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

Ayda L¹*, Imen K¹, Mounir C², Dalenda H² and Hassen H²

Received: November 14, 2017;   Published: December 04, 2017

DOI: 10.26717/BJSTR.2017.01.000563

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Abstract

Purpose: To assess the 3-year survival rates and the incidences of biological and technical complications of all-ceramic and metal-ceramic tooth-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.

Keywords: Tooth-supported single crowns; Fixed dental prosthesis; All-ceramic; Metal-ceramic; Survival; Technical complications; Biological complications

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