Crown options

I had a crown for my molar for 4 years, and it fell off recently. I was suggested by the dentist to consider a new crown. There are some options I am given, the one with complete gold, the one with alloy then porcelain, and complete porcelain. I was told that alloy with porcelain will give better force support at the molar, also complete porcelain maybe will be easily shattered. If alloy, then what kind of alloy, it seems to me that the earlier crown I had has gold instead of alloy. Please advise.

[Jerome Tsang, DDS]

You should probably discuss the specifics with your dentist.

A complete porcelain crown has a tendency to fracture.  The latest belief though is that it is sufficiently strong enough for posterior molars due to recent advances in the technology of its core underneath.  But since its relatively new, it isn't as widely used.

A porcelain fused with alloy is a crown with a metal base underneath with porcelain baked on top.  The alloy underneath can vary in consistency of gold with more gold generally being more expensive.  The benefit of gold is that it is softer so it is more easily manipulated to create a tighter, better sealed crown.  Gold also has a more natural yellow appearance and its more cosmetic as more gold is used.  Unfortunately, gold, being soft, has the tendency to not be as supportive as more base metals underneath.

A complete gold crown is probably the most ideal restoration in terms of margin/seal and wear/tear on your teeth.  Gold is soft enough that when you bite, it wears away along with your teeth.  Porcelain is actually harder than your teeth and actually wear your teeth down.  The biggest drawback to gold is that it is cosmetically poor.