Clinical study to evaluate the wear of natural enamel antagonist to zirconia and metal ceramic crowns

Abstract

Statement of problem: Tooth wear is a complex process, which, if not prevented, may adversely affect the integrity of the stomatognathic system. Different restorative dental materials may affect the amount of wear on natural enamel antagonists.

Purpose: The purpose of this in vivo study was to evaluate and compare the wear of enamel opposing natural enamel, zirconia, and metal ceramic crowns after 1 year.

Material and methods: Ten participants between 18 and 35 years of age requiring 2 complete crowns, 1 on either side of maxillary or mandibular molar region, and having healthy natural teeth in the opposing arch were selected. For each participant, 1 monolithic polished zirconia crown and 1 glazed metal ceramic crown were fabricated and cemented. To evaluate the wear of the antagonistic natural enamel (premolar and molar), polyvinyl siloxane impressions were made immediately (baseline) and at 1 year after cementation. The wear of natural enamel against natural enamel was evaluated as the control. The resulting casts were scanned (using a 3D white light scanner), and 3D software was used to calculate the maximum amount of linear wear.

Results: One-way repeated measures ANOVA was conducted to analyze data. Mean ±SD occlusal wear of the antagonistic enamel 1 year after the cementation of metal ceramic crowns was 69.20 ±4.10 μm for premolar teeth and 179.70 ±8.09 μm for molar teeth, whereas for zirconia crowns, it was 42.10 ±4.30 μm for premolar teeth and 127.00 ±5.03 μm for molar teeth. Occlusal wear of natural enamel opposing natural enamel was 17.30 ±1.88 μm in the premolar region and 35.10 ±2.60 μm in the molar region. The Bonferroni post hoc test revealed that the occlusal wear of antagonistic enamel 1 year after the cementation of a metal ceramic crown was significantly higher (P<.001) than that of an opposing zirconia crown or natural enamel.

Conclusions: Zirconia crowns led to less wear of antagonist enamel than metal ceramic crowns, but more than natural enamel.