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A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic single crowns
Author(s) -
Pjetursson Bjarni E,
Valente Nicola A,
Strasding Malin,
Zwahlen Marcel,
Liu Shiming,
Sailer Irena
Publication year - 2018
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.13306
Subject(s) - medicine , implant , dentistry , poisson regression , cubic zirconia , incidence (geometry) , ceramic , surgery , materials science , population , composite material , mathematics , geometry , environmental health
Objectives The aim of the present systematic review was to analyze the survival and complication rates of zirconia‐based and metal‐ceramic implant‐supported single crowns ( SC s). Materials and Methods An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort and retrospective case series on implant‐supported SC s with a mean follow‐up time of at least 3 years. Patients had to have been clinically examined at the follow‐up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5‐year proportions. Results The search provided 5,263 titles and 455 abstracts, full‐text analysis was performed for 240 articles, resulting in 35 included studies on implant‐supported crowns. Meta‐analysis revealed an estimated 5‐year survival rate of 98.3% (95% CI : 96.8–99.1) for metal‐ceramic implant supported SC s ( n = 4,363) compared to 97.6% (95% CI : 94.3–99.0) for zirconia implant supported SC s ( n = 912). About 86.7% (95% CI: 80.7–91.0) of the metal‐ceramic SC s ( n = 1,300) experienced no biological/technical complications over the entire observation period. The corresponding rate for zirconia SC s ( n = 76) was 83.8% (95% CI: 61.6–93.8). The biologic outcomes of the two types of crowns were similar; yet, zirconia SC s exhibited less aesthetic complications than metal‐ceramics. The 5‐year incidence of chipping of the veneering ceramic was similar between the material groups (2.9% metal‐ceramic, 2.8% zirconia‐ceramic). Significantly ( p = 0.001), more zirconia‐ceramic implant SC s failed due to material fractures (2.1% vs. 0.2% metal‐ceramic implant SC s). No studies on newer types of monolithic zirconia SC s fulfilled the simple inclusion criteria of 3 years follow‐up time and clinical examination of the present systematic review. Conclusion Zirconia‐ceramic implant‐supported SC s are a valid treatment alternative to metal‐ceramic SC s, with similar incidence of biological complications and less aesthetic problems. The amount of ceramic chipping was similar between the material groups; yet, significantly more zirconia crowns failed due to material fractures.