How accurate can a ceramic crown be if it isn't CEREC?

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Aug 4, 2021
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I have to have one of my upper right premolars crowned. One problem here is that I suffer from Obsessive Compulsive Disorder, and one feature of this is that I'm extremely sensitive to anything 'feeling wrong' in my mouth: as soon as I have any restoration done, I feel around it with my tongue, and if it doesn't feel exactly the same as before I'd had the work done, I feel distress.

My present dentist is very good, but he told me that to do the crown, he would only be making an impression of the tooth AFTER it had been ground down, plus an impression of the opposing (ie: lower) teeth. I asked him how a lab could possibly deliver a crown that was exactly the shape of my tooth if it did not have an impression of it, but all he said was "they're very experienced people".

I know that the impression of the opposing teeth would be enough to make a crown that would occlude satisfactorily, but I need more than this: I need a crown where the shape of the whole tooth, not just the occlusal surface, is the same as the original tooth, because otherwise my tongue will feel the difference.

I've had several CEREC crowns done, and they're fine, but with CEREC, an impression is made (via a camera) of both the unprepared tooth and the prepared tooth. The problem is, to get CEREC, I would have to go to another dentist in a distant town - a dentist who'd be an unknown quantity, whereas I know my own dentist is first rate.

So I suppose my question is: can I rely on a lab-made crown being natural enough to satisfy my OCD? Thanks.
 

honestdoc

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No, handmade lab crowns will never be exactly like your original contours. A possibility is your dentist will need to provide an impression of the tooth before it gets prepped. The technician can then survey the contours to match as close as possible (analog way). If you had CEREC (digital) crowns and your fine with them, then that may be the option. I find CEREC crown margins not as well-sealed in the margins as the handmade ones.
 

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