Contraindications for the metal-ceramic crown, as for all fixed restorations, include patients with active caries or untreated periodontal disease. In young patients with large pulp chambers, the metal-ceramic crown is also contraindicated because of the high risk of pulp exposure (see Fig. 7-4). If at all possible, a more conservative restorative option such as a composite resin or porcelain laminate veneer (see Chapter 25) is preferred.
A metal-ceramic restoration should not be considered whenever a more conservative retainer is feasible, unless maximum retention is needed-as for a long-span FPD. If the facial wall is intact, the practitioner should decide whether it is truly necessary to involve all axial surfaces of the tooth in the proposed restoration. Although perhaps technically more demanding and time consuming, a more conservative solution usually can be found to satisfy the patient's needs that may provide superior long-term service.
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