Porcelain fused to metal (PFM)
Metal-Ceramic Crowns in Turkey
Metal-ceramic crowns have a strong metal base under a layer of tooth-coloured porcelain. In fact, dentists have used them for more than 50 years. Today, however, metal-free crowns reach similar survival in reviews, so your dentist weighs looks, strength and the tooth itself before suggesting one.
At a glance
- Also called
- Porcelain fused to metal (PFM) or porcelain bonded to metal
- Structure
- A metal base with porcelain on top
- Metals used
- Precious alloys, such as gold-platinum, or base alloys, such as cobalt-chromium
- Tooth removed in one lab study
- About 63% to 72% of the tooth above the gum, as with all-ceramic crowns
- Survival in a 2026 review
- 97.1% at 5 years
- Main drawbacks
- Porcelain chipping and greying of the gum
These figures come from research reviews rather than from any one clinic. Your dentist confirms your plan after an in-person examination.
How metal-ceramic crowns work
A crown covers the whole tooth above the gum. With metal-ceramic crowns, a thin metal shell fits over the prepared tooth first. Then a technician adds porcelain on top, so the crown looks like a natural tooth.
The metal can be a precious alloy, such as gold-platinum, or a base (non-precious) alloy, such as cobalt-chromium. In one study of back teeth, crowns on both types of alloy lasted equally well. For example, 81% were still in place after almost 15 years.
Because the crown needs room for both metal and porcelain, your dentist trims the tooth on all sides. In one lab study, the metal-ceramic design used 1.4 mm of side-wall reduction. By contrast, the all-ceramic designs used 0.8 to 1.0 mm.
- 1
The metal base
In short, a thin cast or milled shell that gives the crown its strength.
- 2
The porcelain layer
Next, tooth-coloured porcelain covers the metal. This layer can chip, as with other layered crowns.
- 3
The prepared tooth
Finally, your dentist shapes the tooth to make space, then cements the crown in place.
When metal-ceramic crowns may still suit
No single crown material suits every mouth. So your dentist matches the material to your teeth, bite and goals after examining you.
They may be considered if
A different plan may be safer if
Metal-ceramic crowns vs zirconia and glass-ceramic
Reviews now find similar survival for these single crowns. However, the studies differ in design and length, so compare them with care. Monolithic means the crown uses one material with no porcelain layer.
Your metal-ceramic crowns journey
Most crowns need two appointments, with laboratory work in between. Your dentist will confirm how many days you need in Istanbul.
- 1Online
Remote review
First, you send photos and any recent X-rays. Then a dentist explains whether a crown, a filling or another option looks suitable.
- 2Visit 1
Examination and choice of material
When you arrive, your dentist checks the tooth, gums and bite. Next, you agree on the material together, and the plan becomes final.
- 3Visit 1
Preparation and impression
After that, your dentist shapes the tooth and takes an impression. You wear a temporary crown in the meantime.
- 4In the lab
Making the crown
Meanwhile, a technician makes the metal base and builds up the porcelain on top.
- 5Visit 2
Fitting
At the second visit, your dentist removes the temporary crown. Then they check the fit, bite and colour before cementing the new one.
- 6At home
Regular check-ups
Afterwards, see a dentist regularly, ideally close to home. So problems at the edge of the crown can be caught early.
Living with metal-ceramic crowns
Daily cleaning
Brush twice a day with fluoride toothpaste and clean between your teeth every day. In particular, keep the edge of the crown clean, because decay can start there.
Chips in the porcelain
The porcelain layer can chip. So tell your dentist early if the crown feels rough or sharp, and avoid biting very hard objects.
Grey gums around metal-ceramic crowns
Metal-ceramic crowns often cause some greying of the gum. If this bothers you, ask your dentist whether replacing the crown makes sense.
Metal allergy
Allergy to dental alloys seems rare, although doctors have reported it. Therefore, tell your dentist about any known metal allergy before treatment.
Risks of metal-ceramic crowns
Metal-ceramic crowns do well in studies. For example, a 2026 review of 64 studies estimated that 97.1% were still in place after 5 years. A Cochrane review also quotes older estimates of about 92% at 10 years and 75% at 15 years.
