Prospective study of monolithic zirconia crowns: clinical behavior and survival rate at a 5-year follow-up

Abstract

Purpose: To evaluate the clinical behavior and survival of full coverage monolithic zirconia crowns on posterior teeth over a 5-year follow-up. Methods: Fifty patients were recruited and underwent restoration with a Lava Plus monolithic zirconia crown (Lava™ Frame Zirconia, 3M Espe, Germany) on premolars or molars. Patients were monitored over a 5-year follow-up (2014-19), recording any biological and/or mechanical complications; these data were used to estimate the crowns' success rate. Periodontal clinical parameters were recorded (pocket probing depth (PPD), plaque index (PLI), bleeding on probing (BOP), and gingival recession (GR)). Wear to the zirconia crowns and antagonist teeth were also evaluated with Geomagic software (3D Systems, U.S.A.). Patients' satisfaction with treatment was evaluated in a questionnaire. Results: For the 50 monolithic zirconia crowns analyzed, the survival rate was 98% after 5 years. Only 6% of the crowns presented some type of complication (two debonding and one root fracture). No fracture or fissures were detected. GR and BOP were the only clinical parameters found to be significantly greater around teeth restored with crowns. The monolithic zirconia crowns suffered less wear than the enamel of antagonist teeth. Patient's general satisfaction with treatment was high. Conclusions: Monolithic zirconia crowns on posterior teeth are a highly predictable treatment option, with a high survival rate. The single treatment failure was due to a biological complication arising from root fracture. This treatment may be recommended as a treatment that conserves dental structure, and requires minimal dental preparation.

Five-year clinical performance of monolithic and partially veneered zirconia single crowns—a prospective observational study

“…The literature contains only one clinical study conducted over a medium-term observation period. Rare technical complications with monolithic zirconia crowns were confirmed in this study by Solá-Ruiz et al Among 50 monolithic crowns fabricated from zirconia stabilized with 3-mol% yttrium oxide, only two decementations and one longitudinal fracture occurred over the observation period [16]. Sulaiman et al counted the frequency of remakes of monolithic restorations due to fracture over a 5-year period in two dental laboratories.…”

“…The dentists were somewhat more critical than the patients themselves. For patients, it seems to be more important that their restoration(s) are unaffected by complications [16] rather than that the tooth shade is 100% consistent.…”

Endocrowns Clinical Performance and Patient Satisfaction: A Randomized Clinical Trial of Three Monolithic Ceramic Restorations

“…Debonding was the most noted complication for full-coverage 3% Y-TZP monolithic posterior crowns in a 5-year prospective study. 33 This study showed that all three ceramic endocrowns bonded to tooth structure provided an adequate coronal seal that enabled at least partial healing of periapical lesions within the two-year observation period. 34 In the lithium disilicate group, one tooth developed a new periapical lesion.…”

Fracture Load of CAD/CAM Fabricated Cantilever Implant-Supported Zirconia Framework: An In Vitro Study

“…There is a substantial increase in the use of zirconia (Zr) dental restorations in the recent years [ 1 ] due to the excellent biocompatibility, superior mechanical properties (such as high fracture strength/fracture toughness) and physical properties (dimensional stability, color matching with the teeth and sufficient precision) for dental applications [ 2 ]. The use of Zr ceramics is not limited to the single crowns and used for the fabrication of endodontic posts, fixed partial dentures (FPD), implant abutments and frameworks [ 3 , 4 ]. The brittle nature of ceramic leading to the formation of inherent defects and microcracks remain the main obstacle for using the metal-free ceramic restorations [ 5 ].…”