My Dentist Recommended Porcelain Fused Crowns for my Smile Line (#6-#10). Is This the Best Choice Aesthetically? (photo)

I put my full trust in my dentist initially because of his credibility, but I read a lot online that these can discoloration along the gum line over time. I'm 24 years old, and I am getting these because of cavities along my front gum line and to correct a gap. I already had my teeth prepped and temps put in place. I did not pick a shade for my crowns, does that mean they didn't begin making them? I provided pictures of before and after temps.

Doctor Answers 4

Porcelain Fused to Metal Crowns....the best choice aesthetically?

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All ceramic crowns with no metal generally look much better than porcelain fused to metal crown.  The primary reason is that light passes through all ceramic crowns much like the do with normal teeth.  Porcelain fused to metal crowns often times ends up looking flat and artificial.  Many cosmetic dentists use all ceramic crowns most of the time for front teeth, and reserve porcelain fused to metal crowns more often for back teeth.

Generally speaking, most dentists will pick the shade, matching the crowns to the adjacent teeth.  So he may have already done that and the lab may have already started making them. 

It seems to me that you and your dentist aren't communicating very well.  Suggest you call his office, as he could answer some of your concerns better than I could since I haven't seen you.

If he prepared your teeth for porcelain fused to metal crowns and you decide you want all ceramic non-metal containing porcelain crowns, he may have to change the way he prepared your teeth and take new impressions and make you new temporary crowns.  Also, some insurance plans do not cover the (generally) more costly all ceramic crowns and only the less costly porcelain fused to metal crowns.  Thus, if you change your mind about treatment this late you might incur some additional fees.

Laguna Niguel Dentist

Most Esthetic Restorations for Upper Front Teeth

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Porcelain fused to metal crowns are the least esthetic anterior restoration available today.  They were the standard of care years ago but all porcelain restorations such as empress and emax are far superior appearance wise initially and long term.

Porcelain fused to metal crowns on the front teeth

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I have not placed porcelain fused to metal (PFM) crowns in the anterior for over 15 years with the exception of some captek crowns where I could not block out bleed though of a very discolored tooth.  PFM's are not the most esthetic option due to the fact that there is no light coming through the crown.   How a restoration acts in regards to light is very important.   Three things are critical 1) light has to bounce off in different directions 2) light has to enter and then bounce back in different directions 3) light needs to travel all the way through.

Without light traveling through it is virtually impossible to mimic natural teeth in all conditions.

Hope this helps,

John Schmid DDS LVIF

My Dentist Recommended Porcelain Fused Crowns for my Smile Line (#6-#10). Is This the Best Choice Aesthetically?

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PFM crowns are not my first choice for the front.  A better option would be lithium disilicate (E max) or zirconium, both of which are with no metal and more aesthetic.  If you grind and clench your teeth, then PFM would be stronger.  Until the shade is given to the lab, the crowns have not been made yet.

Murray Bruckel, DDS
Norwalk Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.