Why Would a Doctor Put a Metal/porcelain Crown in the Mouth? (photo)

Cracked molar....it was suggested to have a crown which ended up being a 2 tone crown!? In addition, he didn't even match the color of the other teeth. They offered to fix it and get a porcelain crown but that it would be in danger of getting close to the nerve/root?

Doctor Answers 8

PFM crown with metal occlusal surface

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The metal occlusal surface is usually made for those who grind the teeth heavily. The question how the crown will look like is usually discussed before the tooth is preped for the crown. The is a lack of communication between the dentist and the patient definitely. Before any crown is cemented is should be shown and approved by the patient before it is cemented. If you`re not happy with your current crown you should talk to your dentist, so he can change it. BTW porcelain crown for a molar is not a good idea. 


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Despite many years of successful clinical track records with non metal crowns, some dentists only do all porcelain crowns by request.  Functionally there is nothing wrong with what you have, and that is how many (if not most) dentists operate today.


Replacing as your dentist suggest carries a very low risk of nerve damage, so I would take them up on their offer.  In the end, it should work out just fine.

Durability of Crowns

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Thanks so much for your question!  Dentists wear two hats--that of an "engineer" and that of a "beautician".  Often times it is possible to combine the two roles to offer patients options that are both durable and esthetically-pleasing.  It's not uncommon to do high-noble metal crowns (usually full gold) or porcelain crowns with a metal base on molars.  Although there are more-esthetic options available, these are the restorations that can best withstand the force of your teeth coming together.  Of the two, a porcelain crown with a metal base can be matched to the shade of your other teeth.


Why put a metal crown on a tooth?

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Porcelain to metal crowns are still the norm, they are the strongest and fracture the least. In most cases most dentist will consider covering second molars with all metal for strength. With metal crowns you have to reduce your natural tooth less!!! because the metal is stronger than porcelain. When the patient wants all porcelain in order to have the porcelain strong enough and thick enough we have to reduce your natural tooth more increasing risk of root canal on the tooth. Good luck

Kevin Coughlin DMD, MBA, MAGD      CEO Baystate Dental PC

Kevin Coughlin, DMD
Springfield Dentist

Metal crowns

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A lot of the crowns I do today are replacing an old metal based crown with all porcelain. The technology today is at the point that for a single crown there is no reason it can not be all porcelain. I would have them replace the crown with either emax or zirconia, They are strong, kind to the opposing tooth, and better accepted by your tissues then metal. There is always risks with any dental treatment but it is low and if it were me I would have it redone. 

Thomas R. Froning, DDS
Littleton Dentist

Metal on crown

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Some dentist still believe the best crown is porcelain fused to metal in one way or another.  The metal on the biting surface was supposed to prevent people that grind from breaking the porcelain on the crown, the porcelain on the cheek side of the tooth was for aesthetics.  If you are going to go as far as to have metal showing on 3/4 of a crown, you may as well go all metal in my opinion.  In our office, we have chosen to go with a very durable, more aesthetic option - the Zirconia crown.  They are very strong and look great.  I would take him up on the offer to replace it if you are not happy.  Your dentist should be able to remove the crown in place with very little chance of causing damage to the nerve. 

Don W. Ririe, DDS
Portland Dentist


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are you able to wear ear rings that are not gold? does cheap jewelry give you skin sensitivity? Women especially have a high rate of metal sensitivity and can lead to gingival recession, sensitivity, etc.. All crown prep procedures include possible nerve issues. Is the tooth sensitive now? Was the tooth cracked? Why was the crown put on? All these questions are important to decide what to do next. As for crown material strength and esthetics you can choose Zirconium, lithium discilicate, feldspathetic porcelain, porcelain fused to metal, or all gold. I would favor the lithium disciliate option or Emax due to its properties and esthetics. The crown will have to be prepped differently at the gingival margin in order to get a proper marginal seal and the chewing surface may also need to be adjusted. Porcelain needs more space to get max strength which could get closer to the nerve. But in the end you pay alot of money to get a crown that is "ugly" even though no one will see it you have to live with it.

J. Willis Baker, DDS
Wichita Dentist

Technically it works right

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technically speaking it will work ok, however aesthetically it is not the correct choice. if you are a grinder, probably this was the best choice your dentist had but i believe that a full porcelain on top and metal below crown would work fine for you. Now, that crown can be removed and place a new one that matches the color of the rest of your teeth.

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.