9 Steps in Getting a Dental Crown at Picasso Dental Hanoi

A dental crown is one of the most versatile and commonly performed restorative procedures in dentistry. It is used to restore a tooth that is too damaged for a filling but still has a healthy root — protecting it, restoring its shape, and allowing it to function normally for many years. Crowns are also placed over implants, used as the anchors for dental bridges, and applied to teeth that have undergone root canal treatment to protect them from fracture.

Despite how common crowns are, many patients arrive at their first appointment without a clear picture of what the process actually involves. How many visits are needed? What does the dentist actually do to the tooth? What happens in between appointments? These are reasonable questions that deserve straightforward answers.

This guide walks through the nine steps of the dental crown process at Picasso Dental Clinic in Hanoi — from the clinical assessment at step one through the final check and aftercare advice at step nine. Understanding each stage removes uncertainty and helps patients arrive prepared, which consistently leads to better clinical experiences and outcomes.

Step 1: Clinical Assessment and Diagnosis

The crown process begins with a thorough examination of the tooth that has been identified as requiring a crown. This is not simply a visual inspection — the dentist uses a combination of clinical instruments, digital X-rays, and clinical probing to assess the full extent of the tooth’s condition.

The dentist is evaluating several things at this stage. First, is the tooth restorable with a crown, or has the damage progressed to a point where the tooth requires extraction? A tooth with a vertical root fracture extending below the bone level, or with insufficient remaining structure to retain a crown, cannot be saved by crowning alone. Second, is there any active infection or pulp involvement that needs to be treated before the crown is placed? A crown placed over an untreated infection seals the bacteria inside, which leads to treatment failure. Third, what is the bite situation around the tooth — are there opposing teeth that will place abnormal forces on the crown once it is in place?

If the X-ray reveals the pulp is compromised, root canal treatment is completed before the crown procedure begins. If the tooth is found to be unrestorable, the conversation shifts to extraction and dental implant planning. In straightforward cases where the tooth is restorable and the pulp is healthy, the crown process proceeds directly.

Step 2: Treatment Planning and Material Selection

Once the diagnosis is confirmed, the dentist and patient discuss the most appropriate crown material for the situation. This decision involves several clinical and aesthetic factors.

Zirconia crowns are the standard recommendation for posterior (back) teeth — premolars and molars — because they combine excellent strength with reasonable aesthetics. Modern monolithic zirconia has flexural strength of 900–1200 MPa, far exceeding the forces generated during normal chewing, making it highly resistant to fracture even under heavy bite loads. Zirconia is also biocompatible and does not provoke gum irritation.

Emax (lithium disilicate) crowns are recommended for anterior (front) teeth and premolars where the primary concern is matching the natural appearance of adjacent teeth. Emax has superior translucency and light-reflective properties compared to zirconia, allowing skilled ceramists to create restorations that are indistinguishable from natural enamel. Its flexural strength of approximately 400 MPa is sufficient for front teeth but makes it less ideal for the high-force demands of molar positions.

PFM (porcelain-fused-to-metal) crowns remain available on request and are appropriate for certain clinical situations, but the clinic’s in-house ceramic lab and digital workflow are optimised for full-ceramic restorations. The dentist will explain the material options and their respective advantages based on your specific tooth, bite, and aesthetic priorities.

Step 3: Tooth Preparation

This is the appointment where the bulk of the clinical work takes place. The tooth preparation appointment takes approximately 60 to 90 minutes depending on the complexity of the case, and is performed entirely under local anesthesia. You will receive the anesthetic injection at the beginning of the appointment and will typically be numb within 5 to 10 minutes.

Once you are anesthetised, the dentist uses a high-speed handpiece with diamond burs to reduce the outer surface of the tooth uniformly on all sides and on the biting surface. The amount of tooth structure removed depends on the material selected — zirconia requires approximately 1.0 to 1.5mm of reduction on all surfaces, while Emax requires similar reduction for anterior teeth. This reduction creates the space needed for the crown to sit over the prepared tooth without making the restored tooth wider than its natural dimensions.

