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Zirconia vs PFM Crowns: Should You Replace Your Old Metal-Ceramic Crowns?
Medically reviewed byDt. Beyza İlistir, DDSQuick answer
Zirconia crowns contain no metal, so they cannot show a grey line at the gum, and monolithic zirconia cannot chip at a porcelain layer. PFM (porcelain-fused-to-metal) crowns have the longest track record and cost less. Replace an old PFM crown when it has a clinical problem. A grey line alone is a cosmetic reason, and every replacement removes a little more tooth.
Key facts
- Indicative Turkey prices: metal-ceramic (PFM) £100–£200 per crown; zirconia £150–£350.
- PFM is the benchmark that all-ceramic crowns are measured against in systematic reviews.
- Grey margins appear when the gum recedes from a metal collar; they are not harmful in themselves.
- Cheap PFM alloys can contain nickel, a common allergen; cobalt-chromium and high-noble alloys are nickel-free.
- Replacing a crown removes more tooth each time and carries a small risk to the nerve.
How do zirconia and PFM crowns differ?
A PFM crown is a metal shell with layers of porcelain fired onto it. A zirconia crown is milled from a block of zirconium dioxide ceramic, either as one solid piece (monolithic) or with porcelain added on the front (layered).
| PFM (metal-ceramic) | Zirconia | |
|---|---|---|
| Metal inside | Yes; alloy varies | No |
| Grey line if the gum recedes | Possible | No |
| Typical chipping risk | Porcelain can chip off the metal | Monolithic: very low; layered: porcelain can chip |
| Tooth reduction | Deeper, to fit metal, opaque layer and porcelain | Less for monolithic; similar to PFM for layered |
| Masks a dark tooth or metal post | Yes | 3Y and multilayer: yes; 5Y: often not |
| Clinical track record | Longest of any tooth-coloured crown | Shorter, but good for current materials |
| Long-span bridges | Well established | Possible with suitable design |
| Indicative Turkey price | £100–£200 | £150–£350 |
For most new single crowns, zirconia is now the sensible default. PFM still has a place for long-span bridges and some implant work. The porcelain crowns guide explains the alloys and preparation in detail.
Should you replace your old PFM crowns?
Start from whether the crown has a problem, not from what it is made of.
| Situation | Replace? | Why |
|---|---|---|
| Decay under the crown edge | Yes | The crown is no longer sealing the tooth |
| Fractured or badly chipped porcelain | Usually | Repairs on PFM rarely last |
| Persistent gum inflammation around the crown | Often, after treating the gum | A deep or poorly fitting margin may be the cause |
| Poor fit, food trapping, or a loose crown | Usually | Fit problems tend to worsen |
| Suspected reaction to a nickel alloy | Discuss with your dentist | Confirm the alloy and the allergy first |
| A grey line at the gum, nothing else | Optional | The line is cosmetic, not harmful |
| Wanting a whiter colour to match whitened teeth | Optional | Weigh the cost in tooth structure |
If the answer is "optional", the decision is yours. Remember that each new crown removes a little more tooth, and that preparing an already-crowned tooth carries a small risk of needing root canal treatment afterwards.
If you replace, what should the new crown be?
The right material depends on the tooth and what sits underneath it:
- Front teeth on a light-coloured core: e-max or multilayer zirconia for the most natural look.
- Front teeth on a dark, root-treated core or metal post: 3Y or multilayer zirconia, which masks the colour underneath.
- Back teeth, especially if you grind: monolithic zirconia, or a gold crown where appearance does not matter.
- Long-span bridges: PFM or a zirconia framework, depending on the span and your bite. See dental bridges.
Ask for the new crown's margin to sit at the gum line rather than deep beneath it. Deep margins inflame the gum and lead to the same recession that exposed the old metal. Our guide to biological width explains why.
What should you ask before replacing PFM crowns abroad?
- Which crowns need replacing for a clinical reason, and which are optional?
- Will each tooth be X-rayed before the old crown is removed?
- What is the conditional price if a tooth needs a root canal or a new post?
- Which zirconia grade, and is the crown monolithic or layered?
- Where will the new margin sit relative to the gum?
For why zirconia prices vary so much between clinics, see why zirconia crowns are so cheap in Turkey. Before booking, read how to check a Turkish dentist's credentials.
Frequently Asked Questions
Is zirconia better than PFM?
For most single crowns, yes: no metal, no grey line, and monolithic zirconia cannot chip at a porcelain layer. PFM has a longer track record and is still a good choice for long-span bridges and some implant restorations.
Can PFM crowns be replaced with zirconia?
Yes. The old crown is cut off, the tooth is checked and reshaped if needed, and a zirconia crown is made for it. Because the tooth was already prepared for PFM, little extra reduction is usually needed, but it is not zero.
Why do PFM crowns go grey at the gum?
The gum line recedes over the years and exposes the metal collar, or thin gum lets the metal show through as a shadow. It is a cosmetic issue unless the gum is also inflamed.
How much does it cost to replace a PFM crown with zirconia in Turkey?
A zirconia crown typically costs £150–£350 in Turkey. Budget separately for conditional extras such as root canal treatment or a new post, in case removing the old crown reveals a problem.
References
- Sailer I, Makarov NA, Thoma DS, Zwahlen M, Pjetursson BE. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns. Dent Mater. 2015;31(6):603–623. doi:10.1016/j.dental.2015.02.011
- Thyssen JP, Menné T. Metal allergy: a review on exposures, penetration, genetics, prevalence, and clinical implications. Chem Res Toxicol. 2010;23(2):309–318.
- Turkey MedMatch. Porcelain Crowns in Turkey: Metal-Ceramic or All-Ceramic? Prices last updated 2 October 2026.