Porcelain Fused to Metal Crown

Porcelain on Gold crowns were designed to appear like natural teeth for this Chicago socialite. Restorations with metallic substructures were selected due to this patient's chronic clenching and bruxism habits.

Porcelain on Gold crowns were designed to appear like natural teeth for this Chicago socialite. Restorations with metallic substructures were selected due to this patient’s chronic clenching and bruxism habits.

This type of crown (full tooth coverage restoration) has been the most common option done in dentistry for 35 years. Tooth colored ceramic is baked on top of a metallic alloy substructure called a coping for the ultimate in strength. Although the all-porcelain crown is very strong, there are many circumstances when a porcelain fused to metal (PFM) version is a better choice. The PFM is often used when destructive night grinding is a problem or when long span bridges are needed. The longevity and esthetics of these restorations can vary significantly depending on the quality level of the dentist and laboratory technician team that makes it. Absolutely fabulous esthetic results can be achieved with PFMs if your dentist works with a true ceramic artist.

More example images of PFM crowns below at bottom of page

PFM or POM CROWN QUALITY LEVELS OF  DISCUSSED:  Non-precious vs. high noble gold, translucency, biocompatability

Depending on what market niche your dentist operates in determines what your porcelain-on-metal restoration will look like. The average American dentist will contract with a laboratory to construct a PFM for about $155. This cost is usually hidden and rolled into the fee for service that the dentist charges the patient. An average crown will have a medium quality ceramic fused or baked over a base metal (non-precious alloy or low noble) coping. It will approximate the shape and coloration of a natural tooth. The dark metallic coping will be exposed at the margin or edge yielding a dark or black line at gum. For $60 more, the dentist could request a “porcelain-butt-joint-margin” so if or when the gum receeds, an exposed metal margin will not appear. Because all the lab costs are rolled into the price of the service, patients are rarely informed of what their dentist is selecting and prescribing for them. An inexpensive dental office might pay as little as $35 as a total fee for a mass production laboratory which is often offshore to make your restoration. At this level of quality, the coping will be an inexpensive non-precious alloy and the ceramic will be more opaque. Cheaper alloy does not cast well and will not fit as intimately and has less biocompatibility. Dr. Fondriest uses 14+ carat gold alloys (high-noble alloys primarily containing gold, platinum, palladium) under the veneering ceramic of his restorations. High carat gold’s warm color is easier to mask with the ceramic layers and less tooth reduction is required to make it attractive. High noble gold alloys will cast better producing a much better marginal fit and it is far more biocompatible. High quality laboratories charge the dentist over $500 for a PFM but if the your particular case has complexity or many teeth are being done at the same time the laboratory costs to the dentist can rise to $1000 for each restoration. At this level of quality, PFMs can mimic nature’s beauty.

This Winnetka patient unfortunately lost two of her front teeth in an accident. She brought several detailed photos of her smile as a teenager and wanted us to shape her new teeth just as they were 20 years before.   The damage to her jaw precluded implants. PFM bridgework was created with the tooth shapes that she wanted.

This Winnetka patient unfortunately lost two of her front teeth in an accident. She brought several detailed photos of her smile as a teenager and wanted us to shape her new teeth just as they were 20 years before. The damage to her jaw precluded implants. PFM bridgework was created with the tooth shapes that she wanted.

PFMs were created for this British businessman while on an extended stay in Chicago on the upper front four teeth.   These ceramic supported by metallic alloy restorations can have the translucency of natural teeth.

PFMs were created for this British businessman while on an extended stay in Chicago on the upper front four teeth. These ceramic supported by metallic alloy restorations can have the translucency of natural teeth.

 

Depending on each patient's preferences, restorations can be created to be perfectly symmetrical in shape and alignment or they can be created with the slight asymmetries and blemishes found in natural teeth as these PFM restorations were.  Perfect symmetry is not a natural phenomenon and it is a tell tale for "artificial".  This Northbrook, IL patient even wanted chips to be placed on the edges of her teeth to simulate natural.

Depending on each patient’s preferences, restorations can be created to be perfectly symmetrical in shape and alignment or they can be created with the slight asymmetries and blemishes found in natural teeth as these PFM restorations were. Perfect symmetry is not a natural phenomenon and it is a tell tale for “artificial”. This Northbrook, IL patient even wanted chips to be placed on the edges of her teeth to simulate natural.

Tongue side view of PFMs on the laboratory die immediately prior to insertion. There is a 360 degree ceramic butt joint margin with absolutely no metal exposed.

Tongue side view of PFMs on the laboratory die immediately prior to insertion. There is a 360 degree ceramic butt joint margin with absolutely no metal exposed.

Dr. Fondriest is proud to serve the Chicago, Illinois area, including the North Shore suburbs of Barrington, Gurnee, Winnetka, Grayslake, Highland Park, Northbrook, Northfield, Vernon Hills, Glenview, Lincolnshire, Deerfield, Libertyville, and Wilmette.