What is an E.max crown?
An E.max crown (also written "emax" or "e-max") is an all-ceramic crown made of lithium disilicate, a material made by Ivoclar Vivadent, that combines strength with a natural look.
The E.max crown material comes in two versions: IPS e.max CAD, milled with CAD/CAM technology, and IPS e.max Press, made by heat-pressing. In both versions, the lithium disilicate crystals give a semi-translucent look that closely mimics a natural tooth, a key advantage for front teeth. An E.max dental crown is hard to tell apart from the natural teeth around it.
Benefits of E.max crowns
E.max crowns combine mechanical and aesthetic properties that set them apart among ceramic restorations.
- Good mechanical strength: stronger than traditional ceramics, though less strong than zirconia.
- Natural aesthetics: semi-translucency that mimics the color and depth of a real tooth.
- Preserves tooth structure: requires less tooth reduction than metal-based crowns.
- Biocompatible: metal-free, suitable for patients sensitive to metals.
- Color-stable: does not change shade over the years, unlike composite materials.
Mild sensitivity after treatment is possible and usually fades within days; sensitivity that persists should be checked.
E.max crowns vs traditional porcelain crowns
According to a systematic review, the 5-year survival rate of lithium disilicate or leucite crowns is about 97%, similar to porcelain-fused-to-metal crowns (about 95%) (Sailer et al., Dental Materials, 2015).
Unlike a traditional porcelain crown built up in layers over a metal core, a monolithic E.max crown is made from a single block, with no separate layers that could chip off. Like E.max veneers, it offers a natural translucency that porcelain-fused-to-metal crowns struggle to achieve because of their opaque core, which can create a dark line at the gumline. In practice, patients with old porcelain-fused-to-metal crowns often notice a dark shade at the base of the tooth, something that does not happen with a metal-free E.max crown.
E.max crown vs zirconia crown: what is the difference?
Both materials are metal-free ceramics, but they differ in their properties and in the clinical situations each one suits.
An E.max crown is preferred for front teeth because of its superior aesthetics, while zirconia crowns are preferred when maximum strength is needed on back teeth.
Zirconia has a higher flexural strength than E.max, but it is less translucent.
| Criterion | E.max crown | Zirconia crown |
|---|---|---|
| Main indication | Front teeth | Back teeth |
| Translucency | Semi-translucent | Lower |
| Flexural strength | High, but lower than zirconia | Higher than E.max |
| 5-year survival (systematic review) | About 97% | About 92% |
When are E.max crowns recommended?
E.max crowns suit a wide range of clinical situations, but whether they are right for you depends on your individual case.
- Front teeth: when a natural-looking smile is the main priority.
- Partly damaged teeth: fractures, wear or extensive decay that does not justify an extraction.
- After root canal treatment: protecting a root-canal-treated tooth that needs full coverage.
- Metal sensitivity: patients who need a metal-free solution.
- Cosmetic improvement: when veneers are not enough for the correction needed.
Why a crown rather than a veneer? A veneer covers only the front surface, while a crown covers the whole tooth and suits more extensive damage.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
How durable are E.max crowns?
According to a systematic review, about 97% of lithium disilicate or leucite crowns survived 5 years, with similar survival on front and back teeth (Sailer et al., Dental Materials, 2015).
Monolithic crowns
A randomized controlled trial (RCT) on root-canal-treated molars and premolars followed reduced-thickness monolithic crowns for 36 months and found a 96% survival rate, while layered crowns reached 100% (Špehar & Jakovac, Acta Stomatologica Croatica, 2024).
Ultra-thin crowns
A laboratory (in vitro) study tested ultra-thin lithium disilicate crowns for back teeth and found 98% reliability over 100,000 load cycles at 100 newtons (Benalcazar Jalkh et al., Journal of Esthetic and Restorative Dentistry, 2024). This is lab data and does not replace clinical follow-up, but it supports the possibility of preserving more natural tooth structure.
96%
- survival over 36 months (clinical trial)
98%
- reliability over 100,000 load cycles (lab study)
Getting an E.max crown: steps and treatment time
Placing an E.max crown follows several structured steps to ensure a precise fit and a natural-looking result.
1. Initial assessment
Examination of the tooth and X-rays, with a digital scan (Shining 3D Aoralscan 3 intraoral scanner), with no impression paste.
2. Tooth preparation
The tooth is shaped with minimal reduction to receive the crown.
3. Temporary crown
A temporary crown protects the tooth while the permanent crown is being made.
