Porcelain
vs. composite or PFM
In the past, teeth which lacked structural
strength due to decay or fracture would be restored
by placement of a metal crown. A crown would completely
encircle and cover the tooth. This is a very strong
restoration but has the liability of needing to “grind
down” the top and sides of the tooth. As you
can imagine teeth find this very stressful and a certain
percentage of these teeth need to have the nerve removed
(root canal treatment). Also, the metal conducts heat
in and out of the tooth and sensitivity was a problem.
Later on, the technique of covering the metal with
porcelain was developed. This allowed “tooth
colored” crowns. Due to the metal underneath
the porcelain it is not possible to make a porcelain/metal
crown look exactly like a tooth. In some cases the
metal would produce a dark line by the gums.
A tooth colored filling material has been in use
for more than 20 years. Called composite, this material
provided a more natural appearing filling material.
Though this material was kinder to the teeth than
mercury, it is not strong enough to be used in large
areas.
Porcelain was tried but often failed because it was
not strong enough to stand up to the forces found
on back teeth. When it could be used without metal
support it provided a very natural translucent appearance
missing in porcelain/metal restorations.
Recently a very “high tech” porcelain
was developed which is much stronger than the old
porcelain. In fact it is stronger than tooth structure!
When this material is correctly bonded it produces
a hybrid tooth structure that is strong and beautiful.
The availability of these new materials means that
we can more often treat a tooth before it becomes
broken down with materials which may never need replacement.
