PFM vs. All-Ceramic

Porcelain-fused-to-metal (PFM) and all-ceramic are two main material options for crowns and bridges. Each has its place — but their proportions in prosthodontics are rapidly changing.

History and Current Status of PFM

PFM is the longest-used technology for prosthetic crowns. Metal (CoCr alloy, gold, or titanium) provides mechanical strength, and the porcelain layer provides aesthetics. For decades, PFM was the standard because it combined acceptable aesthetics with predictable retention.

Limitations of PFM observed in practice:

• Gray shadow at the gingival margin — the metal substructure shows through, especially with recession
• Lack of translucency — a PFM crown looks opaque compared to a natural tooth
• Allergic reactions — non-precious alloys can cause reactions in sensitive patients
• Porcelain chipping — the ceramic layer detaches from the metal under load

Advantages of All-Ceramic

All-ceramic eliminates the metal substructure. Available materials include e.max (lithium disilicate), zirconia, and feldspathic ceramic. Key advantages:

• Better aesthetics — translucency similar to natural enamel
• No gray shadow at the gingiva — even with recession, the margin looks natural
• Biocompatibility — zero risk of metal allergic reactions
• CAD/CAM precision — digital milling eliminates casting errors

Material Comparison

Monolithic zirconia (5Y-TZP, 4Y-TZP) offers flexural strength of 600–1200 MPa — comparable to PFM. E.max at 400 MPa is weaker, but sufficient in the anterior segment.

3-unit monolithic zirconia bridges are routine today. Longer bridges (4+ units) in the posterior segment — zirconia performs well, although PFM still has proponents for very long spans.

When PFM Is Still Justified

• Bridges with more than 4 units in the posterior segment — proven strength for long spans
• Patient budget — PFM can be cheaper for large cases
• Minimal clinical height — when there is insufficient space for all-ceramic (zirconia requires min. 0.8 mm occlusally)
• Implant-supported restorations with metal abutments — gray metal will show through anyway

When All-Ceramic Is Better

• Anterior segment — aesthetics is a priority
• Single crowns and bridges up to 3 units — sufficient strength
• Patients with metal allergies
• Implant-supported restorations with zirconia abutments
• Any situation where the patient expects a natural appearance

How We Select Materials at deltalabs.

At deltalabs., we design restorations using CAD/CAM and select the material according to the clinical situation. For each order, we analyze: arch position, occlusal forces, clinical height, and aesthetic expectations.

If the clinical situation allows for all-ceramic — we recommend it as the first choice. For cases requiring metal, we design PFM with an optimized substructure for aesthetics.

Frequently Asked Questions

Is zirconia strong enough for posterior bridges?

Yes. Monolithic 3Y-TZP zirconia achieves flexural strength above 1000 MPa. 3-unit zirconia bridges in the posterior segment are now standard practice with good clinical documentation.

Is PFM outdated?

Not entirely. PFM still has applications in specific situations (very long bridges, minimal clinical height). But its share is decreasing — in a modern CAD/CAM laboratory, all-ceramic accounts for over 80% of orders.

Can I order PFM at deltalabs.?

Yes. We fabricate PFM restorations when the clinical situation requires it. With each order, we always advise whether all-ceramic would be a better option for a specific case.