In dentistry, the gold standard was once—and for a long time—gold crowns. Over time, porcelain fused-to-metal (PFM) crowns took this mantle. Better looking (depending on your taste, of course. Pirates and punk rockers aside.) than metal alloys, PFM crowns were the standard-bearer for looks and function, with aesthetic tooth-matching and a hygienic and biological utility that kept mouths clean and healthy. And they didn’t get rejected by many patients with various allergies and biocompatibility issues. PFM crowns have been, for some time, the go-to tooth replacement material, preferred and loved by dentists and patients alike for decades. The rise in newer materials prompts us to take a look at porcelain fused to metal vs zirconia.
PFM crowns are made the way their name describes. A durable porcelain/ceramic material is fused to a metal base, to keep cost relatively low with esthetics at a quality that patients can live and be happy with. Only recently has the world of dental tooth replacement entered an abundance when it comes to tooth-replacement materials. With the advent and now growth of intraoral scanning and CAD/CAM dental labs, we can use more sophisticated materials, like Zirconia, to create both ultra-durable and nice-looking replacements.
As the cost of precious metals can rise and fall, and as porcelain can notably fracture over time, even when fused with metal alloy, it’s worth considering: is there a benefit to the zirconia crown. How does it compare to PFM? Is there an obvious best option? Let’s look into it.
PFM & Zirconia crowns with Dandy
Dandy offers a variety of zirconia and PFM crowns. Explore all the crown and bridge materials offered by Dandy labs!
What is a porcelain fused to metal crown?
Porcelain has been the best-looking tooth replacement in the biz for a long time, long valued for its visual appeal. As a ceramic material, it can be color-matched to surrounding teeth, and looks strikingly like a natural tooth. The underlying metal base typically fuses well to existing tooth structure, so while there can be some visible metal at the gumline, the porcelain that sits on top makes for a nice dental double. As a relatively affordable option, they also are preferred with long-term bridge work is going to be a solution.
Pros of porcelain fused to metal crowns
The continued improvement of crown material technology in dentistry has been iteratirve: whenever a new material is introduced, it has likely been developed, perfected, and even marketed as either more durable, prettier, or more cost-affordable than the existing options.
In the case of PFM crowns, they are prettier than metal, stronger than pure porcelain, and more affordable than almost all newer, more modern options, especially pure porcelain. For bridges, the benefit of metal bases can be a factor—adhering multiple PFM crown bases to a bridge might be easier than multiple single replacements with something like Zirconia.
Cons of porcelain fused to metal crowns
Porcelain and PFM crowns are, unfortunately, going the way of the traditional impression, now that we have digital intramural scanning. They have been a durable, fine-looking tooth replacement for decades, but when compared to ultra-durable zirconia, they are less aesthetically pleasing and less durable. They also may require more complicated implant procedures, because a hand-made PFM crown, determined and fabricated from an impression mold, is a less precise prosthetic than something milled from a digital scan.
Other cons of PFM crowns are not cons by comparison but long-running negatives about the crown type. For one, the metal base leaves a small metal ridge at the bottom of the crown, so that as your gums recede, more of a thin metal band is visible. Another is biocompatibility: metal allergies are more common than with ceramic materials (which are almost nonexistent in a regular patient population), so PFM is off the table for some smiles. And another is their installation, which requires a bit more tooth material to be removed than with other prostheses—remember, the more natural tooth you have, the more likely you’ll enjoy long-term oral health with less complication.
What are zirconia crowns?
Zirconia crowns are a newer material found in tooth replacement—made of a translucent metallic oxide that does a great job approaching the look of natural teeth while still providing unbelievable toughness and durability. The ultra-strong material is typically milled with a machine, to specifications provided by digital scanning. Zirconia has been popular in framework treatments, where the material is layered and masked with porcelain or glass, and also in “monolithic,” full-countour single blocks, milled to fit less-aesthetically demanding locations, like molar and posterior tooth repair.
Pros of zirconia crowns
Zirconia crowns are more expensive than the old-fashioned porcelain and PFM crowns, but compared to some modern materials, still relatively cost-effective. And you get what you pay for: they are much, much more durable and resilient than porcelain. They are biocompatible and won’t cause reactions, last quite long, and do incredible work covering stained and off-color teeth.
Cons of zirconia crowns
Compared to a PFM crown, zirconia can sometimes be too strong: those who have strong jaws and/or grind their teeth at night may find that a zirconia crown could do minor damage to other, opposing teeth. However, some strong biters (those with bruxism) have had success, as zirconia itself will not fracture typically, no matter how strong the jaw. In general, zirconia is a terrific option that is quickly helping make porcelain-fused-to-metal crowns a thing of the past.
For more zirconia crown advantages and disadvantages, you can read this article.
Porcelain fused to metal vs zirconia crowns
So: which do you imagine is “better” between porcelain-fused-to-metal crowns and zirconia crowns?
Durability — Zirconia crowns
When it comes to material strength, Zirconia crowns are a lot more durable than PFM. Because of this, dentists often recommend zirconia crowns for back teeth—it is a good idea to replace the cracked, missing, and otherwise unhealthy molars of patients in need with zirconia. Still a strong choice for posterior replacements and bridges, Zirconia takes the day when it comes to matters of brute strength.
Function — Case-dependent
The functionality of a tooth replacement depends completely on the needs of the smiler and their smile. Patient’s mouths, budgets, and oral health are all different, but the general functionality of a zirconia crown is still typically better than PFM. They are stronger, easier to install, and leave more tooth base, possibly helping long-term hygiene and avoiding gingivitis. They are also biocompatible, so metal allergies are a nonissue. Even when considering all the variables, zirconia is typically a better option for more mouths.
This is before even considering the patient- and doctor-ease with installing zirconia on the heels of digital, intraoral scanning, where visits for impressions are reduced to a single scan, and precise zirconia crowns are implanted much more easily than PFM, because they likely are a better fit with less human error.
Appearance — Zirconia
Zirconia crowns have a degree of translucency, and are better at tooth-matching than their opaque predecessors (like porcelain) by a pretty significant factor. There is no small metal ring at the gumline and no worry of fracturing or discoloring over time as with porcelain. We are reaching an inevitable conclusion—can you figure what it’ll be?
Cost — Affordability: porcelain fused to metal. Quality for dollar: Zirconia
When it comes to aesthetics, durability, fit, and functionality, you get what you pay for. Zirconia crowns are among the most expensive tooth replacement materials on the market because they’re among the best. And when you pay slightly more for one, you have to consider not just the tooth itself but the process. Operating in a world with digital dentistry labs like Dandy means that the path to better-fitting, stronger tooth replacements also includes fewer uncomfortable impressions, less chair time, fewer visits, and less chance of return visits to get the fit just so.
Porcelain fused to metal vs zirconia crowns: which is better?
There is nothing wrong with PFM crowns, but there is a better option (or two) on the market. Zirconia crowns are stronger, fit better, easier to fabricate (with help from digital labs like Dandy), and give your practice trickle-down benefits, like more efficiency, more chair time available to grow your practice, and less waiting time after scanning and deciding on treatment.
The time comes in all industries when technology improves to a point that adoption is a no-brainer. A little cost difference is worth all the benefits for patients and practices when comparing PFM crowns to Zirconia, milled by a lab that has perfect digital measurements from an intraoral scan. You get stronger, longer-lasting, prettier, and more functional replacement crowns with an easier implantation. Zirconia is the way of today, and digital dentistry advancements and do-it-all labs like Dandy are helping clear the way.
