E-max crowns in Turkey: when a front tooth needs to look real

E-max crowns are what our dentists usually suggest when a front tooth needs a crown and has to sit next to natural teeth without standing out. At our Turkish dental clinic in Antalya, E-max is one of two crown materials we use, alongside zirconia. Each has a job it does best. This page explains what makes E-max look so natural, where its strength runs out, how we match a single front tooth, and what it costs.

What E-max is

E-max is the brand name Ivoclar uses for its lithium disilicate glass-ceramic. It is made as a block or ingot, then either milled from a digital design or pressed in the laboratory into the shape of your crown. After a firing in the furnace it reaches its final strength and colour, and the technician adds surface stain and glaze.

The property that matters most is translucency. Natural enamel is not opaque: light goes into it, scatters, and comes back out, which gives teeth depth. Lithium disilicate behaves in a similar way. An E-max crown takes on some of the colour around it, so it tends to look alive rather than painted. Zirconia has improved a lot, but it is still more opaque, especially in its strongest forms.

Where E-max works best

• a single front tooth that is broken, heavily filled or darkened after root canal treatment
• two or four front teeth being crowned together, where a lifelike look matters
• replacing an old metal-based crown that shows a grey line at the gum
• some premolars in people with a normal, gentle bite

If the front tooth is healthy and only the colour or shape bothers you, a crown is usually too much. A laminate veneer, often in the same E-max material, keeps far more of the tooth. Our page on Turkish veneers explains how the dentist decides between the two.

Strength: the honest limits

E-max is strong for a glass-ceramic. Ivoclar gives a flexural strength of around 500 MPa for its milled lithium disilicate, which is enough for most single crowns. Zirconia is considerably stronger. That difference shapes the plan.

A large review of single crowns found lithium disilicate crowns had survival over five years comparable to metal-ceramic crowns when used for single teeth. The picture changes with longer spans and heavier bites, which is why E-max is mainly used for single crowns here and zirconia for dental bridges.

Matching a single front tooth

One crown among natural front teeth is one of the hardest jobs in cosmetic dentistry. Your other teeth are not one colour. They are slightly warmer near the gum, more see-through at the edge, and may have small white flecks or lines. A crown that matches only the middle shade will look wrong from a step away.

So we take the shade in daylight, not under the dental light, and photograph the neighbouring teeth with shade tabs beside them. The technician uses those photos to layer stain and glaze. If the tooth underneath is dark, for example after root canal treatment, that is noted too, because it can show through a thin crown. Dt. Şeyda Yılmaz, one of our aesthetic dentists, works with full-ceramic crowns like these.

Before the crown is fixed, it is tried in so you can see it in a mirror in natural light. If it is not right, it goes back to the laboratory. We would rather spend an extra day than fix a crown that does not match.

If you are planning to whiten your teeth, do it first. Ceramic does not whiten, so the crown is matched to the colour your teeth will stay.

E-max after root canal treatment

A front tooth that has had root canal treatment often turns grey or brown over time, because the inside of the tooth changes once the nerve is gone. It also becomes more brittle. Both are good reasons for a crown rather than a veneer.

The colour is the tricky part. E-max is translucent, which is its strength, but it also means a dark tooth underneath can shine through. The technician can choose a less see-through version of the material, or the dentist can lighten or mask the core of the tooth first. In some very dark teeth, a zirconia base with a lifelike ceramic layer is the better choice. We will explain the options once we have seen the tooth.

The root itself also has to be healthy. If an old root filling looks poor on the X-ray, or there is an infection at the tip of the root, it is treated before the crown is made. Root canal treatment is priced in your written plan.

Looking after an E-max crown

Care is the same as for your own teeth. Brush twice a day along the gum line with a fluoride toothpaste and clean between your teeth once a day, because decay starts at the edge where crown meets tooth. Avoid biting very hard things with the front teeth, such as ice, bottle tops or pens. If you clench or grind, especially at night, wear the night guard we recommend. Keep regular check-ups with a dentist at home and send us your X-rays if anything changes.

Your stay, step by step

1. Photos or X-ray from home. A dentist reviews them and sends a written plan with an itemised price.
2. Examination. The tooth and its root are checked on X-ray. Any decay, infection or gum problem is treated first.
3. Shade and design. The shade is taken in daylight and photographed. The shape is agreed with you.
4. Preparation. Under local anaesthetic, the tooth is shaped and scanned. A temporary crown goes on.
5. Try-in. The E-max crown is checked for fit, bite and colour, and adjusted or remade if needed.
6. Bonding. The crown is bonded or cemented and polished, and the bite is checked.

Crowns are one trip, with airport and clinic transfers included. Flights are not. Your plan gives the length of stay. Practical details are on your trip.

Risks and limits

• Fracture. E-max can crack under heavy load, which is why we are careful with grinders and back teeth.
• Permanent preparation. A crowned tooth will always need a crown.
• Nerve reaction. A tooth that was badly damaged before may need root canal treatment later.
• Decay at the edge. The tooth under a crown can still decay at the gum line if cleaning slips.
• Colour drift. Your own teeth may change colour over the years, and the crown will not.

Price and guarantee

Your written plan says which material is proposed for each tooth and why. Crowns, including E-max, carry a 5-year written guarantee. Conditions apply, such as check-ups and a night guard for grinders, and they are in the written terms on our guarantee page. See prices for every figure.