Crowns and dental implants are two procedures that are used frequently in restorative dentistry to fix a patient's smile, each with its own purpose, benefits, placement procedure, and cost. While it's sometimes obvious which procedure would be most appropriate for a patient, at other times either procedure could be used. The right solution for you will depend on several factors including the severity of the problem, your budget, and your timeline.
Key Differences Between Dental Implants vs Crowns
The main difference between dental implants vs crowns is that a dental implant replaces an entire tooth (including the root) whereas a crown is a cap that fits over a partial natural tooth. Implants are generally used to replace missing teeth or teeth that are too heavily damaged to repair using other techniques. Crowns are used to cover teeth that are discolored, decayed, chipped, or cracked but still have a strong root.
A dental implant consists of a titanium post or screw, an abutment, and a porcelain crown. The titanium post is screwed into the jaw bone—forming an artificial root. The abutment is attached to the post and protrudes from the gum line. The porcelain crown is cemented onto the abutment, replacing the missing tooth.
A dental crown consists of a cap that can be made of gold, stainless steel, ceramic/porcelain, or composite resin. Like the crown used in an artificial tooth, a standalone crown is made in a dental laboratory to match the shape and size of the patient's other natural teeth and is cemented onto the natural tooth.
2. Treatment Time
Dental crowns can be placed in two appointments: one appointment to clean out the tooth and take the mold and the second appointment to fit the dental crown. The entire process is generally completed in one to two weeks.
Dental implants take much longer to place and several steps are involved:
Perform a bone graft, if needed. Wait up to three months for healing and jaw bone tissue growth.
Drill a hole in the jaw bone and insert the titanium post. Wait three to six months for healing and osseointegration.
Open the gumline and attach the abutment to the post. Wait four to six weeks for the gum to heal.
Take impressions of the patient's teeth to ensure that the dental crown is the right shape and size. Wait one or two weeks for the dental laboratory to make the crown.
Fit the dental crown to the abutment.
Dental crowns are roughly as invasive as fillings and are usually performed under local anesthesia. The recovery time is a few days to a week or two. A dental implant is far more invasive—requiring one or several surgical procedures—and several months of healing time including around two weeks of eating soft foods.
Dental implants are as strong as natural teeth, whereas patients with dental crowns need to avoid foods that are very hard or sticky such as ice cubes and toffee.
Dental crowns that are made of durable materials such as porcelain or gold can last for 10 to 15 years if properly cared for. In contrast, dental implants have a 97% success rate after 5 years and can last for 25 years or more—making them a near-permanent solution.
6. Likelihood of Tooth Decay
Dental crowns don't decay but the natural tooth under the crown can. That's why dental crowns need to be replaced every 10 to 15 years just like porcelain inlays and onlays. Dental implants are not alive and therefore can't decay. However, maintaining good oral health is still important to prevent inflammation and gum disease around the replacement tooth.
The likelihood of a prosthetic tooth or crown staining depends on the material used. Porcelain crowns and porcelain veneers don't stain unless they become scratched by an abrasive material like baking soda.
Dental crowns are much more cost-effective than dental implants at the outset. However, implants can last twice as long as crowns (many remain in the mouth permanently). It's important to consider the cost of dental implants vs crowns in terms of how long each is expected to last.
Dental crowns that are considered "medically necessary" are often covered by dental insurance whereas dental implants—which could be considered to be primarily cosmetic—might not be. Check which procedures are covered by your insurer before committing to either one.
10. Diagnostic Testing
Cosmetic dentists will typically ask for an X-ray before performing any kind of dental work, including both implants and crowns. Because crowns only involve the top of the tooth, you should only be asked for one dental X-ray. In the case of dental implants, you might be asked for X-rays:
Before any dental work is done
After a bone graft, to ensure there is sufficient bone to support the implant
After the post is placed, to ensure the post has fused with the jawbone
In both cases, the dentist may take photos before, during, and after the treatment and may use other diagnostic tools, including scans.
Key Factors When Deciding Between Dental Implants vs Crowns
Dental crowns are generally most appropriate for people who have:
A damaged tooth
A superficially cracked tooth
A heavily discolored tooth with some decay
After a root canal procedure
Dental implants are indicated for people who have:
A lost tooth
A tooth that is cracked from the root
A heavily damaged tooth that can't support a crown
In the case of a tooth with moderate damage but an intact root, either procedure can be used. The decision would depend on your goals, budget, timeline, and the individual assessment of your dentist.
Alternatives to Implants and Crowns
Taken on a case-by-case basis, an alternative procedure to either an implant or crown may be indicated. For example:
A front tooth that is damaged on the visible side could be fixed using a porcelain veneer.
A missing tooth with damaged teeth on either side could be replaced using a porcelain bridge consisting of a row of crowns (without any need for a post).
We routinely perform all of these procedures—and more—in our Beverly Hills office as isolated treatments or as part of a smile makeover or full-mouth reconstruction. The best results are always obtained by examining each tooth as well as the patient’s goals and overall oral health.
Discuss the Options with Your Cosmetic Dentist
Today, there is a wide range of cosmetic dentistry treatment options available to fix problems ranging from moderate tooth decay to chips, cracks, infection, and missing teeth. Each treatment has advantages, disadvantages, and specific indications that may make one or the other more suitable for you.
Ultimately, visiting your dentist for an evaluation and discussion of the options available to you will help you choose between dental implants vs crowns, or alternative procedures like bridges and veneers. With the appropriate care, these treatments can produce wonderful results!