Mix and Match Porcelain-Fused-to-Metal Crown and All-Porcelain Crowns?

Question

I have fewer than half my teeth left and plan to get a bunch of crowns/bridge work done. The dentist plans to use ALL Porcelain-fused-to-metal crowns, so that everything is consistent/symmetrical/predictable. I asked about using all-porcelain in the front-top teeth and metal in the back, but he said that the metal-infused ones will look darker when the sun hits then vs. the porcelain in the front that will allow more light to pass through. Is this a VERY noticeable difference?

Joseph H. Hidalgo, DDS · Answer

I would use all porcelain crowns in your smile zone. You can take a photo of your self on your phone while smiling and count how many teeth you see in your smile. Those are the teeth I would use as All porcelain crowns. The remaining back teeth can be restored with PFM crowns. I will tell you that all porcelain crowns look superior to PFM crowns around the gums. PFM crowns can leave a darkness around the gums because of the metal. However, the all porcelain crown can break even if it is bonded to your tooth. If you grind or clench your teeth, then you should wear a night guard to protect your investment and your all porcelain crowns. I have had PFM crowns break as well but not as often. Hopefully, I have not confused you. Not knowing what your teeth look like now makes it hard to be definite. Hope this helps.

B. Curtis Neal, DDS · Answer

Hello, I am glad that you have chosen to undergo this treatment as it can be a life changing one. The main difference between porcelain fused to metal(PFM) and full porcelain crowns and bridges are the translucency of the material. Before we had high strength porcelain ceramic restorations, PFMs were the material of choice. They provide a strong foundation for a crown or bridge and a much more natural esthetic look than a full metal. However, in order to block the metal from showing through an opaque layer of porcelain is used to cover the metal substructure which blocks light and prevents the teeth from having a natural translucency. Today, we have high strength ceramics that hold up relatively well to the forces our teeth are subjected to, but are also made from more translucent material that looks more natural. So, to answer your question, the full porcelain ceramic restorations would look noticeably different because of this difference in translucency but a skilled lab technician may be able to disguise it well. Though I don't know the specifics of your case, you may ask your dentist about using full porcelain ceramic instead for an ideal esthetic result.

Mix and Match Porcelain-Fused-to-Metal Crown and All-Porcelain Crowns?

Answers (2)