Survival probability of zirconia‐based fixed dental prostheses up to 5 yr: a systematic review of the literature

Abstract

The purpose of this systematic review was to calculate the 5-yr survival rates of all-ceramic zirconia-based fixed dental prostheses (FDPs) and to analyze technical and biological complications. An electronic literature search of MEDLINE (PubMed) was conducted independently by three reviewers to identify clinical studies from 1999 to 2009 and was completed by a manual search. Keywords and inclusion and exclusion criteria were well-defined. The search revealed 399 titles and led to the final analysis of 18 full-text articles. Nine studies met the inclusion criteria. Extracted data were statistically calculated into 5-yr survival rates and 5-yr complication-free rates by using Poisson regression analysis. In total, 310, 3- to 4-unit FDPs and 20 FDPs with more than 4 units were included. The estimated 5-yr survival rate for all FDPs was 94.29% (95% CI: 58.98-99.32); 19 FDPs were lost as a result of catastrophic failures. The 5-yr complication-free rate regarding technical complications was 76.41% (95% CI: 42.42-91.60) with chipping being the most frequent complication. Regarding biological complications, the 5-yr complication-free rate was 91.72% (95% CI: 59.19-98.53). The survival rates of zirconia-based short-unit FDPs are promising. However, an important improvement of the veneering systems is required, and for FDPs with more units in function, further randomized, controlled clinical trials are necessary.

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

“…This confirmed previous findings with low or non-existent fractures of the zirconia core itself [4][5][6]. No relation was established between the type of abutment and the type of fracture.…”

“…Only one fracture of the zirconia core was reported [12]. Current clinical studies on zirconia-based multiunit FDPs [18][19][20][21] confirm previous systematic reviews [4][5][6]: chipping of the veneering ceramic was a frequent complication, whereas fractures of the core only seldom occurred.…”

“…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].…”

Dental ceramics: a review of new materials and processing methods

“…1,2 Zirconia exists in three different crystallographic forms: cubic, tetragonal and monoclinic phases. Y-TZP shows superior performance among dental ceramics due the high strength level of more than 1000 MPa and its superior fracture toughness of 4 to 5 MPa.m 0.5 .…”

Multifactorial analysis of the impact of different manufacturing processes on the marginal fit of zirconia copings

“…The clinical performance of zirconia-based restorations was previously investigated in fi xed partial dentures and single crowns 1,2) . A recently published systematic review documented a framework survival rate for posterior fi xed partial dentures of 99% after three years 3) .…”