Metal-Ceramic (PFM) Crowns

Where it may be suitable

• A tooth that has lost much of its structure, or is at risk of breaking, and that a filling cannot repair
• Bridges of several units, in selected cases where the supporting teeth and the surrounding tissues are sound. The longer the bridge, the more carefully its load and the risk of complications need to be assessed.

Where it is not suitable, or another option should be considered first

• Healthy, well-shaped teeth. A crown should not be made on a healthy tooth only for its appearance. Options that remove less tissue are considered first, such as teeth whitening, shaping with composite (bonding) or laminate veneers.
• Teeth that a filling or a partial restoration can repair. An inlay fills a cavity inside the tooth; an onlay also covers weakened cusps (the raised chewing points) where needed. If enough of the tooth remains, these can take the place of a full crown.
• A known metal allergy. If you are allergic to metals used in dental alloys, tell your dentist; metal-free options are then considered.
• Untreated decay or gum disease. These are treated first.

Where extra care is needed

• Heavy chewing forces, clenching and grinding. The porcelain on top can chip. A 2026 review reported fewer fractures and chips¹ on single-piece (monolithic) zirconia and lithium disilicate crowns than on designs with a porcelain layer on top.
• Limited space. The tooth needs enough room for both the metal and the porcelain. Where space is limited, the material and the design are chosen with this in mind.
• Expectations about appearance on front teeth. The metal framework does not let light through. The crown can look more opaque than an all-ceramic one, and a dark line may show at its edge if the gum recedes.

The right option is decided at an examination, with X-rays assessed. Recent X-rays you already have can be used.

• Doing nothing, or monitoring. For a tooth that causes no symptoms and has kept its structure, waiting is an option; your dentist will explain the risk to you.
• A filling or a partial restoration (inlay, onlay). Both keep more of the healthy tooth than a full crown.
• For a missing tooth, options other than a bridge. In suitable patients, an implant, a resin-bonded bridge (glued to the neighbouring teeth) or a removable denture is also considered. Leaving the gap and monitoring it is another option. A conventional bridge also needs the neighbouring supporting teeth to be reduced.
• Zirconia. Contains no metal; depending on the type, it is used on front and back teeth and in bridges.
• Lithium disilicate (e.max). Contains no metal and lets more light through; used for single crowns, veneers and partial restorations.

How the result looks depends on more than the material: the colour of the tooth underneath, the laboratory's work and the clinical conditions matter too.

The steps below are for crowns on natural teeth and are usually completed in two or three appointments. Bridges and work on several teeth can take longer. How the appointments fit a trip is covered in "If you are coming from abroad".

The risks below apply to crowns on natural teeth.

Risks and disadvantages

• It cannot be undone. Tissue is removed from every surface of the tooth for a crown; from then on, the crowned tooth will always need a restoration.
• Effect on the tooth's nerve. The pooled results of 37 studies cover teeth that were alive at the start. These teeth then received a crown or a partial restoration, or supported a bridge. In about 5 in every 100 of these teeth, the nerve lost its vitality². In studies with more than ten years of follow-up, the figure was about 7 in 100. These figures are from published studies, not from our own records, and the certainty of this evidence is low. If it happens, root canal treatment is needed to keep the tooth.
• New decay. A crown does not protect the tooth beneath it from decay. New decay can develop at its edge or underneath it.
• Chipping of the porcelain. Fractures can occur in the porcelain layer on top. Small chips can sometimes be smoothed or repaired; more extensive damage may mean the crown has to be replaced.
• A visible metal edge. If the gum recedes, a dark line may show at the edge of the crown.
• Gum inflammation. Plaque at the edge of the crown, or an edge that does not fit or is poorly shaped, can inflame the gum. Bleeding and swelling should be assessed.
• Wear of the opposing tooth. A porcelain surface, especially a rough one, can add to wear of the tooth it bites against. Polishing the surface after the bite has been adjusted matters.
• Sensitivity. Sensitivity to hot and cold may follow the procedure; it usually eases within weeks.
• Coming loose, and replacement. If the cement bond weakens, the crown can come off. The dentist checks why it came off and examines the crown and the tooth. It can be cemented back only if both are sound and the crown still fits. No crown stays in place for ever, and in time it may need replacing.

Benefits

• It is one of the crown options whose long-term clinical results are well documented³.
• In selected cases it can be used for bridges of several units.

After the procedure, wait until the anaesthetic has worn off before eating or drinking. While the temporary crown is in place, avoid hard and sticky foods. Mild sensitivity and tender gums are normal in the first days.

