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Title No Significant Difference Between The Failure Rates Of Zirconia And Other All Ceramic Systems For Single Tooth Full Coverage Crowns
Clinical Question For a patient in need of a full coverage crown do Zirconia crowns show improved failure rates when compared to other all-ceramic systems?
Clinical Bottom Line For a patient in need of a full coverage crown; crowns composed of Zirconia and other all ceramic systems show no significant differences in failure rates.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18021828Conrad/200710 year review of studies (’96-’06) 288 total articlesSystematic Review
Key resultsThe authors of this review concluded that no evidence supports the exclusive use of one system over the other for all clinical situations. Typical survival rates for all-ceramic restorations ranged from 88-100% after 2-5 years depending on the classification of failure.
#2) 22259801Beier/2012302 patients (1,335 all-ceramic restorations)Retrospective Study
Key resultsMean observation time was 102± 60 months, survival rate was 97.3% after 5 years and 93.5% after 10 years. No significant differences found for type of restoration or distribution in the mouth.
#3) 20698417Senylimaz/20105 groups; 16 samples per groupIn Vitro Testing
Key resultsThe different all-ceramic systems showed similar fracture load values during laboratory testing pt dynamic loading using a chewing simulator.
Evidence Search failure[All Fields] AND rate[All Fields] AND ("ceramics"[MeSH Terms] OR "ceramics"[All Fields] OR "ceramic"[All Fields]) AND ("crowns"[MeSH Terms] OR "crowns"[All Fields])
Comments on
The Evidence
This systematic review is based on 288 relevant studies individually assessed for their value. A retrospective study showed an adequate study population (total of 1,335 all-ceramic crowns in a total of 302 patients) and a standard measure of success across all subjects (success rate of all crowns was determined using the Kaplan-Meier survival analysis). This in vitro study compared different all-ceramic crown systems against an acceptable gold standard of porcelain fused to metal crowns. All systems were treated alike and comparisons made between groups.
Applicability Due to the inherent sensitivity to technique and other variables that exists in the placement and survival of all ceramic crowns this evidence should be considered in general terms. This evidence does not show a statistical bases for a clinician to choose one all-ceramic system over another, and should yield to his or her own case by case decision making ability. This statement is based on the assumption that the treatment is within the realm of the typical general dentist and the caveat that survival rate is also related to the skill of the clinician.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Failure rate, All-ceramic crowns, Zirconia, full coverage crowns
ID# 2231
Date of submission: 04/12/2012spacer
E-mail mcalistert@livemail.uthscsa.edu
Author Travis McAlister
Co-author(s) e-mail
Faculty mentor/Co-author Erica Oliveira, DDS, MPH
Faculty mentor/Co-author e-mail oliveirae@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Dianne Sanchez, William Gillum (San Antonio, TX) on 11/30/2017
A PubMed search conducted in November 2017 yielded a more recent publication: Aldegheishem/2017, PMID: 28267829. This systematic review on the success of various all-ceramic single crowns filtered for a mean follow-up time of 5 years or longer. Similar results as those published in the CAT were found. No evidence supported the superiority of a single ceramic system or material over another. Further research should focus on long-term prospective studies or comparison to metal-ceramic crowns.

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