What is a Porcelain Fused to Zirconia (PFZ) Crown
PFZ stands for porcelain fused to a zirconia crown that produces a superlative result in many situations. Zirconia is zirconium oxide that has porcelain like qualities but is strong. Feldspathic porcelain is pure porcelain that is layered on top to mimick a natural tooth both in shade, hue and light transmission. Both these materials are very biofriedly as I will show later. In this post I will show why PFZ’s are better than PFM’s for front teeth.
PFM’s: The Old Cadillac of Crowns
The gold standard in dentistry used to be the PFM crown, but they have gone out of favor because they contain metal, hense the name porcelain fused to metal crowns. These are the crowns that most likely your parents have, as they were the best crowns available at that time. We are talking the 1980’s, 1990’s and up until around 2010.
In my previous article, I talk more about PFM’s and the problems they create, namely inflammation in the gums around them. In the article I show photos and a microscope comparison of a PFM and full porcelain crown. Pretty interesting. Here is the link if you are interested: https://myholisticdentist.com/2024/02/19/is-a-full-porcelain-crown-better-than-porcelain-fused-to-metal/
The fact is many dentists still swear by them. That’s because it has stood the test of time. This is why I used to call PFM’s the Cadillac of crowns, because in many cases they last 25 years or longer.
But this is 2024 where patients want all porcelain crowns that don’t contain any metal. This is especially true of holistic, biological, and cosmetic practices that use all porcelain crowns and no metal. If a patient is given the choice of a PFM or all ceramic crown, they usually opt for the latter.
The King is Dead – Long Live the King
PFM’s have gone out of favor because of their cosmetic limitations. 20 or 30 years a ago they were the best choice for crowns on back teeth but often for front teeth too.
Recently, this patient came to me with a request to replace these 20 year old PFM’s. Although they could be considered acceptable, they certainly were not highly cosmetic due to their opacity. When it came down to it she thought they were just dated and ‘old’ looking. No argument there.
From the side you can see how unnatural the front crowns look on the 4 front teeth when compared to the teeth behind them.
Bleached crown are no longer acceptable, as these days patients want a more natural and pleasing look to their smiles.
My Lab Tech is my Secret Weapon
My lab tech is willing to go the extra mile and do the extra work it take to do a two step porcelain crown vs. the one-step milled crowns that are popular today. He is motivated by quality and excellence rather than convenience and efficiency.
So, in order to get masking, brightness, and strength, in the end we decided that PFZ’s would be the best approach in this case. The zirconia would give the porcelain layered on top support so it wouldn’t break down the road. The feldspathic porcelain layered by hand on top of the zirconia would be a lot more cosmetically pleasing.
Picture on Date of Bonding
Here are the PFZ’s after bonding. Much Better! And blends well the teeth behind them.
The patient was pretty happy with them as well.
3 Months Post Cementation
End result after 3 months check. Notice how healty and pink the gums look. Gum health looks better due to biofriendly materials of the PFZ, porcelain fused to zirconia, vs the porcelain fused to metal crowns she had before.
Carey O’Rielly DDS has been a practicing dentist for 35 years. He went to USC Dental School and Duke University for his undergraduate degree. He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office.
He began his career by owning and operating a network of six offices in the San Francisco Bay Area. Presently he owns a private holistic practice in North County San Diego’s Encinitas.
Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm.
He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years. He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free ‘white’ fillings. He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient’s own blood.
Dr. O’Rielly teaches C.E. courses on the systemic effects of gum disease. He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole.
He has an educational blog and is writing a book on dental health called ‘Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser’ where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.
