Restorative dentistry is in a constant state of evolution, driven by advancements in material science and digital technologies, alongside increasing patient demands for aesthetic and durable outcomes. Among the plethora of restorative options, pressed metal-ceramic (PMC) systems have carved out a significant niche, offering a unique combination of the proven strength of a metal substructure with the superior aesthetics of a pressed ceramic veneer. This article aims to provide a comprehensive, evidence-based clinical justification for the indications and contraindications for the use of pressed metal-ceramic restorations. The relevance of this topic is underscored by the need for clinicians to make informed, nuanced decisions when selecting materials for fixed prosthodontics. While monolithic zirconia and lithium disilicate have gained immense popularity, PMC restorations remain a highly viable, and often superior, choice in specific clinical scenarios. Misapplication of any restorative material can lead to premature failure, aesthetic dissatisfaction, and iatrogenic damage. Therefore, a clear understanding of the mechanical, biological, and aesthetic principles governing the use of PMC systems is paramount for achieving predictable, long-term clinical success. This paper synthesizes current literature to delineate precise clinical guidelines, analyze the material's properties in relation to clinical performance, and compare its utility against both traditional porcelain-fused-to-metal (PFM) and modern all-ceramic alternatives. The goal is to equip dental practitioners with the necessary knowledge to confidently integrate PMC restorations into their practice, optimizing patient care and treatment outcomes.

Pressed Metal-Ceramic, Press-on-Metal, Fixed Prosthodontics, Clinical Indications, Contraindications, Dental Materials, Restorative Dentistry.

Beuer, F., Schweiger, J., & Edelhoff, D. (2008). Digital dentistry: an overview of recent developments for CAD/CAM generated restorations. British Dental Journal, 204(9), 505–511. https://doi.org/10.1038/sj.bdj.2008.350

Bindl, A., & Mörmann, W. H. (2002). Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. Journal of Oral Rehabilitation, 29(12), 1157–1164. https://doi.org/10.1046/j.1365-2842.2002.00947.x

Fradeani, M., & Barducci, G. (1996). A new method for the provisional restoration of a single prepared tooth. The International Journal of Periodontics & Restorative Dentistry, 16(6), 546-553. https://pubmed.ncbi.nlm.nih.gov/9040770/

Qualtrough, A. J., & Piddock, V. (1997). Ceramics update. Journal of Dentistry, 25(2), 91–96. https://doi.org/10.1016/s0300-5712(96)00020-0

Raigrodski, A. J. (2004). Contemporary all-ceramic fixed partial dentures: a review. Dental Clinics of North America, 48(2), 531-544. https://doi.org/10.1016/j.cden.2003.12.005

Sailer, I., Pjetursson, B. E., Zwahlen, M., & Hämmerle, C. H. (2007). A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part II: Fixed partial dentures. Clinical Oral Implants Research, 18(Suppl 3), 86–96. https://doi.org/10.1111/j.1600-0501.2007.01468.x

Soares, C. J., Soares, P. V., de Freitas, A. P., & de Paula, R. G. (2015). The influence of cavity preparation design on the fracture resistance of posterior leucite-reinforced ceramic restorations. Journal of Prosthetic Dentistry, 113(4), 305-310. https://doi.org/10.1016/j.prosdent.2014.10.012

Stappert, C. F., Att, W., Gerds, T., & Strub, J. R. (2006). Fracture resistance of different partial-coverage ceramic molar restorations: an in vitro investigation. Journal of the American Dental Association, 137(4), 514-522. https://doi.org/10.14219/jada.archive.2006.0223

Thompson, J. Y., Anusavice, K. J., Naman, A., & Morris, H. F. (1994). Fracture surface characterization of clinically failed all-ceramic crowns. Journal of Dental Research, 73(12), 1824-1832. https://doi.org/10.1177/00220345940730120801

Zarone, F., Russo, S., & Sorrentino, R. (2011). From porcelain-fused-to-metal to zirconia: clinical and experimental considerations. Dental Materials, 27(1), 83-96. https://doi.org/10.1016/j.dental.2010.10.024