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Porcelain fused to metal (PFM) crowns and bridges have been used for many years. They have a precious metal alloy substructure covered with lifelike porcelain to create an aesthetically pleasing result. They are strong and durable and can last for years. A PFM restoration is more affordable than all ceramic crowns and bridges, and modern porcelains can be closely matched to your existing teeth, creating a natural and lifelike appearance.
However, over time the gum around the margin can gradually recede, exposing the edge of the crown. Because the crown has a metal substructure, it tends to be greyer around the margin, and the receding gum can expose this metal, creating a dark line. A greyer appearance around the margin can also be a problem for people with naturally thinner gum tissue. Some people have metal allergies that make them less suitable for porcelain fused to metal crowns. Also, we need to remove more of the tooth to place a PFM crown.
Zirconium is a newer material that is entirely metal-free, creating a highly aesthetic appearance. The latest zirconia crowns have translucency and liveliness, making them appear entirely natural. They are a popular choice for restoring front teeth but are strong enough to restore any tooth in the mouth.
Because zirconia crowns do not contain metal, they are perfect for anyone with metal allergies or who would prefer to have metal-free restorations. There is no risk of a dark line developing around the margin, and these crowns and bridges are precision made using digital dentistry, so they fit extremely well, creating a tight seal that protects the tooth underneath. Zirconia is very biocompatible and is even suitable for people with bruxism. A special type of zirconia for bruxism ensures the opposing teeth will not become damaged or worn down.
The disadvantage of zirconia crowns and bridges is their price. This is a premium material; crowns and bridges are more expensive to produce, but they are long-lasting with the right aftercare.
Emax is an all-ceramic called lithium disilicate, and the restorations are created from a single block of pre-shaded material that is hand-finished and characterised. They are very translucent and are excellent where aesthetics is a concern, for example, when restoring front teeth. However, although relatively strong, Emax restorations are not as durable as zirconia and are unsuitable for bridges. They also tend to cost more than zirconia or PFM crowns.