The preparation is shaped to a specific design at the margin — the boundary between the crown and the remaining tooth structure at the gumline. A well-designed margin seals precisely, preventing bacteria from entering beneath the crown. At Picasso Dental Clinic, preparations are completed to a chamfer or shoulder margin depending on the material and clinical situation.

Any decay within the tooth is removed during preparation. If the preparation extends close to the pulp, a protective liner is placed. If significant tooth structure has been lost to decay or fracture, a build-up of composite resin is placed before preparation to create a stable foundation for the crown.

Step 4: Digital Impressions

Once the tooth is prepared, the dentist captures precise measurements of the prepared tooth and the surrounding teeth. At Picasso Dental Clinic, this is done digitally using an intraoral scanner — a handheld device that takes thousands of photos per second and constructs a three-dimensional model of your teeth in real time on a screen.

Digital impressions are more accurate than traditional putty impressions, which can distort during the time between impression-taking and pouring of the stone model. The digital file can be inspected immediately on screen, and any areas of the scan that are unclear can be rescanned before the patient leaves the chair. The digital file is then sent directly to the in-house lab’s CAD/CAM design station, where the crown technician uses it to design the crown.

The scan also captures the opposing teeth (the ones that bite against the prepared tooth), the adjacent teeth, and the relationship between the upper and lower jaws — all information the technician needs to design a crown that fits precisely in three dimensions.

Step 5: Shade Selection

For anterior (front) teeth and premolars where aesthetics matter, the shade selection appointment is a careful process. The dentist uses a standard shade guide — typically the Vita Classical or Vita 3D Master system — to identify the natural colour of the adjacent teeth.

Shade selection should ideally be done at natural light or under specific clinical lighting conditions, not under the artificial overhead lighting used in many dental operatories. Picasso Dental Clinic’s consultation rooms use calibrated shade-matching lighting to ensure the ceramic shade selected by the technician matches the patient’s natural teeth accurately.

For posterior teeth, shade selection is simplified — a standard tooth colour that blends with the natural dentition is sufficient without the nuanced shade matching required for highly visible front teeth.

Step 6: Temporary Crown Placement

After tooth preparation and impression-taking, the prepared tooth must be protected while the permanent crown is fabricated — a process that takes 5 to 7 days in the lab. A temporary crown is fabricated chairside, typically from acrylic resin, and cemented with temporary cement.

The temporary crown serves several functions. It protects the prepared tooth from sensitivity, prevents adjacent teeth from drifting into the preparation space, and restores normal eating function during the waiting period. It also gives the patient a preview of approximately how the final crown will look and feel in terms of size and position — though the temporary crown is not designed to match the colour and surface quality of the final ceramic restoration.

Temporary crowns are not permanent and require care. Patients are advised to avoid chewing sticky or very hard foods on the temporary crown side, to floss gently around it rather than lifting the floss vertically (which can dislodge the temporary), and to contact the clinic if the temporary crown comes off before the permanent crown appointment. Replacement of a dislodged temporary is a routine procedure that takes 15 minutes.

Step 7: Crown Fabrication in the Dental Laboratory

While the patient is away between appointments, the dental technicians at Picasso Dental Clinic’s in-house digital lab fabricate the permanent crown from the digital design based on the intraoral scan.

The technician first designs the crown using CAD (computer-aided design) software, adjusting the anatomy, contact points with adjacent teeth, and marginal fit to precise specifications. For zirconia crowns, the design is then milled using a CAM (computer-aided manufacturing) machine that mills the crown shape from a solid zirconia block. The milled crown is then sintered in a furnace at temperatures exceeding 1400°C, which increases its density and final strength. The sintered crown is then individually characterised by hand — the technician applies surface staining and glazing to replicate the natural colour variations, surface texture, and translucency of a real tooth.

