CASE · Cosmetic dentistry
Replacing Old Front Tooth Crowns: Six Zirconia-Based Porcelain Crowns in Two Trips to Seoul (Case Study)
Old front tooth crowns can lose their fit at the gum line and stand out in color over the years. In this case, we replaced six upper front teeth (four old crowns and two canines) for a woman in her 50s living in Japan with PFZ crowns, porcelain fused to a zirconia core. Treatment took two trips to Seoul, with about three months in temporary crowns in between.
Case at a glance
- Concern: Old front crowns that looked discolored and uneven (woman in her 50s, lives in Japan)
- Diagnosis: Four upper front teeth with root canals, posts and cores under old PFM crowns; right canine with a root canal and core but no crown; left canine with a composite filling; gaps, black triangles and a deep bite
- Treatment: Six PFZ crowns from canine to canine; the two central crowns were splinted so the gap would not reopen
- Timeline: Trip 1 for crown removal, core build-up, impressions and temporaries; trip 2 about three months later for the final crowns
- Number of trips to Korea: 2
- Key design points: deep bite, a prominent upper jaw ridge, and natural color
Why do old front crowns need to be replaced?
Porcelain-fused-to-metal (PFM) crowns have a metal core. Over time the edge at the gum line can lose its fit, and the metal can make the gums look grey. Bacteria can also get in through a small gap and cause decay underneath.
From the outside, this patient’s crowns mainly looked old and discolored. Once removed, the teeth underneath were heavily stained and had secondary decay.
Can a tooth be lost when an old crown is removed?
Yes. Sometimes the post comes loose or the root is cracked, and the tooth has to be extracted. Before starting, we explained this risk and that, as a patient travelling from Japan, she would live with temporary crowns for about three months.
In her case the posts were intact and the roots were not cracked, so no extraction was needed. After removing the decay, we rebuilt the cores with a light-colored material so no dark color would show through the final crowns.
Why PFZ crowns instead of PFM or all-ceramic?
With a deep bite, the front teeth take strong forces, so strength was essential. Because these are front teeth, appearance mattered too. PFZ crowns combine a strong zirconia core with hand-layered porcelain for a more natural translucency.
- PFM: metal core; a dark line or greyish gums can show at the gum line
- PFZ: zirconia core, no metal; strength and natural color are easier to balance
What did you pay special attention to in the design?
- The upper jaw ridge was prominent, so the crowns were shaped as flat as possible to avoid pushing the lips forward
- The two central crowns were joined so the gap between them would not reopen
- The crown shapes were designed to shrink the black triangles between teeth
- The shade was chosen to suit her skin tone, not simply as white as possible
What did the result look like?
After about three months in temporaries, the six final PFZ crowns were placed on her second trip. The gaps and black triangles are much smaller, the color is even, and the crown edges fit closely at the gum line.
How many trips to Korea, and what does it cost?
This case took two trips: one for removal, cores, impressions and temporaries, and one for the final crowns about three months later. Temporary crowns are weaker than final ones, so we ask patients not to bite hard foods with their front teeth.
Typical fees per tooth: front PFZ crown KRW 800,000 (about USD 604); all-ceramic or zirconia crown KRW 700,000 (about USD 528). If a post or core is needed, add KRW 150,000 (about USD 113) or KRW 100,000 (about USD 75). Converted at USD 1 = KRW 1,325 on 2026-10-23.
Frequently asked questions
How long do front tooth crowns last before they need replacing?
There is no fixed number of years. We check the fit at the gum line, color and decay at regular visits; problems in those areas are the signal to replace them.
Is it safe to fly home with temporary crowns?
Yes. Temporaries can come off more easily, so we explain what to do if that happens. Send us a photo on WhatsApp.
Could veneers have worked instead?
Not here. These teeth already had crowns and weakened tooth structure, so full crowns were the better choice. Teeth without existing crowns can sometimes be treated with veneers.
Can I get an opinion before I travel?
Yes. Send your X-ray and photos of your teeth on WhatsApp. A final diagnosis is made in person.
This case was treated at our clinic. The article was medically reviewed by Dr. Sunmin Kim, our lead dentist and a board-certified orthodontist.
About the reviewer
Dr. Sunmin Kim is the lead dentist at Ceramic Dental Clinic in Gangnam, Seoul, a board-certified orthodontist (Ministry of Health and Welfare, Korea) with a PhD from Tokyo Medical and Dental University. Our clinic is registered with the Ministry of Health and Welfare to treat international patients.
Important information
This is a real case. Results, treatment time and the number of visits vary from person to person.
How much tooth structure is removed for veneers or crowns depends on the case. Some cases can be no-prep or minimal-prep (case by case, decided after diagnosis), others need more. After bonding, sensitivity, chipping, debonding or gum changes can occur, so regular check-ups are needed.
Photos show teeth only and are published with the patient’s consent. Fees are as of October 2026.
Questions about your own teeth?
Send us photos of your teeth for a preliminary opinion. A final plan and quote are given after an in-person examination.
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