Survival and Chipping of Zirconia‐Based and Metal–Ceramic Implant‐Supported Single Crowns

Schwarz, Stefanie; Schröder, C.; Hassel, Alexander J.; Bömicke, Wolfgang; Rammelsberg, Peter

doi:10.1111/j.1708-8208.2011.00388.x

Cited by 66 publications

(60 citation statements)

References 17 publications

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“…Previous publications evaluating the same material composition (Cercon/Cercon Ceram Kiss; DeguDent, Hanau, Germany) in a comparable setup found significantly higher complication rates of 7.5% after 6 months and 24.5% after two years, respectively [9,23]. Furthermore, the patient-reported outcome was assessed in this trial [22], revealing a high patient satisfaction, as observed in the present investigation.…”

Section: Patient-reported Outcome (Vas)supporting

confidence: 82%

“…Because market-available zirconia implants are mostly designed as one-piece implants comprising an endosseous, transmucosal, and intraoral part in a single piece, the restoration has to be cemented to the implant abutment comparable to tooth-supported reconstructions. Especially in posterior regions, the same polycrystalline ceramic material (Y-TZP) as used for ceramic implant production proved to be a reliable substructure for the fabrication of highly esthetic, implantsupported, bi-layer crowns [9]. For both tooth-and implant-supported, zirconia-based SCs, survival rates seem to be comparable to those of conventional porcelain-fused-to-metal (PFM) crowns [10].…”

Section: Introductionmentioning

confidence: 99%

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All-ceramic, bi-layered crowns supported by zirconia implants: Three-year results of a prospective multicenter study

Spies

Balmer

Jung

et al. 2017

Journal of Dentistry

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OBJECTIVES: To determine the clinical and patient-reported outcomes of bi-layered, allceramic posterior single crowns (SCs) supported by zirconia implants in an uncontrolled, prospective, multicenter study. METHODS: In two centers, 60 patients received 71 one-piece zirconia oral implants to be restored with either SCs (n=49) or three-unit fixed dental prostheses (n=11). Of these patients, 45 implants were restored with all-ceramic, zirconia-based posterior SCs (one per patient). Survival rates of implants and reconstructions were assessed, and technical success was evaluated according to modified U.S. Public Health Service (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Kaplan-Meier (KM) plots and log-rank tests were used for success/survival analyses. The Wilcoxon matched-pairs signed-rank test was used to evaluate time effects on response variables (PROMs, USPHS criteria). RESULTS: Forty patients with 40 SCs could be evaluated after 36.7±1.2months. No SC was replaced, resulting in 100% survival. The KM success estimate was 87.5% (two chippings, one restoration margin, and one contour were rated Charlie). In general, the incidence of chipping (p=.0005) and occlusal roughness (p=.0003) was frequent. Compared with the pre-treatment patient surveys (67-93%), all surveys at prosthetic delivery except for speech (p=.139) showed significantly improved VAS scores (81-94%; p<.0001). Thereafter, no decrease in satisfaction could be observed over time until the 3-year follow-up (86-93%; p.390). CONCLUSION: Veneered, zirconia-based SCs supported by zirconia implants satisfied patients' needs highly. However, significant incidence of chipping and roughness of the veneering ceramic may compromise the clinical longterm outcome for this indication. CLINICAL SIGNIFICANCE: Posterior, zirconia-based SCs supported by zirconia oral implants entirely survived the follow-up period of 3 years, but two major chippings, one a significant marginal opening and one pronounced over-contouring, resulted in a reduced KM success estimate of 87.5% after 36 months of observation. Spies, Benedikt C; Balmer, Marc; Jung, Ronald E; Sailer, Irena; Vach, Kirstin; Kohal, Ralf-Joachim (2017 AbstractObjectives: To determine the clinical and patient-reported outcomes of bi-layered, all-ceramic posterior single crowns (SCs) supported by zirconia implants in an uncontrolled, prospective, multicenter study.Methods: In two centers, 60 patients received 71 one-piece zirconia oral implants to be restored with either SCs (n = 49) or three-unit fixed dental prostheses (n = 11). Of these patients, 45 implants were restored with all-ceramic, zirconia-based posterior SCs (one per patient). Survival rates of implants and reconstructions were assessed, and technical success was evaluated according to modified U.S. Public Health Service (USPHS) criteria.Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Kaplan-Meier (KM) ...

