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Risk factors for technical and biological complications with zirconia single crowns

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Abstract

Objectives

This practice-based study evaluated the clinical performance and risk factors for biological and technical complications with conventionally luted zirconia crowns.

Materials and methods

Sixty-eight patients (39 female) with a total of 323 restorations placed on 219 vital teeth, 69 endodontically treated teeth (ETT), and 41 implants (incisors, 96; premolars, 89; molars, 138; observational period, 79.7 ± 14.2 months) underwent a clinical follow-up examination and were included in the study. Time-dependent survival (in situ), success (event free), and veneering ceramic fracture (VCF) rates were calculated and analyzed relative to the following risk factors: smoking status, location of the crown, and type of abutment.

Results

Fifty-three complete failures were recorded. A significant influence of the abutment type on survival could be detected (p = 0.033): ETT demonstrated a significantly (p = 0.029) lower 7-year survival rate (73.8 %, 95 % confidence interval [95 % CI] 0.600–0.876) than crowns placed on implants (90.0 %, 95 % CI 0.814–0.990). The success rate of the crowns was significantly influenced by the location of the restoration (p = 0.0058). A total of 75.6 % (95 % CI 0.648–0.864) of the anterior crowns remained event free, compared to 50.4 % (95 % CI 0.388–0.621) of the molar crowns. Furthermore, the location of the crowns affected the VCF rate (p = 0.018, event-free anterior teeth 95.2 % (95 % CI 0.880–1), event-free molars 80.9 % (95 % CI 0.706–0.913)).

Conclusions

Survival and success rates were significantly influenced by the type of abutment and the location of the restoration.

Clinical relevance

More complete failures should be expected for crowns placed on ETT, while crowns on molars demonstrated more biological and technical complications than anterior zirconia crowns.

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References

  1. Miyazaki T, Nakamura T, Matsumura H, Ban S, Kobayashi T (2009) Current status of zirconia restoration. J Prosthodont Res 57(4):236–261

    Article  Google Scholar 

  2. Raigrodski AJ, Hillstead MB, Meng GK, Chung KH (2012) Survival and complications of zirconia-based fixed dental prostheses: a systematic review. J Prosthet Dent 107(3):170–177

    Article  PubMed  Google Scholar 

  3. Anusavice KJ (2012) Standardizing failure, success, and survival decisions in clinical studies of ceramic and metal-ceramic fixed dental prostheses. Dent Mater 28(1):102–111

    Article  PubMed Central  PubMed  Google Scholar 

  4. Groten M, Huttig F (2010) The performance of zirconium dioxide crowns: a clinical follow-up. Int J Prosthodont 23:429–431

    PubMed  Google Scholar 

  5. Schmitt J, Wichmann M, Holst S, Reich S (2010) Restoring severely compromised anterior teeth with zirconia crowns and feather-edged margin preparations: a 3-year follow-up of a prospective clinical trial. Int J Prosthodont 23(2):107–109

    PubMed  Google Scholar 

  6. Tartaglia GM, Sidoti E, Sforza C (2011) A 3-year follow-up study of all-ceramic single and multiple crowns performed in a private practice: a prospective case series. Clinics (Sao Paulo) 66:2063–2070

    Article  Google Scholar 

  7. Poggio CE, Dosoli R, Ercoli C (2012) A retrospective analysis of 102 zirconia single crowns with knife-edge margins. J Prosthet Dent 107(5):316–321

    Article  PubMed  Google Scholar 

  8. Hosseini M, Worsaae N, Schiødt M, Gotfredsen K (2013) A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal-ceramic materials in patients with tooth agenesis. Clin Oral Implants Res 24(10):1078–1087

    Article  PubMed  Google Scholar 

  9. Monaco C, Caldari M, Scotti R, AIOP Clinical Research Group (2013) Clinical evaluation of 1,132 zirconia-based single crowns: a retrospective cohort study from the AIOP clinical research group. Int J Prosthodont 26(5):435–442

    Article  PubMed  Google Scholar 

  10. Ozer F, Mante FK, Chiche G, Saleh N, Takeichi T, Blatz MB (2014) A retrospective survey on long-term survival of posterior zirconia and porcelain-fused-to-metal crowns in private practice. Quintessence Int 45(1):31–38

    PubMed  Google Scholar 

  11. Larsson C, Wennerberg A (2014) The clinical success of zirconia-based crowns: a systematic review. Int J Prosthodont 27(1):33–43

    Article  PubMed  Google Scholar 

  12. Pjetursson BE, Sailer I, Zwahlen M, Hämmerle CH (2007) A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part I: single crowns. Clin Oral Implants Res 18(Suppl 3):73–85

    Article  PubMed  Google Scholar 

  13. Takeichi T, Katsoulis J, Blatz MB (2013) Clinical outcome of single porcelain-fused-to-zirconium dioxide crowns: a systematic review. J Prosthet Dent 110(6):455–461

    Article  PubMed  Google Scholar 

  14. Ortorp A, Kihl ML, Carlsson GE (2012) A 5-year retrospective study of survival of zirconia single crowns fitted in a private clinical setting. J Dent 40:527–530

    Article  PubMed  Google Scholar 

  15. Schwarz S, Schröder C, Hassel A, Bömicke W, Rammelsberg P (2012) Survival and chipping of zirconia-based and metal-ceramic implant-supported single crowns. Clin Implant Dent Relat Res 14(Suppl 1):e119–e125

    Article  PubMed  Google Scholar 

  16. Kimmich M, Stappert CF (2013) Intraoral treatment of veneering porcelain chipping of fixed dental restorations: a review and clinical application. J Am Dent Assoc 144(1):31–44

