Porcelain crowns have been popular for a long time due to the fact that it is aesthetic and natural looking.  Full porcelain crown were often used on front teeth as they look good. Unfortunately they can fracture with high forces. Nowadays there are stronger, aesthetic materials available to use instead. Porcelain is still used to coat a strong substructure made from zirconium, which gives a strong, yet very natural looking result.

Full Porcelain Crown

For back teeth, porcelain-fused-to-metal crowns have been the ‘gold standard’ for crowns for a very long time.  Porcelain-fused-to-metal crowns have been used since the 1950’s.

Porcelain-fused-to metal crowns

Porcelain-fused-to-metal dental crowns (PFM’s) are still very popular today as they provide a good, predictable result and do not cost as much as many of the newer all ceramic options.

PFM’s have a dental alloy substructure that is constructed to fit on the tooth/ root.  Porcelain is then layered over the metal and fused in an oven at a high temperature.  The porcelain provides the desired color and shape.

Porcelain-fused-to-metal crown

Advantages

• Affordable: PFM’s are a lot more affordable than the newer, all-ceramic options.
• Durable: Porcelain-fused-to-metal crowns are very strong and can be used successfully on back teeth.
• Aesthetic: The porcelain comes in many shades and the technician can use a combination of these when building up the crown, in order to get a natural looking result which looks good – even on front teeth.
  

  Natural appearance 

Disadvantages

• The porcelain can fracture: Although porcelain-fused-to-metal crowns are strong, it is possible for the porcelain to chip or break, exposing the metal substructure.  If it is a back tooth it may be possible to retain the crown, but usually the crown will need to be replaced as it is difficult to repair porcelain.
  

  Fractured PFM crown

• Metal substructure is not translucent: Due to the metal, it is impossible to create a crown with the translucency of a natural tooth. This may mean that the crown often doesn’t look as natural as we would like it to.
• Opposing tooth may wear down. As the porcelain is very hard, the tooth opposing the crown may wear down, especially in people who tend to grind their teeth.  In these cases full metal crowns should be considered for back teeth.
• Dark line showing: Due to the metal substructure, a dark line may be visible at the edge of the crown which can be very unsightly.
  

  Dark line showing

• Allergy to the metal: PFM’s may not be suitable for people with a metal allergy.   Full porcelain or other metal-free options should be considered.

Indications for a porcelain-fused-to-metal crowns

• Restoring weak, decayed or broken teeth.
• PFM’s can help to prevent a tooth – weakened due to decay, root canal treatment, large fillings etc. from fracturing.
• To hold a bridge in place (a bridge abutment)
  

  Use for Bridges

• It can be placed on dental implants
  

  Crown to fit on implant

• Improving the appearance of discolored or misshapen teeth.
• Suitable for use on front and back teeth.