Question: Hi there, I am a 51 year old woman in pretty good health. In 2004 I had my 4 front teeth removed and porcelain crowns put in. It has become apparent that they were not sealed well enough, so over time decay has set in behind the crowns. They must now be removed and new ones inserted. My financial situation has changed considerably since then and the insurance I have now only covers porcelain infused over metal crowns. It would cost me another $600 per tooth if I want porcelain. I had never heard of these other ones so I would like your input on the aesthetics and longevity of the porcelain infused over metal.Thank you for your time and opinion

 

Answer: The porcelain fused to metal(PFM) crowns have been around much longer than all porcelain crowns. They are known for strength and I typically do these on back teeth. They do work well on front teeth but can be more challenging to make them look esthetic. I would talk with your dentist about doing the PFM crowns but it will be much more difficult to match the esthetics that you had with all porcelain crowns. I like the all porcelain better but if done correctly the PFM crown can be acceptable as well. My biggest concern is that if they are designed corrected or even if your gums even slightly recede, you can possibly see dark line or metal hue around where the gum has receded. If you have ever seen someone smile and you see a dark color or gray hue around the gum, it is likely it is PFM crown. With an all porcelain crown, even with recession it is not as visible. All porcelain is typically my choice, if and only if your bite will allow it.

 

Dr.G

 

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