PFM Crowns in 2026: Are They Still Worth Prescribing?

Twenty years ago, PFM crowns were the default. Today, the default is monolithic zirconia, and lithium disilicate owns the anterior. So is there any reason left to prescribe a PFM? Short answer: yes, for specific cases. Long answer below.

Where PFMs still win

• Long-span posterior bridges (4+ units) where you want a metal substructure for flex resistance
• Cases where you're matching existing PFMs in the same arch and chroma transition would be obvious
• Patients with severe parafunction where you want a metal occlusal surface and porcelain facial-only
• Telescopic and precision-attachment removable cases where zirconia substructures are impractical

Where PFMs lose

Most single-unit posterior crowns, almost all anterior crowns, and the majority of 3-unit bridges. Monolithic zirconia is stronger, requires less reduction, doesn't show metal margins over time, and costs the same or less. e.max wins on anterior esthetics by a wide margin.

The margin problem

The single biggest reason dentists migrated away from PFMs is the dark gingival line that develops over 5–10 years as tissue recedes. It's not a manufacturing defect, it's the nature of having a metal coping under a tooth-colored crown. For any patient with a high smile line or thin gingival biotype, PFMs are a bad esthetic bet.

When you do prescribe a PFM, get the metal right

Noble or high-noble alloys (gold-based) bond better to porcelain, fit more precisely, and are kinder to opposing dentition than base-metal alloys. The cost difference is real but worth it for crowns and bridges that need to last 15+ years.

VDL's PFM workflow

We still make PFMs for the indications above. We use high-noble alloys by default for single units and small bridges, and we'll quote noble or base-metal options for long-span work if cost is a factor. Specify the alloy class on the Rx, or write "tech to call" and we'll discuss before we start the case.