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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.