#All-Ceramic
versus Metal-Ceramic Tooth Supported Single Crowns with a Minimum
Follow-Up Time of 3 Years; Survival and Complications: A Systematic
Literature Review by Ayda L in BJSTR
Abstract
Purpose: To assess the 3-year survival rates and the
incidences of biological and technical complications of all-ceramic and metal-ceramictooth-supported single crowns.
Material and Methods: An online research of literature on Pub
med was conducted independently by 3 reviewers to identify the clinical
studies performed from 2000 up to 2017 and completed by a manual
research. Keywords, inclusion and exclusion criteria were well-defined.
Results: The research revealed 501 titles and led to a final
analysis of 31 full text articles. Only 6 studies met the inclusion
criteria and
reported on 215 metal-ceramic and 501 all-ceramic TSSCs. The
meta-analysis of the included studies indicated an estimated survival
rate of
metal-ceramic TSSCs of 90.14% (95% CI: 89.72%-91.35%) after 3 years.
This was a little bit higher than the estimated 3-year survival rate
of Lithium-disilicate (89.54%; 95% CI: 87.18%-91.89%). However the
3-year survival rate, of Zirconia TSSCs was statistically much higher
(92.01%; 95% CI: 89.58-94.43%). When the outcomes in anterior and
posterior regions were compared, Zirconia and Lithium-disilicate TSSCs
exhibited survival rates of 91.64% and 91.12% respectively, in the
posterior region, where metal-ceramic TSSCs exhibited only 90.14% as a
3-year survival rate. As for the anterior region, we could only compare
the TSSCs made out of Lithium-disilicate and Zirconia as the
metalceramic
ones were all laid on the posterior regions. Zirconia performed the
highest 3-year survival rate in the anterior region (93.54%; 95% CI:
91.08-96%) whereas Lithium-disilicate showed only 87.5%. This was due to
the low level of the mechanical properties of such material, which
clinically indicated by major chipping and tooth fracture.
Conclusion: Survival rates of metal-ceramic crowns were nearly
similar to those reported for most types of all-ceramic TSSCs in the
posterior region. Weaker Lithium-disilicate-based ceramics should be
limited to application in the anterior region, even if they expressed a
higher survival rate in the anterior regions. Zirconia-based TSSCs
should not be considered as a primary option due to their high incidence
of
technical problems.
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