Why use PFM bridges?
Porcelain fused to metal was invented to overcome the esthetic problems of metal restorations.
Metal crowns and bridges are highly durable and long-lasting, but their esthetic appeal is quite limited.
The dental industry found a way to mitigate this problem by fusing a layer of porcelain on the metal.
The result still has the great physical properties of metal restorations, but, thanks to the porcelain layer, it pretty much looks like your natural teeth.
PFM bridges have been widely used in restorative dentistry in the past few decades. Even though all-ceramic bridges - e.max and zirconia - are getting more and more popular, still many dentists are using porcelain fused to metal restorations.
Indications - When do you need a PFM bridge?
Porcelain fused to metal bridges can be used both in the anterior (front), and posterior (back) regions.
A pfm bridge is strong enough to replace multiple missing teeth.
Instead of your natural teeth, dental implants can also be used to support the bridge. Actually, implant-fixed bridges are recommended when you have multiple adjacent missing teeth.
You need to have and keep good oral hygiene to get pfm restorations.
Advantages
PFM bridges have many advantages that make them a popular choice:
- Strength and durability: The underlying metal layer makes these bridges very tough. With proper oral hygiene and eating habits, they can last long.
- Good esthetics: PFM bridges are far more esthetic than metal restorations. The outer porcelain layer makes them look like your natural teeth.
- Tried and tested: Having been used for more than three decades, porcelain fused to metal bridges proved to be a successful way of replacing missing teeth.
- Affordable: They are more affordable than popular all-ceramic restorations.
Disadvantages
Unfortunately, pfm bridges have their cons. There is a reason why the popularity of all-ceramic restorations is increasing rapidly.
These are the main disadvantages of PFM bridges:
- Too much trimming of the teeth: PFM restorations are relatively thick, because of the two layers. Fitting such bridges requires a good amount of tooth structure to remove.
- Gum problems: The metal layer increases the chance of developing gingivitis. This only applies to base metals, porcelain fused to gold should not cause any gum issues.
- Allergic reactions: The metal layer, especially if base metals - like nickel - are used, might cause allergic reactions. Porcelain fused to gold is less likely to cause any allergic problems.
- May chip off: The porcelain layer might chip off. This is especially true if you are a grinder or if you like to chew hard foods (e.g. ice, carrot, nuts, etc.)
- Not as esthetic as all-ceramic: After some time a black line might occur near your gums. Also because of the metal layer, the bridge is more opaque than your natural teeth.
Porcelain fused to metal bridges vs all-ceramic bridges
Even though porcelain fused to metal used to be the material of choice in restorative dentistry, nowadays all-ceramic restorations are usually preferred over PFM.
This is because ceramic restorations - like e.max or zirconia - have many advantages over PFM:
- Esthetics: The translucency of ceramic matches your natural teeth much better. PFM bridges are a bit opaque. This makes ceramic bridges look more natural.
- Allergy: Allergic reactions to ceramic are almost non-existent, metal allergy is far more common. Especially if your bridge was manufactured using base metals and not precious metals.
- Oral health: It is less likely to have gum issues when using ceramic restorations. Plaque accumulation is also reduced when using ceramic.
How much does a porcelain fused to metal bridge cost?
The average cost of a pfm bridge unit is around $500 - $1,500. This means a three-unit bridge, that replaces one missing tooth, can be anywhere between $1,500 and $4,500.
Besides the number of units, the metal used in the restoration also affects the price.
The price of porcelain fused to base metal bridge is usually lower than the cost of a porcelain fused to gold bridge. Of course, gold is the better choice, as it is more durable, more esthetic and it is better for your oral health.
Alternatives
Depending on which part of the mouth a pfm bridge is used, both e.max and zirconia bridges can be great alternatives:
- e.max bridge: Suitable for short span (3-4 units) bridges in the front region as the material is not strong enough for longer bridges. The most esthetic solution.
- zirconia bridge: Can be used both in the front and back region. Zirconia is strong enough for full arch bridges. Somewhat less esthetic than e.max, but still looks great.
Albeit more expensive, using dental implants instead of bridges is preferred. If you have good bone quality and quantity, you should consider getting dental implants instead of dental bridges.
Frequently asked questions
Are porcelain fused to metal bridges good?
Pfm bridges have been used for decades.
Being more esthetic than metal bridges, but still very durable, they used to be the go-to solution when restoring a missing tooth.
However, nowadays all-ceramic restorations (e.max, zirconia) are preferred as they are even more esthetic and support better oral health.
How long do porcelain fused to metal bridges last?
A pfm bridge lasts around 5 - 15 years.
Proper dental hygiene, regular dental visits, and using gold instead of base metals all extend the lifespan of the bridge.
