Clinical Oral Investigations

, Volume 22, Issue 2, pp 697–706 | Cite as

Clinical evaluation of zirconia-based all-ceramic single crowns: an up to 12-year retrospective cohort study

  • Shoko Miura
  • Shin Kasahara
  • Shinobu Yamauchi
  • Yayoi Okuyama
  • Akio Izumida
  • Jun Aida
  • Hiroshi EgusaEmail author
Original Article



This study aims to investigate the incidence of clinical complications with tooth-supported zirconia-based all-ceramic single crowns and identify pertinent risk parameters.

Materials and methods

A retrospective cohort study (May 2004 to April 2016) utilizing clinical records of patients receiving yttrium-oxide–partially stabilized zirconia (Y-TZP)-based all-ceramic crowns placed at Tohoku University Hospital was performed. The length of time of treatment success (complication event-free) and restoration survival (including minor complication events and remaining clinically functional) were estimated using Kaplan–Meier analysis. Multilevel survival analysis was used to identify risk factors.


One hundred thirty-seven crowns were evaluated (mean follow-up time, 7.0 years). A total of 21 crowns experienced at least one complication with fracture of veneering ceramic being the most common (16 crowns). Estimated success and survival rates at 5 years (96.9 and 98.5%, respectively) decreased at 10 years to 62.1 and 67.2%, respectively. The risk of complications was significantly higher for molar crowns compared to anterior crowns (p < 0.01). A significant association of complications with metal antagonist restorations was shown by univariate analysis (p < 0.01).


Given the study limitations, Y-TZP single crowns placed on anterior teeth demonstrated encouraging clinical results over a period of up to 10 years. However, there is a substantial risk of complications with posterior teeth within 10 years of restoration placement.

Clinical relevance

Treatment with zirconia-based all-ceramic crowns for molar teeth with metal antagonist occlusion should be undertaken with caution.


All-ceramic crown Retrospective cohort study Risk factor Survival rate Veneering ceramic fracture Yttrium oxide partially stabilized zirconia 



We are grateful to Dr. Masanobu Yoda for his valuable support to initiate and accomplish this work. The authors thank Dr. Shihoko Koyama and Dr. Masahiro Yamada for providing us with helpful comments on this study, as well as colleagues in our department for their invaluable assistance in the conduct of the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


This work was supported by Grant-in Aids for Scientific Research (C: 26462908, C: 15K11145, and C: 17K11739) from the Japan Society for the Promotion of Science.

Ethical approval

This study was performed following a protocol approved by the Research Ethics Committee of Tohoku University, Graduate School of Dentistry (approved number 25-3).

Informed consent

Informed consent of patients was verbally obtained to conduct this study. This study was a retrospective, non-interventional clinical study without the need for a formal consent in accordance with the ethical standards of the institutional and/or national research committee.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Shoko Miura
    • 1
  • Shin Kasahara
    • 1
  • Shinobu Yamauchi
    • 1
  • Yayoi Okuyama
    • 1
  • Akio Izumida
    • 2
  • Jun Aida
    • 3
  • Hiroshi Egusa
    • 1
    Email author
  1. 1.Division of Molecular and Regenerative ProsthodonticsTohoku University Graduate School of DentistryAoba-ku, SendaiJapan
  2. 2.Department of Comprehensive DentistryTohoku University HospitalSendaiJapan
  3. 3.Department of International and Community Oral HealthTohoku University Graduate School of DentistrySendaiJapan

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