth are treated, whether a bridge is involved and whether other treatment is needed first. Before you book, a written preliminary plan states the appointments and the number of days. It is made from photographs, so the examination confirms or changes it.

Will I need follow-up, and will that be in Turkey or at home?

Yes. A crown needs regular check-ups for as long as it is in the mouth. These are usually with a dentist where you live, at an interval set for your risk6. Tell them about the treatment and bring the written record. For a problem with the crown that is not urgent, write to the clinic with photographs; for urgent symptoms, get local care first. Before you travel, check the rules of the health service or your insurer in the country where you live about care after treatment abroad.

Dt. Dilek Aksu Güler

Dt. Dilek AKSU GÜLER

Dentist · Founder

She has completed advanced training in implantology and works in aesthetic restorations and smile design.

Sources

  1. Survival and complication rates of ceramic laminate veneers by material: systematic review and meta-analysis (29 studies). Journal of Esthetic and Restorative Dentistry 2025;37(3):601-619. 2025.↩
    doi.org
  2. Incidence of pulp necrosis and periapical pathosis after indirect restorations: systematic review and meta-analysis (37 studies, 11,615 teeth). BMC Oral Health 2023. 2023.↩
    pmc.ncbi.nlm.nih.gov
  3. Antagonist enamel wear against monolithic zirconia: systematic review and meta-analysis of in-vivo studies. Journal of Clinical Medicine 2020;9(4):997. 2020.↩
    pmc.ncbi.nlm.nih.gov
  4. Survival of monolithic lithium disilicate, monolithic zirconia and metal-ceramic single crowns: systematic review. International Journal of Prosthodontics 2026;39(3):308-324. 2026.↩
    doi.org
  5. Dental tourism and the risk of barotrauma and barodontalgia (narrative review with guiding principles). British Dental Journal 2023;234(2):115-117. 2023.↩
    doi.org
  6. Dental checks: intervals between oral health reviews (clinical guideline CG19). National Institute for Health and Care Excellence, published 27 October 2004. 2004.↩
    nice.org.uk

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