Clinical evaluation of zirconia-based all-ceramic single crowns: an up to 12-year retrospective cohort study

Clin Oral Investig. 2018 Mar;22(2):697-706. doi: 10.1007/s00784-017-2142-y. Epub 2017 Jun 12.

Abstract

Objectives: This study aims to investigate the incidence of clinical complications with tooth-supported zirconia-based all-ceramic single crowns and identify pertinent risk parameters.

Materials and methods: A retrospective cohort study (May 2004 to April 2016) utilizing clinical records of patients receiving yttrium-oxide-partially stabilized zirconia (Y-TZP)-based all-ceramic crowns placed at Tohoku University Hospital was performed. The length of time of treatment success (complication event-free) and restoration survival (including minor complication events and remaining clinically functional) were estimated using Kaplan-Meier analysis. Multilevel survival analysis was used to identify risk factors.

Results: One hundred thirty-seven crowns were evaluated (mean follow-up time, 7.0 years). A total of 21 crowns experienced at least one complication with fracture of veneering ceramic being the most common (16 crowns). Estimated success and survival rates at 5 years (96.9 and 98.5%, respectively) decreased at 10 years to 62.1 and 67.2%, respectively. The risk of complications was significantly higher for molar crowns compared to anterior crowns (p < 0.01). A significant association of complications with metal antagonist restorations was shown by univariate analysis (p < 0.01).

Conclusions: Given the study limitations, Y-TZP single crowns placed on anterior teeth demonstrated encouraging clinical results over a period of up to 10 years. However, there is a substantial risk of complications with posterior teeth within 10 years of restoration placement.

Clinical relevance: Treatment with zirconia-based all-ceramic crowns for molar teeth with metal antagonist occlusion should be undertaken with caution.

Keywords: All-ceramic crown; Retrospective cohort study; Risk factor; Survival rate; Veneering ceramic fracture; Yttrium oxide partially stabilized zirconia.

MeSH terms

  • Adult
  • Crowns*
  • Dental Prosthesis Design*
  • Dental Restoration Failure*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Molar
  • Retrospective Studies
  • Risk Factors
  • Yttrium / chemistry*
  • Zirconium / chemistry*

Substances

  • yttria stabilized tetragonal zirconia
  • Yttrium
  • Zirconium