Daily care

• Brush twice a day with a fluoride toothpaste.
• Clean every day where the crown meets the gum, and under bridges; use interdental brushes or bridge floss.
• If you clench or grind your teeth, wear the night guard your dentist recommends.
• Keep up regular check-ups with a dentist where you live.

Studies do not give a lifespan in years. They report how many crowns are still in place after a period of time. The figures below come from published studies, not from our own records. They describe crowns staying in the mouth; they do not mean that no problem or repair was needed during that time.

A 2026 review combined the results of earlier studies of single crowns on natural teeth. It estimated how many of every 100 would still be in place after five years. For metal-ceramic it was about 97¹, for monolithic zirconia 97 and for layered zirconia 97. For monolithic lithium disilicate it was 98 to 99.

For a longer period, there is a series of 2,340 single crowns from one practice, made on a high-gold alloy framework. In this series, 2,211 crowns were judged to be in a favourable condition when they were cemented. Of every 100 of them, about 97 were still in the mouth after 10 years and 85 after 25 years³. This result belongs to one practice, to selected crowns and to one type of alloy. It cannot be applied to other alloys or to everyone.

These estimates are for single crowns on natural teeth and cannot be applied directly to bridges or implant crowns. The material, the state of the tooth, the bite and oral hygiene together affect how long a crown stays in place.

Contact your dentist if any of the following happens:

• The crown feels loose or comes off (keep it, and do not glue it back yourself)
• The porcelain cracks, chips or feels rough
• Sensitivity that lasts more than a few weeks or keeps getting worse
• Pain that starts on its own, wakes you at night or gets worse when you bite
• Swelling, bleeding or discharge from the gum around the crown
• The crown feels high when you bite, or your jaw feels tired

Emergencies. If pain is increasing, or you have facial swelling or a fever, see a dentist where you are without waiting for the clinic's reply. If you have difficulty breathing or swallowing, or swelling in the mouth or neck that spreads quickly, go to an emergency department. In an emergency, call the emergency number of the country you are in; in Turkey it is 112.

Before you fly home

Make sure your bite has been checked and that you have written care instructions. Take the written record of your treatment with you for your dentist at home.

Once you are home

If a problem comes up that is not urgent, write to the clinic and send photographs. Photographs do not replace an examination, so see your dentist at home as well. In the emergencies above, do not wait for a reply.

A crown on a natural tooth usually needs two or three appointments. The crown is made in a laboratory between preparing the tooth and fitting it, and you wear a temporary crown in between. The number of days in Antalya depends on how many teeth are treated and whether a bridge is involved. It also depends on whether decay, root canal or gum problems need treating first. Before you book, you receive a written preliminary plan with the appointments and how many days they need. It is based on your photographs, so the examination confirms or changes it, and with it the days and the cost.

Flying. A 2023 review of flying after dental treatment suggests waiting at least 24 hours after restorative treatment⁴, and longer after surgical procedures. The authors note that the research is limited and comes mainly from military aviation. These times assume there is no pain, swelling or bleeding where you were treated. Treat it as a starting point for your dentist's advice, not as a rule.

Your dentist at home. Talk to your own dentist before you go. They need to know the plan in case problems come up later. If you do not have a dentist where you live, it helps to find one before you travel. Ask for a written record of the treatment to take back to them. It should show which teeth were crowned and the materials used, including the metal alloy. A crown needs regular check-ups for as long as it is in the mouth. UK guidance (NICE) says the interval between check-ups should be set for each person according to their risk⁵; agree it with your dentist at home. Before you travel, check the rules of the health service or your insurer in the country where you live about care after treatment abroad.

Questions to ask before you commit. Before treatment abroad, ask:

1. Who will carry out my treatment, and what are their qualifications?
2. Are you regulated by a professional body and registered with it?
3. Are the remake and correction terms in writing, and for how long do they apply?
4. What aftercare do you provide, and who can I contact after the treatment?
5. If there are complications, who pays for further treatment, extra flights and the hotel?
6. Do you have a complaints system, and can I see a copy?

Before treatment, we give you in writing how complications are handled and the terms for remaking a crown or bridge. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone. A longer list, with our answer to each question, is on our page about dental treatment abroad.

This page does not show prices. A treatment plan is prepared for you after an examination. The main factors that shape it are:

• How many teeth need crowns, or how many units a bridge has
• The metal alloy used and the laboratory work
• Treatment needed first: decay treatment, root canal treatment, gum treatment, rebuilding the tooth
• The number of trips the appointments need

Ask for the plan in writing, including what it covers and which procedures would be assessed separately. Ask too who pays for further treatment and extra travel if there is a complication.