4. Fabrication
The crown is made in the clinic's own dental lab using CAD/CAM technology.
5. Final bonding
The permanent crown is placed and bonded with a resin cement.
Because the lab is on site, in suitable cases the crown is ready and cemented the same day (same-day crowns), with no temporary crown stage.
E.max crown cost: what is included?
The cost of an E.max crown is set after an examination and depends on the condition of the tooth, any treatment needed first (such as a root canal or a core build-up), the fabrication method and the number of teeth treated. The clinic does not publish a general price list: at the end of the consultation you receive a written estimate (check that it lists tooth preparation, the temporary crown, lab work and bonding of the crown) and itemized receipts you can submit to your insurer (coverage depends on your policy).
Can E.max crowns be used on any tooth?
This question often comes up when patients consider restoring several teeth; the answer depends on precise clinical conditions.
E.max crowns are suitable for most teeth, but for back teeth under very high loads, such as in patients with severe grinding, the dentist assesses whether zirconia would be a better choice.
A retrospective study of 21,340 lithium disilicate restorations (15,802 of them monolithic) found a failure rate of only 0.91% for monolithic single crowns over about 45 months (Sulaiman et al., Journal of Prosthetic Dentistry, 2015).
For a full mouth rehabilitation involving several teeth, the dentist reviews each tooth separately and chooses the right material for it.
When is an E.max crown not suitable?
Despite its many advantages, there are specific situations where an E.max crown is not the preferred option.
An E.max crown is not suitable when there is severe, untreated teeth grinding (bruxism), when the tooth root is significantly damaged, or when maximum strength is needed on back molars.
90.58%
5-year survival of E.max bridges
E.max bridges also do less well than single crowns: in a retrospective study, the 5-year survival rate was 90.58% for bridges versus 94.69% for single glass-ceramic crowns (Brandt et al., Materials, 2019). This is why long bridges in the back of the mouth are not made in E.max.
How to care for E.max crowns
Caring for E.max crowns means normal daily hygiene (brushing twice a day, flossing and interdental brushes), check-ups as often as your dentist advises based on your individual risk (for many people, every six months) to catch wear or loosening early, and a night guard if you grind your teeth, without which the crown may not last as long. Avoid unusual loads, such as opening bottles with your teeth.
E.max crowns: book a consultation in Jerusalem
E.max crowns are one of the conservative ways to restore a tooth with a full crown, with limited removal of healthy tooth structure and a result very close to a natural tooth. They are especially suitable when the goal is to keep the natural tooth and blend it into the smile. The clinic's approach is simple: a natural tooth that can be saved is usually better than a replacement, and many teeth can be saved.
To book a full consultation with Dr Haim Aseriel, a US-trained dentist (NYU College of Dentistry), including a personal, detailed estimate, contact the clinic at 12 HaTnufa Street in Talpiot, south Jerusalem.
E.max crowns: frequently asked questions
An E.max crown is made of ceramic, which does not pick up stains the way natural teeth or composite fillings do, so its shade usually stays stable for years. On the other hand, the crown does not respond to whitening: according to the American Dental Association (ADA), whitening works only on natural teeth, not on crowns, so whitening done after the crown is bonded will not change its shade.
Yes, in most cases. A tooth that has had root canal treatment needs a permanent restoration without delay, sometimes after a core build-up: in a retrospective study, teeth restored 60 days or more after root canal treatment were 73% more likely to be extracted. When the tooth is very dark or little tooth structure remains, the dentist may prefer a more opaque and stronger material such as zirconia.
An E.max crown covers the whole tooth and suits a tooth that is badly damaged, broken or root canal-treated. An E.max veneer is a thin shell bonded only to the front surface of a mostly healthy tooth to improve its color and shape, and it requires removing much less tooth structure.
Sources
- Sailer I et al., Dental Materials, 2015 – Link to study
- Sulaiman TA et al., Journal of Prosthetic Dentistry, 2015 – Link to study
- Špehar D & Jakovac M, Acta Stomatologica Croatica, 2024 – Link to study
- Benalcazar Jalkh EB et al., Journal of Esthetic and Restorative Dentistry, 2024 – Link to study
- Brandt S et al., Materials, 2019 – Link to study
- Fee PA et al., Cochrane Database of Systematic Reviews, 2020 – Link to study
- American Dental Association, Whitening (Oral Health Topics), 2022 – View the page
- Sadaf D, Therapeutics and Clinical Risk Management, 2020 – Link to study
