In the last decade, the replacement of old PFM restorations has been a common dental procedure, especially on the anterior regions. Gingiva conditions in most re-treatment cases are not healthy with the old restorations due to ill-fitting margin, improper tooth reduction and poor oral hygiene. Practitioners must carefully evaluate and manage periabutmental gingiva for final restorations. The role of provisional restoration became a major clinical concern at this point. Well-fabricated provisional restorations with precise-fit margin and proper anatomy are critical for achieving good gingival health. Thus, the key of success in replacing old PFM crown depends on the proper tissue management by precise provisional restorations.

As patients have concerned the esthetics of dental restorations, the porcelain fused to metal restorations have gain their popularity due to their strength and esthetic appearance for many years. However, metal collar in subgingival level of porcelain fused to metal restoration often causes black shadows. Inadequately positioned metal collar causes plaque depositions, gingival inflammations, black shadows, and discolorations of margin area. Those problems can be avoided by a clear finishing line, well-fabricated provisional restorations with precise margin and fine polishing, collarless porcelain fused to metal restoration, and all ceramic restoration. In this case report, collarless porcelain fused to metal restoration was used to treat cervical discoloration from old restorations.