PFM Crown Warranty/Guarantee? And Ratio Metal to Porcelain?

Every patient wants a long-term, long-lasting result from their dental care. As a dentist, I want it to last a really long time for you as well.

After more than twenty years in practice here's how I handle it. We have no specific written warranty. There are MANY factors that can affect how long it lasts. However, I stand behind my work and want my patients to be happy. IF you had one of those very rare circumstances that you damaged some of my dental work, if it was the first year or two I would probably just replace it for you at my cost. I have found that IF there is any sort of issue, it tends to show up fairly quickly.

As a cosmetic dentist I am concerned about creating the BEST looking crowns possible. For back teeth we also need to make them very strong as well.

The types of crowns we can make on your molars have improved (with great supporting research as well) and I find I am NO longer doing aPFM (porcelain over metal) type crowns. And we have had NO breakage as well. 

So, my advice is to consider a type of crown that is NOT Porcelain over metal. 

Also- beware there are MANY different types of metals used, the cheaper the costs, the more likely that undesirable metals are also included in the formulation.

First I don't like the word guaranteed in Medicine but the point is most dentist will redo or replace treatment that was recommended as a goodwill gester... the reason if you don't take care of your health the problem is yours not necessarily ours!!! The second question should be what type of metal is being used high noble semiprecious and or base metal that determines the ratio of precious metal to non precious metal. In the US all dentist submit to dental ins. companies and must indicate the type of metal since many times each will have a different fee. Under normal circumstances you want 1-2mm of porcelain covering .5-1.5mm of metal. Good Luck     Kevin Coughlin DMD, MBA, MAGD    CEO Baystate Dental PC

Firstly, medical procedures are never guaranteed.  One does not walk into surgery asking for a gurantee.  Dental medicine should be seen the same way.  A restoration of a severely traumatized tooth that has had history of decay, fracture and multiple restorations has a certain success rate when treated with a full coverage restoration, also known as a crown.  The average longevity of a PFM crown restoration is 90% at 10 years.  If you make sure to keep hygiene impecable and the pulp of the tooth is healthy and the bite is perfect the crown should last you a very long time.  Most clinics will give you a 5 year guarantee as long as you maintain attendance for your regular checkups.  This is because early problems may be easily corrected.  Showing up after 5 year with cavities under the crown and fractures of porcelain usually voids any gurantee either in Mexico or state side.   Your other question as to the ratio of metal to porcelain is rather invalid.  The composition of any crown has to do with the thickness of material layers not percentage composition.  A PFM crown has a metal layer which is the core of the crown, an opaquer layer that masks the dark metal and a veneered porcelain layer that imparts the lifelike characterization of the tooth.  The thicker the porcelain layer is, the more lifelike the crown, but potentially more brittle.  Thickness is limited but the amount of space a technitian is given by the doctor, the more tooth is reduced the thicker the crown. Other materials may be more well suited for this situation, but that is a clinical decision that is made based on tooth and jaw parameters.  Hope this helps. 

Can you really enforce the Mexican guarantee?  I would have my doubts.  Crowns should not be made with any metal any more.  Good crowns are 100% ceramic either zirconia or dilithium silicate.  THey are absolutely proven to have the strength to endure in the posterior.  They don't have the potential for allergic reaction to a base metal undercasting and are more esthetic.  I would advise you use a US dentist who guarantees his work an uses all-porcelain crowns.