D6604 Dental Code: Crown – Porcelain/Ceramic Substrate

The D6604 dental code, as defined by the American Dental Association (ADA), refers to a crown restoration made primarily of porcelain/ceramic substrate. Unlike porcelain-fused-to-metal (PFM) crowns (D2740), this code applies to all-ceramic or full-porcelain crowns, which are highly aesthetic and biocompatible.

This code is essential for dental billing and insurance claims, ensuring accurate documentation of the procedure. Porcelain/ceramic crowns are widely preferred for their natural appearance, making them ideal for front teeth restorations.

2. Understanding Porcelain/Ceramic Crowns

Porcelain and ceramic crowns are tooth-colored restorations designed to mimic natural teeth. They are fabricated using high-strength ceramics such as:

• Lithium disilicate (e.g., IPS e.max)

• Zirconia-reinforced ceramics

• Feldspathic porcelain

These materials provide exceptional aesthetics while offering durability comparable to metal-based crowns in certain cases.

Key Features:

✔ Aesthetic Excellence – Blends seamlessly with natural teeth.
✔ Biocompatibility – No metal, reducing allergy risks.
✔ Stain Resistance – Less prone to discoloration compared to resin crowns.

3. Indications for D6604 Crowns

Porcelain/ceramic crowns (D6604) are recommended for:

• Anterior teeth restorations (front teeth) where aesthetics are critical.

• Patients with metal allergies or sensitivities.

• Teeth with extensive decay or fractures that cannot be restored with fillings.

• Cosmetic enhancements for discolored or misshapen teeth.

When Not to Use D6604 Crowns?

• Bruxism (teeth grinding) patients – May require stronger alternatives like zirconia.

• Molar teeth under heavy chewing forces – Metal or PFM crowns may be better.

4. Materials Used in Porcelain/Ceramic Crowns

5. Step-by-Step Procedure for D6604 Crown Placement

1. Tooth Preparation – Removal of decay and shaping the tooth.

2. Impressions – Digital or traditional molds sent to the lab.

3. Temporary Crown Placement – Protects the tooth while the permanent crown is fabricated.

4. Crown Fabrication – Custom-made in a dental lab.

5. Crown Cementation – Permanent bonding using dental adhesive.

6. Cost and Insurance Coverage

The average cost of a D6604 crown ranges from $1,000 to $2,500 per tooth. Insurance may cover 50-80% if deemed medically necessary.

7. Common Complications & Solutions

• Chipping or Fracture – Can be polished or repaired with composite.

• Debonding – Requires re-cementation.

• Gum Irritation – Proper margin fit reduces this risk.

8. Conclusion

The D6604 dental code represents a high-quality, aesthetic solution for damaged teeth. Porcelain/ceramic crowns offer superior aesthetics, biocompatibility, and durability for anterior restorations. While they may not be ideal for all cases, advancements in materials like zirconia and lithium disilicate have expanded their applications.

9. FAQs

Q1: How long do porcelain/ceramic crowns last?
A: With proper care, they can last 10-15 years or longer.

Q2: Are D6604 crowns metal-free?
A: Yes, they are entirely ceramic/porcelain unless hybrid materials are used.

Q3: Can I get a D6604 crown on a back tooth?
A: Yes, but zirconia may be preferred for durability.