gold filled crowns vs lava crowns

I am in the process of having major work done and my dentist recommended that I get lava crowns for my front 4 teeth #6 - #9.  We have already cemented new porcelain fused to gold crowns on the upper left hand side #10 - #14 (which were made bigger than my old teeth and I love then) but they have to use a different lab for the lava crowns. The new front teeth (lava) arrived and are smaller than the other teeth (same size as old teeth)and they don't seem to be a perfect match color wise - am assuming it's because different material is used. Questions are....a) are gold filled procelain crowns okay for the front teeth instead of the lava crowns? b) Doesn't it make more sense to use the same lab for all of the work, so it all matches? c) My dentist said they will rturn the lava crown so the lab can make them bigger, but shouldn't a mold have been made of the new bigger teeth so the lab can match the front teeth size? (none was made) A lot of money has been paid for this and I need advise - thank you.

[Jerome Bogin, D.D.S.]

I do not have any experience with lava crowns but I do other all porcelain crowns which are very similar. I am more inclined to do anterior crowns in all porcelain. The technology today produces  very esthetic restoration.If the restorations do not match to your satisfaction then I think this has to be discussed with your dentist. Preop study models are often very helpful.

[mike1105]

you do not need another mold as long as the lava crowns fit well on the teeth. However, each time crowns are put back (for porcelain) in the oven they are weakened, so hopefully these lava crowns are being remade altogether and not just resized by adding porcelain to them and putting them back in the oven. Porc/gold crowns in the front are not as good esthetically as all porcelain crowns because the latter are more translucent.

In an ideal situation, a diagnostic wax up should have been made of what you want your teeth to look like (size wise) for you and your dentist to approve before the crowns were made and if the lab is local you should have been sent there for their techncians to do a custom shading. The dentist should have also taken a mold of your teeth BEFORE he startied working on the teeth so the lab could get a good idea of the size of your original teeth for reference. hopefully that was done.

[sp-CA]

Thank you for your reply Mike!  No wax mold was done - just a mold of orginail teeth  The problem is that when the bridge was done (gold fiused to porclein) the lab made them bigger than original teeth, therefore the mold that the 2nd lab had to work with for the lava crowns is not accurate. Luckily, I like the larger ones since it makes my smile bigger.  I am really thinking about swiching to all gold fused to porclein because I want them all to match and I love the way they look on the ones that we have already done, plus they would all be done by the same lab.  How long do these crowns last vs lava crowns?   Any thoughts or suggestions are greatly appreciated!!!  Thank you again...

[mike1105]

i personally am not familiar with Lava crowns. Lava is most likely some sort of tradmarked brand name for a specific type of "all ceramic" (no metal) crown. If done well, and if the patient is careful and has good hygiene, both types should last a long time.

I would discuss these issues with your dentist and make a deision together on which is the best for you.