ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title The 5-Year Clinical Survival Rate of Metal-Ceramic Fixed Dental Prostheses is Similar to That of Its All-Ceramic Counterpart
Clinical Question In patients in need of a fixed dental prosthesis (FDP), is the 5-year survival rate of metal-ceramic fixed dental prostheses greater than that of all-ceramic FDPs?
Clinical Bottom Line The clinical survival rate of metal-ceramic FDPs was similar to that of glass-ceramic, glass-infiltrated, and zirconia ceramic FDPs. The clinical survival rate of metal-ceramic FDPs was significantly higher than the weaker feldspathic/silica-based ceramic and densely sintered zirconia.
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) 25842099Sailer/201567 studies reporting on 4663 metal-ceramic and 9434 all-ceramic FDPsMeta-Analysis
Key resultsThis systematic review assessed the 5-year survival of single-unit FDPs. The annual failure rate of all-ceramic FDPs ranged from 0.69 (95% confidence interval [CI], 0.46 - 1.05) to 1.96 (95% CI, 1.44 - 2.67) with a 5-year survival rate between 90.7% (95% CI, 87.5% - 93.1%) and 96.6% (95% CI, 94.9% - 97.7%). The annual failure rate of metal-ceramic FDPs was 0.88 (95% CI, 0.63 - 1.22), which represents a 5-year survival rate of 95.7% (95% CI, 94.1% - 96.9%). Of the all-ceramic FPDs, lithium-disilicate reinforced glass ceramic had the highest 5-year survival rate (96.6%), similar to that of metal-ceramic FPDs, and feldspathic/silica-based ceramic had the lowest 5-year survival rate (90.7%), which was significantly lower (P < 0.001) than that of metal-ceramic FPDs. Densely sintered zirconia had an annual failure rate of 1.84 (95% CI, 0.89 - 3.77) with a 5-year survival rate of 91.2% (95% CI, 82.8% - 95.6%), also lower than that of metal-ceramic FDPs.
Evidence Search Survival[Mesh] OR survival rate[Mesh] OR survival analysis[Mesh] OR dental restoration failure[Mesh] OR prosthesis failure[Mesh] OR treatment failure[Mesh]
Comments on
The Evidence
Validity: This was a systematic review of prospective and retrospective cohort studies with a Poisson regression meta-analysis. Individual studies were assessed for validity, and studies with less than 3 years of follow-up or those with only chart reviews and interviews were excluded. A total of 4663 metal-ceramic and 9434 all-ceramic FDPs were considered in this review. Perspective: While the evidence shows that metal-ceramic FDPs have a similar survival rate to most all-ceramic FDPs, it can be argued that 5 years is not a long enough timeframe to assess true survival rate. The mean follow-up time of metal-ceramic FDPs was also twice as long as the majority of the all-ceramic counterparts. As all-ceramic restorations become more widely used, further studies will need to be conducted to measure the true life-span of the different materials.
Applicability This evidence is applicable to any adult patient who desires the most clinically stable fixed dental prosthesis; it is important to also consider various contraindications, including occlusal loading stresses.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords All-ceramic crowns, metal-ceramic crowns, fixed dental prosthesis, survival, failure, zirconia
ID# 2983
Date of submission: 02/20/2016spacer
E-mail Kaddourdjebb@livemail.uthscsa.edu
Author Amine Kaddour-Djebbar
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Joseph Connor, DDS, MA
Faculty mentor/Co-author e-mail connorj@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
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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