Abstract
Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.
Highlights
Metal–ceramic restorations are still considered the “gold standard” for the rehabilitation of posterior teeth due to their long-term predictability
Layered zirconia has shown good clinical results compared with metal–ceramic restorations
Anatomic form and marginal integrity did not show any significant differences when the 6-month data, 1-year data and 2-year data were compared with the baseline data
Summary
Metal–ceramic restorations are still considered the “gold standard” for the rehabilitation of posterior teeth due to their long-term predictability. Despite its high survival rate (>90%) and adequate aesthetics, the chipping or fracture of the veneering ceramic (16.97%) after 10 years of follow-up is a common complication, and a cause of failure of this type of zirconia restorations [2,6,7,8,9,10]. The latest modifications in zirconia composition, structure, and fabrication methods have resulted in translucent monolithic zirconia (the third generation), but with a significant reduction in the flexural strength [15,16]. Due to their recent introduction, studies on their clinical outcome are still limited, and most of them are in vitro. More clinical studies are necessary to evaluate their clinical behaviour
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