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CEREC or lab for someone with 'occlusion obsession'?

This is a bit complicated, but I'll make it as brief as possible.

One of my rearmost upper molars (the one just next to the wisdom tooth) has a 3-sided filling, and I think it may have decayed again, so I want a full crown for it.

The problem is, I have a phobia about having an all-metal tooth in my mouth (even if I can't see it) PLUS I am very obsessional about my occlusion, which means I hate a tooth restoration, especially with a molar, to be a different shape than the original tooth was. For this reason, that 3-sided filling has always bothered me when I eat anything. Even after 20 years, it still bothers me.

My choices are gold, Cerec and laboratory-fabricated procelain, and I don't know which of the last two to ask for if I'm told I don't have to have gold.

One of my lower molars got CEREC when a corner cracked off, and the dentist said that, as not all the tooth was there, he wouldn't take pics of the lower teeth, but instead would just photograph the upper teeth, and let the computer extrapolate what shape the crown should be to ensure proper occlusion. Well, the result was that the biting surface was nothing like the original tooth. Even the dentist said it 'looked weird'. But he had the crown milled anyway, and fitted it, and while I've never known any difference in chewing, the thought of its awkward shape has always bothered me.

So the obvious thought that comes into my mind is that the CEREC machine might not be able to look at my 3-sides-filled upper molar and be able to reconstruct the shape of the original tooth. On the other hand, I'm thinking that a lab technician might be able to use their experience to do a better job.

But on the other hand, I've heard that CEREC is better than lab because (1) CEREC uses porcelain that is stronger and more like natural tooth substance than lab fabrication does and (2) with CEREC you get a far narrower and more accurate junction between crown and tooth, meaning less chance of bacteria getting in.

Could anyone advise me, please? Thanks.
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Avatar universal
No crown is made to mimic the natural tooth.  It will always be shaped differently.  They are made to have the most ideal anatomy.  A porcelain fused to metal crown (PFM) would be the strongest choice if you don't want gold.  There is metal on the inside (sorry) and porcelain on the outside that matches the color of your teeth.  Gold and PFM crowns can last for decades.  All porcelain and Cerec crowns will not last as long on a back tooth.  They fracture easily.
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Avatar universal
COMMUNITY LEADER
Not sure what lab fabricated really refers to. Assuming you are referring to technician builds up ceramic restoration. Cerec probably performs better in term of physical properties.however, dentist's knowledge and skill are essential for successful outcome.
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Avatar universal
Yes, I realise that gold is the material of choice, but I have this 'metal phobia, so it has to be porcelain. But the choice is between CEREC and lab fabricated.
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Avatar universal
COMMUNITY LEADER
Gold alloy restoration is probably the best material of choice in terms of fitness,durability, which can service decades in your mouth. However, cosmetics is quite objectionable to cosmetic oriented people. Occlusion , in essence, really depends on dentist's knowledge, skill, and experience.
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