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Question: What's a porcelain fused to metal crown, and should I have one on my front tooth?
Answer: Porcelain isn't strong enough to serve as a dental crown. It requires some kind of reinforcement - being bonded or fused to something stronger underneath.
The most common crown procedure taught in dental school uses porcelain fused to metal. The metal gives strength. But the problem is that the metal is an opaque gray color. Therefore, white opaquers have to be used under the porcelain to create a tooth-colored crown. Therefore, porcelain fused to metal can never have a lifelike translucency.
In addition, they will get a dark line at the gumline over time. Sometimes the dark line can be hidden by the gums, but often the gums will recede over the years and expose the line. This is very noticeable and ugly.
In recent years, technology has been developed for bonding a porcelain crown directly to the tooth. The bonding procedure lends strength, and there is no metal understructure and thus no opaquers need to be used. These all-porcelain crowns can be made to look exactly like a natural tooth so that, even up close, no one can tell the difference from a natural tooth. This is what we prefer to do for our patients. Why have an ugly front tooth when you can have a beautiful one?
Notice in the photos below the flat appearance of the front teeth on the left. After the old porcelain fused to metal crowns were replaced, the new ones are virtually impossible to distinguish from the natural teeth.
Old porcelain fused to metal crowns |
New all-porcelain crowns by Dr. Chal |
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