Porcelain fused to metal crown cost in NZ, and how PFM compares with zirconia

The NZDA Fee Survey (October and November 2023, including GST) reports the porcelain fused to metal crown price by region. Fees have risen since, so expect a current quote to be higher.

A porcelain fused to metal bridge is priced by the unit, as each supporting crown and each false tooth counts as one. The alloy matters too: precious alloys with a high gold content cost more than non-precious cobalt-chromium.

What is a porcelain fused to metal crown?

A porcelain fused to metal (PFM) crown, also called a metal ceramic crown or a porcelain and metal crown, has a thin metal framework, or coping, with tooth-coloured porcelain fired onto it. The metal gives strength and the porcelain gives the look of a natural tooth. PFM crowns and bridges have been used for decades and are among the most studied restorations in dentistry.

The metal is usually a non-precious cobalt-chromium alloy or a precious alloy containing gold, palladium or platinum. An opaque porcelain layer hides the metal, then body and enamel porcelain are built up and fired to match the shade.

A porcelain jacket crown is something different: one of the earliest tooth-coloured crowns, made of porcelain alone with no metal or zirconia core. Jacket crowns looked natural but broke easily, and they have been replaced by stronger all-ceramic materials such as E.max and zirconia.

For a wider comparison, including gold, see zirconia vs porcelain vs E.max vs gold crowns.

How to get a PFM crown: preparation and steps

1. Assessment. Your dentist examines and x-rays the tooth, treats any decay or infection, and chooses the shade with you.
2. Porcelain fused to metal crown preparation. The tooth needs room for both metal and porcelain, typically around 1.5 to 2 mm off the biting surface and 1.2 to 1.5 mm on the visible side. The edge is finished as a shoulder or chamfer at or just under the gum.
3. Scan or impression. A digital scan or impression is taken, with the opposing teeth and bite, and a temporary crown is fitted.
4. Framework. The lab designs the metal coping in CAD software or wax, then casts, mills or 3D-prints it in metal.
5. Porcelain. The technician applies an opaque layer to hide the metal, then builds up and fires the body and enamel porcelain in several firings, shaping and staining it to match your teeth.
6. Fitting. Your dentist checks the fit, contacts and bite, then cements the crown, usually one to two weeks after the preparation.

Your dentist also chooses the margin: a thin metal collar at the edge of the crown, which is strong but can show, or a porcelain margin, which hides the metal on visible teeth. Dentists can see how we make porcelain-fused-to-metal crowns and bridges.

How to use and care for a PFM crown

• Eat normally once the crown is cemented, but avoid biting ice, hard lollies and bottle tops, which can chip the porcelain.
• Brush twice a day and floss daily, paying attention to the edge of the crown, where new decay can start.
• Keep regular check-ups so your dentist can spot gum recession or a worn edge early.
• Wear a bite splint at night if you grind or clench.

With good care, a PFM crown can last many years. In a 2018 review of implant crowns, 98.3% of metal-ceramic crowns and 97.6% of zirconia crowns were still in place after five years, so both materials perform well.

Tips & gotchas

• Porcelain fused to metal crown vs zirconia. Both are strong, but zirconia needs less tooth removed, has no metal to show at the gum and, when monolithic, rarely chips. PFM is still chosen for long bridges and for matching existing PFM crowns.
• Porcelain fused to metal crown vs all porcelain. All-porcelain crowns such as E.max look more lifelike on front teeth because light passes through them. PFM is stronger for longer bridges but looks more opaque.
• Watch for the dark line. If the gum recedes, the metal edge of a PFM crown can show as a grey or dark line. It is cosmetic, not a sign of failure, but it is why many front-tooth crowns are now metal-free.
• Metal allergy is rare but real. If you have a nickel allergy, tell your dentist so they can choose a nickel-free or precious alloy.
• Replacing old PFM crowns. Old PFM crowns are often replaced for appearance rather than failure, so your dentist will check the tooth underneath before recommending a new crown.

A porcelain fused to metal bridge is still a strong option for longer gaps and back teeth. Compare bridge prices and options in how much does a dental bridge cost in NZ, and metal-free crowns in zirconia crown lifespan, types, pros and cons and cost.