Still, metal-free crowns now reach similar survival for single teeth. In fact, a Cochrane review found too little good evidence to say that either choice is better. So the decision rests on your teeth and your preferences.
In one five-year trial on back teeth, chipping was the main failure for both metal-ceramic and zirconia crowns. Small chips may need a repair or, sometimes, a new crown.
The metal base makes it harder to match a natural tooth, especially at the front. In addition, metal-ceramic crowns often cause greying of the gum around them.
Also, crowns remove far more tooth than veneers. In one lab study, a metal-ceramic crown removed 4.3 times more than a standard porcelain veneer.
Decay can start where the crown meets the tooth. Interestingly, one 2026 review found less of this with metal-ceramic bridges than with all-ceramic ones.
Reports link some reactions to palladium, gold, nickel and cobalt. However, nobody yet knows how common these reactions are, so a doctor confirms them with patch testing.
What your metal-ceramic crowns plan should answer
Ask any clinic, including us, for clear written answers before you book.
- 1Does this tooth really need a crown, or would a filling do?
- 2Why do you suggest metal-ceramic rather than zirconia or glass-ceramic?
- 3Which alloy will you use, and can I have its details in writing?
- 4Will the edge of the crown show when I smile?
- 5How much tooth will you remove?
- 6What happens if the porcelain chips?
- 7How many visits and days will I need in Istanbul?
Metal-ceramic crowns: your questions
Yes. In other words, porcelain fused to metal (PFM) and porcelain bonded to metal name the same crown: a metal base with porcelain on top.
A 2026 review estimated that 97.1% lasted 5 years. A Cochrane review quotes older figures of about 92% at 10 years. However, nobody can promise a lifetime, and care and check-ups matter.
Not clearly. In fact, reviews show similar survival for single crowns. Zirconia is metal-free, so it avoids a grey edge. Still, older layered zirconia crowns chipped more often in one review.
Metal-ceramic crowns often cause some greying of the gum. Your dentist can check the gum and the crown, and then explain whether a change makes sense.
It is possible, although it seems rare. Reports mention palladium, gold, nickel and cobalt. So tell your dentist about any metal allergy, and ask which alloy they plan to use.
Yes. In a 2026 review, 91.3% of metal-ceramic bridges lasted 5 years, similar to zirconia. By contrast, lithium disilicate bridges did less well.
Related guides
Medical review required before publication · General information only; it does not replace an examination, diagnosis or personalised treatment plan.
- Pjetursson BE et al. Survival, failure and complication rates of metal-ceramic, veneered and monolithic all-ceramic tooth-supported single crowns: Part 1 (2026)
- Romandini P et al. Survival, failure and complication rates of metal-ceramic, veneered and monolithic all-ceramic multiple-unit fixed dental prostheses: Part 2 (2026)
- Sailer I et al. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses? A systematic review of the survival and complication rates. Part I: single crowns (2015)
- Pjetursson BE et al. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses? A systematic review of the survival and complication rates. Part II: multiple-unit FDPs (2015)
- Poggio CE et al. Metal-free materials for fixed prosthodontic restorations. Cochrane Database of Systematic Reviews (2017)
- Edelhoff D, Sorensen JA. Tooth structure removal associated with various preparation designs for anterior teeth (2002)
- Monaco C et al. Zirconia-based versus metal-based single crowns veneered with overpressing ceramic on posterior root-filled teeth: 5-year randomised trial (2017)
- Chaar MS et al. Long-term clinical outcome of posterior metal-ceramic crowns fabricated with direct metal laser-sintering technology (2020)
- Levi L et al. Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic devices: a systematic review (2012)
- Afroz S et al. Prevalence of metal allergy in patients treated with intraoral prostheses and restorations: a systematic review and meta-analysis (2026)
- Conrad HJ et al. Current ceramic materials and systems with clinical recommendations: a systematic review (2007)
- Oral Health Foundation. Crowns (updated 2026)
Are metal-ceramic
crowns right
for you?
First, send a few clear photos and any recent X-rays. A dentist will then review them and explain whether metal-ceramic crowns, a metal-free crown or another option looks suitable. Your plan stays provisional until you're examined in person.