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Title Simulation Of Natural Tooth Shade In Porcelain-Fused-To-Metal Vs. Zirconia Crowns
Clinical Question Which better simulates natural tooth shades, conventional porcelain used in porcelain-fused-to-metal crowns, or zirconia?
Clinical Bottom Line Although zirconia crowns have become increasingly popular because they are metal free, there is not enough evidence to state that they simulate natural tooth structure significantly better then porcelain-fused-to-metal crowns. An experienced lab technician can create an accurate shade with either material. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21122905Vichi/2010Not applicableNarrative Review
Key resultsIt was not shown that zirconia crowns reproduced natural tooth shade better than porcelain-fused-to-metal crowns.
Evidence Search Search color matching pfm and zirconia #8Search shade in pfm and zirconia
Comments on
The Evidence
The Vichi article described the advantages and disadvantages of porcelain-fused-to-metal and zirconia crowns when trying to restore natural tooth shade. It was not a systematic review of randomized controlled trials. The article did not state whether the individual studies were assessed for validity, or if a detailed search was completed. No meta-analysis was done.
Applicability The Vichi article did not describe any selection criteria for patients, so they may or not be representative dental patients in general. Shade matching in either porcelain-fused-to-metal crowns or zirconia crowns will both give esthetic and accurate results. As a benefit, dental patients could receive crowns that simulate the shade of their natural teeth very well. The restorative dentist would need to discuss the pros and cons of shade matching with patients in order to recognize their values or expectations as far as treatment.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords porcelain fused to metal, zirconia, shade matching, tooth color
ID# 772
Date of submission: 04/28/2011spacer
E-mail Shariff@livemail.uthscsa.edu
Author Salimah M. Shariff
Co-author(s) e-mail
Faculty mentor/Co-author Mary Norma Partida, DDS, MPH
Faculty mentor/Co-author e-mail PARTIDAM@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Randy Middleton, Flor Ruiz, Peggah Hemmat (San Antonio, TX) on 01/13/2014
A Pubmed search was conducted January 2014, an additional publication from 2010 (PMID: 20141812 ) indicates that there is a difference in tooth color shade between PFM and zirconia favoring zirconia.

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