D6605 Dental Code: Crowns – Porcelain/Ceramic Substrate

Dental procedures are categorized using standardized codes to ensure uniformity in billing and treatment documentation. One such code, D6605, refers to the placement of a porcelain/ceramic crown on a tooth. This code is specifically used when a high-strength ceramic material (such as lithium disilicate or zirconia) is used to restore a damaged or aesthetically compromised tooth.

Porcelain/ceramic crowns are highly popular due to their natural appearance, durability, and biocompatibility. Unlike metal or porcelain-fused-to-metal (PFM) crowns, all-ceramic crowns provide superior aesthetics, making them ideal for front teeth and visible areas.

This article will explore the indications, procedure, materials, costs, and clinical considerations of D6605 crowns, providing a comprehensive guide for dentists, dental students, and patients.

2. Understanding Porcelain/Ceramic Crowns

Porcelain/ceramic crowns are full-coverage restorations that encase the entire visible portion of a tooth. They are fabricated using advanced ceramic materials, which offer:

✔ High Esthetics – Mimics natural tooth translucency and shade.
✔ Biocompatibility – No metal, reducing allergy risks.
✔ Strength – Modern ceramics (e.g., zirconia, lithium disilicate) withstand occlusal forces.

Types of Porcelain/Ceramic Crowns

3. Indications for D6605 Crowns

D6605 crowns are recommended for:

• Severely decayed teeth that cannot be restored with fillings.

• Fractured or cracked teeth requiring full coverage.

• Teeth with large existing fillings at risk of further damage.

• Cosmetic enhancements for discolored or misshapen teeth.

• Post-root canal treatment to protect the tooth.

4. Contraindications and Limitations

While ceramic crowns are versatile, they may not be suitable for:

• Patients with heavy bruxism (unless high-strength zirconia is used).

• Cases requiring extreme precision in occlusion (metal crowns may be better).

• Patients with insufficient tooth structure (may require a post-and-core buildup).

5. Materials Used in Porcelain/Ceramic Crowns

A. Lithium Disilicate (e.max)

• Pros: Excellent aesthetics, moderate strength.

• Cons: Less durable than zirconia for molars.

B. Zirconia

• Pros: Extremely strong, good for bruxers.

• Cons: Less translucent than e.max.

C. Feldspathic Porcelain

• Pros: Highly aesthetic.

• Cons: Brittle, not ideal for load-bearing teeth.

6. Step-by-Step Procedure for D6605 Crown Placement

1. Diagnosis & Treatment Planning (X-rays, impressions).

2. Tooth Preparation (reduction of enamel).

3. Digital Scanning or Impression Taking.

4. Temporary Crown Placement.

5. Lab Fabrication (2-3 weeks).

6. Final Crown Cementation.

7. Comparison with Other Crown Types

8. Advantages and Disadvantages

Pros:

✔ Natural appearance.
✔ Metal-free (hypoallergenic).
✔ Durable with proper care.

Cons:

✖ More expensive than PFM.
✖ May wear opposing teeth over time.

9. Cost and Insurance Coverage

• Average Cost: $1,000 – $2,500 per crown.

• Insurance Coverage: Usually covers 50% (if medically necessary).

10. Common Complications and Prevention

• Chipping – Avoid excessive force.

• Debonding – Ensure proper cementation.

• Gum Irritation – Check crown margins.

11. Case Studies

Case 1: A 35-year-old patient with a fractured front tooth received a lithium disilicate crown (D6605) with excellent functional and aesthetic results.

12. FAQs

Q: How long do porcelain crowns last?
A: 10-15 years with proper care.

Q: Can D6605 crowns be used for molars?
A: Yes, especially zirconia crowns.

13. Conclusion

The D6605 dental code represents high-quality porcelain/ceramic crowns, offering superior aesthetics and functionality. Proper case selection, material choice, and technique ensure long-term success. Patients benefit from natural-looking, durable restorations, making D6605 a preferred choice in modern dentistry.

14. Additional Resources

• American Dental Association (ADA) – www.ada.org