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Section: Patient-reported Outcome (Vas)supporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

All-ceramic, bi-layered crowns supported by zirconia implants: Three-year results of a prospective multicenter study

Spies

Balmer

Jung

et al. 2017

Journal of Dentistry

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“…Groten and Huttig [30] reported 2 ceramic veneering material chippings of 54 single crowns after 28 months which needed replacement. Nothdurft and Pospiech [35] showed 10 % and Schwarz et al [36] reported 24.5 % porcelain chipping in Cercon single crowns on implant abutments. In the study conducted by Schwarz et al [36], 11.3 % of fractures led to failure.…”

Section: Discussionmentioning

confidence: 97%

Clinical outcomes of zirconia-based implant- and tooth-supported single crowns

2015

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“…Over the last years, chipping of veneering ceramics has been recognized as the most frequent technical complication of allceramic single crowns (SCs) [1,2] and multiunit fixed dental prostheses (FDPs) [3][4][5][6]. Further, clinical studies indicated that fractures of the veneering ceramic were more frequent with zirconia frameworks than with conventional metal-ceramic restorations [4,7].…”

Section: Introductionmentioning

confidence: 99%

Three- to nine-year survival estimates and fracture mechanisms of zirconia- and alumina-based restorations using standardized criteria to distinguish the severity of ceramic fractures

2015

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Objectives The aims of this study were set as follows:1. To provide verifiable criteria to categorize the ceramic fractures into non-critical (i.e., amenable to polishing) or critical (i.e., in need of replacement) 2. To establish the corresponding survival rates for alumina and zirconia restorations 3. To establish the mechanism of fracture using fractography Materials and methods Fifty-eight patients restored with 115 alumina-/zirconia-based crowns and 26 zirconia-based fixed dental prostheses (FDPs) were included. Ceramic fractures were classified into four types and further subclassified into "critical" or "non-critical." Kaplan-Meier survival estimates were calculated for "critical fractures only" and "all fractures." Intra-oral replicas were taken for fractographic analyses. Results Kaplan-Meier survival estimates for "critical fractures only" and "all fractures" were respectively: Alumina single crowns: 90.9 and 68.3 % after 9.5 years (mean 5.71 ± 2.6 years). Zirconia single crowns: 89.4 and 80.9 % after 6.3 years (mean 3.88±1.2 years). Zirconia FDPs: 68.6 % (critical fractures) and 24.6 % (all fractures) after 7.2 and 4.6 years respectively (FDP mean observation time 3.02±1.4 years). No core/framework fractures were detected. Conclusions Survival estimates varied significantly depending on whether "all" fractures were considered as failures or only those deemed as "critical". For all restorations, fractographic analyses of failed veneering ceramics systematically demonstrated heavy occlusal wear at the failure origin. Therefore, the relief of local contact pressures on unsupported ceramic is recommended. Occlusal contacts on mesial or distal ridges should systematically be eliminated. Clinical relevance A classification standard for ceramic fractures into four categories with subtypes "critical" and "noncritical" provides a differentiated view of the survival of ceramic restorations.

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Survival and Chipping of Zirconia‐Based and Metal–Ceramic Implant‐Supported Single Crowns

Abstract: Chipping was found to be more frequent for all-ceramic implant-supported single crowns. If the reasons for the vulnerability of all-ceramic crowns remain unknown, implants with all-ceramic single crowns should generally be recommended with care.

Cited by 66 publications

References 17 publications

All-ceramic, bi-layered crowns supported by zirconia implants: Three-year results of a prospective multicenter study

All-ceramic, bi-layered crowns supported by zirconia implants: Three-year results of a prospective multicenter study

Clinical outcomes of zirconia-based implant- and tooth-supported single crowns

Three- to nine-year survival estimates and fracture mechanisms of zirconia- and alumina-based restorations using standardized criteria to distinguish the severity of ceramic fractures

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