What do you know about carbon fiber posts and zirconium crowns for teeth?

February 20, 2010 2:30 PM

Is my dentist upselling me on a carbon fiber post and zirconium crown for a root canal on a front tooth?

I recently got a root canal on an anterior bottom tooth that was infected. The dentist told me zirconium crowns were new, stronger, and looked the most natural (no dark line at the gumline). For $1200, I elected to get the zirconium crown. This is in Los Angeles. My dental HMO does not cover the zirconium crown. Not a big deal.

But...I am also wondering about the carbon fiber he used as the post in the tooth. He did not tell me before the procedure that I could choose between a stainless steel and carbon fiber post. During the procedure, he sort of announced to me that he would be using a carbon fiber post because my tooth was so small and he said a carbon fiber post would not show through the tooth like a metal post might. I cannot verify this anywhere. The stainless steel post would be totally covered under my insurance and free to me. The carbon fiber post cost me $250 out of pocket.

I am wary of upselling dentists, especially with respect to patients on HMO plans. I will be switching back to a PPO dental plan during my company's next open enrollment period.

Anybody else have experience or knowledge of 1) carbon fiber posts and 2) zirconium crowns?

Thanks!

posted by KimikoPi to health & fitness (6 answers total)

I'm sorry that options and cost differences were not clearly communicated to you prior to treatment. Were I in the same situation, I would be upset too.

That said, I would have absolutely gone with the treatment option your dentist performed. Lower incisors are extremely thin, so to prep for a Porcelain-fuse-to-Metal crown more tooth structure would have been removed to allow the thickness. In which case, a SS post would have been fine to do. PFM crowns can look flat and fake, especially when in between two "virgin" natural teeth.

The new zirconium crowns are very aesthetic, can be made to be thinner, and are stronger materials under force testing. You get natural looking play with light shining on them and through them. If a SS post was under one, you would get a noticable grey vertical shadow through the crown.

When you say that insurace did not pay for the zirconium vs PFM, did you at least get the allowance for a PFM? If not, I'd certainly fight them on it. Same with the post, try to get them to allow what they would have paid. It isn't unheard of for the dental insurance company to reconsider their decision.
posted by Jazz Hands at 2:59 PM on February 20, 2010

Also, since I noticed you've recently had a root canal... is it possible that you ran out of benefits for the year? Do you know your annual maximum? You may not have been denied payment for the treatment, but because of going over annual max.
posted by Jazz Hands at 3:02 PM on February 20, 2010

The only thing that seems out of whack to me is that a zirconium crown is not translucent, so the stated reason for choosing the aesthetic post is trumped by the crown material. If this were a pressed ceramic crown the clear post would be preferable without question.
Sometimes the post is placed with every intention of using a translucent crown, but then the lab weighs in and suggests a different material based on the specific requirements of the prep, so it may not have been intentional to have this combination.
I second Jazz Hands' suggestion that you may have surpassed your max, and i would suggest that you speak with the office about the charges and your benefits.

UDA (usual disclaimers apply).
posted by OHenryPacey at 3:50 PM on February 20, 2010

Thanks for your great answers.
Even before the root canal was started, I had chosen the zirconium crown. So, if the zirconium crown is not translucent, then I see no reason the dentist chose a carbon fiber post for aesthetic reasons. On the other hand, Jazz Hands' answer suggests that a zirconium crown material would be translucent and allow light through.

My insurance benefits are not maxed out (up to $3,000 I think) as the year just started and this root canal is all I've gotten this year to date.
posted by KimikoPi at 6:56 PM on February 20, 2010

I got a zirconium crown on a front tooth last year, and I think it looks extremely natural. I don't think anyone but a dentist would be able to tell it's not a natural tooth, honestly. I've got a post and core in the same tooth, and I have no idea what it's made of, but when I was going through the crown prep and changing out the temp crown, it looked opaque white, so I don't think it's metal. Whatever it is, it doesn't show through the zirconium crown at all.
posted by Violet Hour at 11:51 PM on February 20, 2010

I'd defer to Dr. Pacey's opinion about the translucency, I would think a dark metal post is going to have some grey shine through, at least with the standard older materials, Empress, Procera it did... we always do white posts and implant abutments under front teeth. Maybe it's habit from the older materials, but they come out looking gorgeous.

Also: $3000 annual maximum? Holy cow! I've only seen that kind of thing on some labor union plans. A lot of plans are still $1000 or $1500 as if it were 1985.

I would still ask your insurance to review the claim and reconsider the post/core benefit, we've been having some luck with Delta Dental, for example, on previously denied treatment being overturned and paid.
posted by Jazz Hands at 5:16 AM on February 21, 2010