For Emax crowns, the process uses heat-pressing or CAD/CAM milling depending on the specific clinical indication, followed by hand-applied layered porcelain characterisation in some cases.

The quality control check before the crown leaves the lab verifies the margin fit against the digital model, the occlusal contacts, and the shade against the original shade prescription.

Step 8: Crown Try-In and Permanent Cementation

At the second appointment, the temporary crown is carefully removed and the permanent crown is tried in before cementation. This try-in step is non-negotiable — it confirms that the crown fits accurately at the margin, that the contacts with adjacent teeth are correct, and that the bite is even when the patient closes down.

The dentist checks the marginal fit visually and with a probe, ensures there is no gap between the crown and the tooth at the margin, and uses articulating paper to verify that the bite contacts are distributed correctly across the crown. If any adjustment is needed, the crown is returned to the lab or adjusted chairside using fine diamond burs.

Once the fit is confirmed and the patient has approved the shade and appearance, the crown is cleaned, the prepared tooth is conditioned, and the permanent cement is applied. The cement used depends on the crown material and the clinical situation — some zirconia crowns are resin-cemented for maximum adhesion, while others are glass-ionomer cemented based on the preparation geometry. Excess cement is carefully removed from all margins and from between the teeth.

Step 9: Bite Check, Polishing, and Aftercare Instruction

After cementation, the dentist performs a final bite check using articulating paper, making minor adjustments to ensure the crown does not hit prematurely in any position — centric occlusion, lateral excursions, or protrusive movement. A single high spot on a newly cemented crown, if left unaddressed, causes cumulative bite discomfort that can progress to pain in the jaw joint.

The crown is polished to a smooth surface gloss and the gumline is checked to ensure no cement has been left beneath the gumline, which would cause gum inflammation in the weeks following cementation.

Before leaving the appointment, you receive specific aftercare guidance for the first 24 to 48 hours — avoiding very hard foods while the cement fully cures, managing any sensitivity with mild pain relief, and knowing what to contact the clinic about if needed. You are also given documentation of the crown material, shade, and the lab that fabricated it — important information for any future dental work.

The crown is fully integrated into your bite and ready for normal use. For international patients, the clinic can provide a written clinical summary to share with your home country dentist for ongoing records.

When to Consider a Crown vs. Other Options

Crowns are not the only restorative option for a damaged tooth. If less than 50% of the tooth structure is compromised by decay or fracture, a large composite resin filling or an inlay/onlay (a partial crown covering only the damaged surfaces) may be sufficient. Crowns are indicated when the damage is extensive enough that a filling alone cannot restore the tooth’s structural integrity or protect it adequately from fracture.

For teeth where the damage is too severe even for a crown, dental implants — following extraction — remain the gold standard tooth replacement option. The implantologist and restorative dentist at Picasso Dental Clinic work collaboratively to recommend the most conservative option that achieves a clinically sound result.

To discuss whether a crown is the right treatment for your specific tooth, contact Picasso Dental Clinic to arrange an assessment at the Old Quarter clinic at 16 Chau Long, Ba Dinh, or the Westlake Square location.

Dental Crown — Overview of crown treatments, materials, and pricing at Picasso Dental Clinic
8 Differences Between Zirconia and Emax Dental Crowns — Which material is right for your tooth
5 Signs You Need a Dental Crown (Not Just a Filling) — When to upgrade from a filling to a crown
6 Differences Between Temporary and Permanent Crowns — What to expect in between appointments
10 Common Reasons for Crown Failure — How Picasso Dental prevents the most common problems
7 Signs Your Old Dental Work Needs Replacing — When existing crowns and restorations have run their course
Root Canal Treatment — Often completed before crown placement for infected teeth
7 Reasons Porcelain Veneers at Picasso Dental Cost a Fraction of US Prices — Why veneer costs in Vietnam are dramatically lower