Dentist material selection for single-unit crowns: Findings from the National Dental Practice-Based Research Network

Abstract

Objectives Dentists enrolled in the National Dental Practice-Based Research Network completed a study questionnaire about techniques and materials used for single-unit crowns and an enrollment questionnaire about dentist/practice characteristics. The objectives were to quantify dentists’ material recommendations and test the hypothesis that dentist’s and practice’s characteristics are significantly associated with these recommendations. Methods Surveyed dentists responded to a contextual scenario asking what material they would use for a single-unit crown on an anterior and posterior tooth. Material choices included: full metal, porcelain-fused-to-metal (PFM), all-zirconia, layered zirconia, lithium disilicate, leucite-reinforced ceramic, or other. Results 1,777 of 2,132 eligible dentists responded (83%). The top 3 choices for anterior crowns were lithium disilicate (54%), layered zirconia (17%), and leucite-reinforced glass ceramic (13%). There were significant differences (p<0.05) by dentist’s gender, race, years since graduation, practice type, region, practice busyness, hours worked/week, and location type. The top 3 choices for posterior crowns were all-zirconia (32%), PFM (31%), and lithium disilicate (21%). There were significant differences (p<0.05) by dentist’s gender, practice type, region, practice busyness, insurance coverage, hours worked/week, and location type. Conclusions Network dentists use a broad range of materials for single-unit crowns for anterior and posterior teeth, adopting newer materials into their practices as they become available. Material choices are significantly associated with dentist’s and practice’s characteristics. Clinical Significance Decisions for crown material may be influenced by factors unrelated to tooth and patient variables. Dentists should be cognizant of this when developing an evidence-based approach to selecting crown material.

Strength and translucency of zirconia after high‐speed sintering

“…A 2016 survey reported that 32% of US dentists would choose full contour zirconia as the material of choice for a single unit posterior crown . Likely the use of zirconia crowns would have been less for those dentists who fabricated crowns with a chairside milling machine as there were few options for chairside fabrication of zirconia crowns until recently.…”

Survival Predictions of Ceramic Crowns Using Statistical Fracture Mechanics

“…Perhaps the most appealing aspect of this new crown type is that it requires preparation specifications similar to those of cast metal. Despite the lack of existing clinical performance data and concerns regarding low-temperature degradation raised by some in the scientific community (Kelly and Denry 2008), many dentists have recommended and prescribed this new crown type for their patients (Makhija et al 2016) A recent systematic review comparing 5-y survival rates of single crowns suggests that several current all-ceramic crown types compare favorably to that of metal-ceramics when used on posterior teeth (Sailer et al 2015). Nearly all of the ceramic crown systems examined in this analysis were layered structures.…”

Remake Rates for Single‐Unit Crowns in Clinical Practice: Findings from The National Dental Practice‐Based Research Network

“…Practice busyness was also associated with the treatment planning process, as was the use of optical scanners . Clinician sex, region of practice, and hours worked per week impacted material choice for single‐unit crowns . Clinician race and ethnicity were associated with the likelihood that a clinician would accept an impression and send it to the laboratory for crown fabrication …”