Wear in Antagonist Teeth Produced by Monolithic Zirconia Crowns: A Systematic Review and Meta-Analysis

Abstract

Background: The aim of this systematic review and meta-analysis was to determine the wear sustained in the natural antagonist tooth in cases of full-coverage fixed-base prosthetic restorations or monolithic zirconia tooth-supported crowns, as well as to determine the wear in the restoration itself, both in the short- and medium-term and considering the factors that may influence wear. Material and methods: A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated wear in antagonist teeth in relation to fixed-prosthesis monolithic zirconia crowns. A total of 5 databases were consulted in the literature search: Pubmed-Medline, Cochrane, Scopus, Embase and Web of Science (WOS). After eliminating duplicated articles and applying the inclusion criteria, eight articles were selected for the qualitative analysis and four for the quantitative analysis. Results: Mean maximum wear of the antagonist tooth in relation to monolithic zirconia crowns of magnitude 95.45 µm (CI at 95% 79.57–111.33) was observed. By using a meta-regression model (R2 = 0.92) the significant effect of time in maximum wear rate (p < 0.001) was observed, estimated at 6.13 µm per month (CI at 95% 3.99–8.27). Furthermore, monolithic zirconia crowns are subject to a mean maximum wear of 58.47 µm (CI 95% 45.44–71.50). By using a meta-regression model (R2 = 0.53) the significant effect of time in the maximum wear value was observed (p = 0.053), estimated at 3.40 µm per month (CI al 95% −0.05–6.85). Conclusions: Monolithic zirconia crowns lead to a progressive maximum wear of the antagonist tooth over time which is greater than the maximum wear sustained in the crown itself. It is not possible to establish an objective and quantitative objection in relation to natural enamel wear or metal–ceramic crowns.

Prospective Clinical Evaluation of Posterior Monolithic Zirconia Fixed Partial Dentures Using a Complete Digital Workflow: Two‐Year Follow‐Up

“…One restoration showed a loss of occlusion in one abutment tooth because of wear at the occlusal surface that could be due to a loss of the surface coating of the glass resulting in an increased surface roughness 68 . The wear of monolithic zirconia restorations was previously reported, and several factors may be involved such as the surface treatment (glazed or polished), the position of the restorations, or surface roughness 33,36,68–71 . However, previous study reported that zirconia wear, either in vitro or clinical, is normally negligible 69 …”

Patient Satisfaction with Implant‐Supported Monolithic and Partially Veneered Zirconia Restorations

“…One previously reported flaw of monolithic zirconia crowns is that, given the superior hardness of the material (Hv ≈ 1200 GPa; double that of porcelain [ 34 ]), zirconia could be more abrasive to enamel than other restorative materials, at least on paper, especially if not polished properly [ 35 ]; recent systematic reviews have concluded though that monolithic zirconia is not more abrasive than other, commonly used, restorative materials, at least in in vitro studies [ 36 , 37 ].…”

Long-term clinical performance and complications of zirconia-based tooth- and implant-supported fixed prosthodontic restorations: A summary of systematic reviews

“…Polished monolithic zirconia crowns showed no accelerated wear compared with metal-ceramic crowns [74]. Solá-Ruíz et al [75] additionally included three newer studies [76][77][78]. With follow-up times varying between 6 and 24 months, a high degree of heterogeneity was found in the meta-analysis.…”