Crown vs large composite filling: when to refer to the lab

<p>The structural question comes first. If the remaining coronal tooth structure is under 50%, or a cusp is undermined by the existing prep, the restoration needs cuspal coverage. A direct composite cannot deliver that reliably on a posterior load-bearing tooth. The five-year literature is consistent on this: large MOD composites on molars survive at 70-85%, while monolithic zirconia and lithium disilicate crowns sit at 94-97%.</p><p>Two decision rules worth holding: <strong>choose a lab-fabricated crown when the tooth has under 50% remaining structure, an endodontically treated molar, or documented parafunction</strong>. <strong>Go with a large direct composite when at least two walls are intact, cusps are fully supported, and occlusal load is moderate</strong>. The middle ground, two intact walls but one undermined cusp, is where an indirect onlay often beats both: it preserves more tooth than a full crown and delivers cuspal coverage a composite cannot.</p><p>Cost and chair time favor composite on the day of treatment. Survival curves favor the crown by year five. Frame the conversation around the structural finding, not the price tag.</p>

<p>Dani Dental fabricates the crown side of this decision. When a referring dentist scans a prep and sends the case, the assigned ceramist (named on the case ticket, reachable by direct line, response within 4 business hours) owns the restoration from design through seat. Remake rate on monolithic zirconia and lithium disilicate sits under 2.5%, and standard turnaround is 5-7 business days from scan receipt to ship.</p><p>That said, if the case genuinely calls for a large direct composite, a crown referral is the wrong call. Single-visit chairside dentistry is faster, cheaper, and clinically appropriate when the structural criteria are met. The honest read: Dani Dental is the right answer when the indication is indirect. When it is not, save the chair time.</p>