Zirconia Crowns vs. PFM Crowns: Which Is Right for You?

Dental crowns are caps placed over damaged or aesthetically compromised teeth to restore function and appearance. Two popular options are zirconia crowns and PFM (Porcelain Fused to Metal) crowns. This guide compares their properties, benefits, drawbacks, and suitability to help you make an informed decision.

What are Crowns?

Crowns are prosthetic restorations that cover a tooth to:

• Protect weakened teeth
• Improve appearance
• Restore chewing function

Choosing between zirconia and PFM crowns depends on durability, aesthetics, cost, and personal needs.

Key Facts About Both Crowns

What Are Zirconia Crowns?

Zirconia crowns are made from zirconium dioxide, a strong, metal-free ceramic material known for its durability and natural appearance.

Good Things About Zirconia:

• Biocompatible: No metal, ideal for allergy-prone patients
• Exceptional strength: Resists fractures, even with heavy biting
• Superior aesthetics: No dark gum lines, blends seamlessly
• Longevity: 94-97% success rate after 5 years

Zirconia is like a super-durable tooth cap, perfect for back teeth where chewing forces are high. Explore layered zirconia crowns for enhanced aesthetics.

Not-So-Good Things:

• Higher cost: $1,200-$2,500 per crown
• Early versions lacked translucency (modern ones improved)
• Insurance coverage may be limited

What Are PFM Crowns?

PFM (Porcelain Fused to Metal) crowns have a metal core (e.g., gold, cobalt-chromium) coated with porcelain to mimic natural teeth.

Good Things About PFM:

• Cost-effective: $800-$1,500 per crown
• Proven history: Widely used for decades
• Reliable strength: Suitable for most teeth
• Insurance-friendly: Often covered more comprehensively

For a front tooth crown with porcelain, PFM offers a balance of cost and aesthetics.

Not-So-Good Things:

• Dark gum line: Metal may become visible over time
• Allergy risk: Metal can cause reactions in sensitive patients
• Porcelain chipping: 12% experience chips
• Shorter lifespan: 85-90% success rate after 5 years

Which Crown Is Best For You?

Pick Zirconia If:

• You have metal allergies
• You prioritize long-term durability
• Aesthetics are critical (e.g., front teeth)
• You grind your teeth (bruxism)
• You need posterior (back) teeth restored

Pick PFM If:

• You’re on a tighter budget
• Your insurance covers PFM
• You need a temporary or short-term solution
• You have no metal sensitivities

Real People Stories

Story 1: Tom’s Back Tooth

Tom needed a crown for a damaged molar and had bruxism. His dentist recommended a zirconia crown because:

• It withstands grinding forces
• It matches natural teeth
• It offers long-term reliability

Seven years later, Tom’s crown remains flawless.

Story 2: Maria’s Front Tooth

Maria chose a PFM crown for a front tooth. After 5 years, gum recession revealed a dark metal line, affecting her smile. She switched to a zirconia crown, which eliminated the line and restored her confidence.

What Do The Numbers Say?

• 5-Year Success Rate:
  • Zirconia: 94-97%
  • PFM: 85-90%
• Failure Causes:
  • Zirconia: Debonding (3%)
  • PFM: Porcelain chipping (12%), metal exposure (5%)
• Patient Satisfaction:
  • Zirconia: 98% satisfied
  • PFM: 82% satisfied

How Much Do They Cost?

Zirconia Crown Costs:

• Range: $1,200-$2,500 per tooth
• Insurance: Partial coverage, varies by plan
• Value: Higher upfront cost, but longer lifespan

PFM Crown Costs:

• Range: $800-$1,500 per tooth
• Insurance: Often covers a larger portion
• Value: Lower initial cost, potential repair expenses

New Crown Technology

Advancements are improving both options:

Zirconia Crowns:

• Multi-layered zirconia: Enhanced translucency for natural aesthetics
• CAD/CAM fabrication: Precision fit
• Custom shading: Matches adjacent teeth

PFM Crowns:

• Biocompatible alloys: Reduced allergy risk
• Improved bonding: Minimizes chipping
• Thinner metal: Less visible at gums

Questions To Ask Your Dentist

• Will gum recession expose a metal line with PFM?
• Do I have bruxism that requires zirconia?
• What’s my insurance coverage for zirconia vs. PFM?
• How long will each crown last for my case?
• Can I preview the aesthetic outcome?

How To Decide

Consider:

• Durability needs: Zirconia for longevity
• Budget constraints: PFM for affordability
• Tooth location: Zirconia for front, either for back
• Allergies: Zirconia for metal sensitivity

What Happens When You Get A Crown

The process takes 2-3 visits:

1. Preparation: Tooth shaping, impression taken
2. Fabrication: Lab creates the crown (1-2 weeks)
3. Placement: Crown cemented, bite adjusted

Mild discomfort may occur initially but subsides quickly.

Taking Care Of Your Crown

To maximize lifespan:

• Brush twice daily
• Floss around the crown
• Avoid hard objects (e.g., ice, pens)
• Visit the dentist every 6 months
• Use a night guard for bruxism

When Crowns Need Fixing

Zirconia Issues:

• Debonding (3%)
• Fractures (1.5%, rare)

PFM Issues:

• Chipping (12%)
• Metal exposure (5%)
• Allergic reactions

Contact your dentist immediately for issues.

Special Cases

People Who Grind Their Teeth

Zirconia is preferred for bruxism due to its superior strength.

Front Teeth vs. Back Teeth

• Front Teeth: Zirconia for aesthetics, PFM acceptable
• Back Teeth: Zirconia for strength, PFM viable

Final Thoughts: Which Is Better?

The choice between zirconia and PFM crowns depends on your dental needs, budget, and priorities:

• Zirconia: Superior for durability, aesthetics, and allergy safety
• PFM: Cost-effective, reliable for budget-conscious patients

Dentists increasingly favor zirconia for its longevity and natural appearance, but PFM remains a viable option for many. Discuss with your dentist to find the best fit.