    Article  PubMed  Google Scholar 

  17. Guess PC, Bonfante EA, Silva NR, Coelho PG, Thompson VP (2013) Effect of core design and veneering technique on damage and reliability of Y-TZP-supported crowns. Dent Mater 29(3):307–316

    Article  PubMed  Google Scholar 

  18. Preis V, Letsch C, Handel G, Behr M, Schneider-Feyrer S, Rosentritt M (2013) Influence of substructure design, veneer application technique, and firing regime on the in vitro performance of molar zirconia crowns. Dent Mater 29(7):e113–e121

    Article  PubMed  Google Scholar 

  19. Belli R, Frankenberger R, Appelt A, Schmitt J, Baratieri LN, Greil P, Lohbauer U (2013) Thermal-induced residual stresses affect the lifetime of zirconia-veneer crowns. Dent Mater 29(2):181–190

    Article  PubMed  Google Scholar 

  20. Rinke S, Schäfer S, Lange K, Gersdorff N, Roediger M (2013) Practice-based clinical evaluation of metal-ceramic and zirconia molar crowns: 3-year results. J Oral Rehabil 40(3):228–237

    Article  PubMed  Google Scholar 

  21. Beuer F, Edelhoff D, Gernet W, Sorensen JA (2009) Three-year clinical prospective evaluation of zirconia-based posterior fixed dental prostheses (FDPs). Clin Oral Investig 13(4):445–451

    Article  PubMed  Google Scholar 

  22. Koenig V, Vanheusden AJ, Le Goff SO, Mainjot AK (2013) Clinical risk factors related to failures with zirconia-based restorations: an up to 9-year retrospective study. J Dent 41(12):1164–1174

    Article  PubMed  Google Scholar 

  23. Schmitter M, Boemicke W, Stober T (2014) Bruxism in prospective studies of veneered zirconia restorations—a systematic review. Int J Prosthodont 27(2):127–133

    Article  PubMed  Google Scholar 

  24. Heintze SD, Rousson V (2010) Fracture rates of IPS Empress all-ceramic crowns—a systematic review. Int J Prosthodont 23(2):129–133

    PubMed  Google Scholar 

  25. Land MF, Hopp CD (2010) Survival rates of all-ceramic systems differ by clinical indication and fabrication method. J Evid Based Dent Pract 10(1):37–38

    Article  PubMed  Google Scholar 

  26. Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS (2012) Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res 23(Suppl 6):2–21

    Article  PubMed  Google Scholar 

  27. Beier US, Kapferer I, Dumfahrt H (2012) Clinical long-term evaluation and failure characteristics of 1,335 all-ceramic restorations. Int J Prosthodont 25(1):70–78

    PubMed  Google Scholar 

  28. Wang X, Fan D, Swain MV, Zhao K (2012) A systematic review of all-ceramic crowns: clinical fracture rates in relation to restored tooth type. Int J Prosthodont 25(5):441–450

    PubMed  Google Scholar 

  29. Beuer F, Aggstaller H, Edelhoff D, Gernet W, Sorensen J (2009) Marginal and internal fits of fixed dental prostheses zirconia retainers. Dent Mater 25(1):94–102

    Article  PubMed  Google Scholar 

  30. Gerds TA, Qvist V, Strub JR, Pipper CB, Scheike TH, Keiding N (2009) Failure time analysis. In: Lesaffre E, Feine J, LeRoux B (eds) Statistical and methodological aspects of oral health research. John Wiley and Sons, West Sussex, pp 259–277

    Chapter  Google Scholar 

  31. Rinke S, Gersdorff N, Lange K, Roediger M (2013) Prospective evaluation of zirconia posterior fixed partial dentures: 7-year clinical results. Int J Prosthodont 26(2):164–171

    Article  PubMed  Google Scholar 

  32. Wettstein F, Sailer I, Roos M, Hämmerle CH (2008) Clinical study of the internal gaps of zirconia and metal frameworks for fixed partial dentures. Eur J Oral Sci 116(3):272–279

    Article  PubMed  Google Scholar 

  33. Ernst CP, Cohnen U, Stender E, Willershausen B (2005) In vitro retentive strength of zirconium oxide ceramic crowns using different luting agents. J Prosthet Dent 93(6):551–558

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Katrin Rinke for the critical reading and language editing of the manuscript. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest

Sven Rinke has received lecture fees from DeguDent GmbH, Hanau, Germany. Katharina Lange, Matthias Roediger, and Nikolaus Gersdorff declare that they have no conflict of interest.

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Authors and Affiliations

  1. Private Practice, Geleitstr. 68, 63456, Hanau, Germany

    Sven Rinke

  2. Department of Medical Statistics, Georg-August-University, Humboldtallee 32, 37073, Göttingen, Germany

    Katharina Lange

  3. Department of Prosthodontics, Georg-August-University, Robert-Koch-Str. 40, 37075, Göttingen, Germany

    Sven Rinke, Matthias Roediger & Nikolaus Gersdorff

Authors
  1. Sven Rinke
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  2. Katharina Lange
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  4. Nikolaus Gersdorff
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Correspondence to Sven Rinke.

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Rinke, S., Lange, K., Roediger, M. et al. Risk factors for technical and biological complications with zirconia single crowns. Clin Oral Invest 19, 1999–2006 (2015). https://doi.org/10.1007/s00784-015-1410-y

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  • DOI: https://doi.org/10.1007/s00784-015-1410-y

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