Porcelain-fused-to metal (PFM) crowns used to be the industry solution for the most natural-looking restorations in high-stress areas. Because ceramic wasn’t strong enough to serve as a crown by itself, a thin layer of it was bonded to metal for structural integrity.
The purpose of this was to create a durable and naturalistic replacement for damaged teeth, but the reality is that PFM crowns didn’t provide either. Compared to full porcelain crowns, which offer both beauty and functionality, PFM crowns can’t compete, and here’s why.
The Porcelain Chips Easily
Designed to utilize ceramic, which wonderfully imitates the gleam of natural enamel, PFM crowns were supposed to be a sustainable solution. The problem is that the porcelain overlay is often too thin, causing unrepairable cracks or chips in the material.
With current dental technology, full ceramic crowns have solved this problem, standing up against the daily wear of teeth. In fact, modern ceramics can be as strong as any metal used in dentistry–even titanium! That means that nowadays, there’s no reason not to use full ceramic crowns in every situation.
One unfortunate drawback of PFM crowns is the metal understructure visible from certain angles, especially at the gumline. This should be concealed by the gums, but if you experience receding gums after crowns have been placed, the margin becomes visible. While this could be related to the increased risk of gum disease with age, another possible cause could be the metal crowns themselves, which often irritate gum tissue and increase the likelihood of gum recession.
While periodontal disease is still a risk factor with full porcelain crowns, there is no embarrassing metal to be seen. And if you do experience receding gums, the ceramic crowns make a hospitable environment for Chao Pinhole ® gum rejuvenation treatment.
What’s the Best Bang For Your Buck?
There are several types of crowns other than PFM, all with their advantages and disadvantages. For example, metal crowns are durable, and work well with natural teeth, but show easily in our mouths.
Now that we have ceramics that are strong enough to handle nature bite forces, full ceramic crowns are generally superior, and should be your choice if you have a failing PFM crown. Natural teeth have a special kind of translucency created by our enamel replicated perfectly by high-quality ceramic, meaning that full ceramic crowns can have both the durability and beauty of natural teeth.
Ceramics are also completely hypoallergenic, and highly biocompatible with gum tissue.
As with everything in life, there are no perfect solutions. Preparation time and cost may be higher with full ceramic crowns. However, considering the difference in quality, this could be worth it. If you’re considering crowns, the first step is scheduling an appointment and meeting with your dentist to discuss the pros and cons in greater detail.