{"title":"Long-term clinical outcomes of posterior monolithic and porcelain-fused zirconia crowns: A retrospective cohort study","authors":"Yu Takaesu DDS, PhD , Yusuke Taniguchi DDS, PhD , Naoyuki Kaga DDS, PhD , Yuichiro Yamaguchi DDS, PhD , Kae Kakura DDS, PhD , Nao Suzuki DDS, PhD , Takashi Matsuura DDS, PhD","doi":"10.1016/j.prosdent.2025.01.033","DOIUrl":null,"url":null,"abstract":"<div><h3>Statement of problem</h3><div>Monolithic zirconia crowns and porcelain-fused zirconia crowns have been evaluated with in vitro studies, but clinical evidence of their longevity is limited.</div></div><div><h3>Purpose</h3><div>The purpose of this retrospective cohort study was to compare the long-term cumulative survival and success rates of posterior monolithic and porcelain-fused zirconia crowns and to investigate risk factors associated with complications.</div></div><div><h3>Material and methods</h3><div>The study included 235 patients and 255 crowns (dropout rate:10.9%). Clinical data were analyzed for single posterior monolithic zirconia crowns and porcelain-fused zirconia crowns placed consecutively during a 10-year period and for subsequent events during follow-up. Survival curves for the monolithic zirconia crown and porcelain-fused zirconia crown groups were drawn using Kaplan-Meier analysis. Statistical differences between groups were tested using the log-rank test (α=.05). The Cox proportional hazards analysis was used to identify risk factors for crown and abutment tooth complications.</div></div><div><h3>Results</h3><div>The 10-year cumulative survival rates of the monolithic zirconia crown and porcelain-fused zirconia crown groups were 86.0% (95% CI, 72.8 to 99.1%) and 71.0% (95% CI, 54.6 to 87.9%), respectively. The monolithic zirconia crown group had a higher survival rate than the porcelain-fused zirconia crown group, but the difference was not statistically significant (<em>P</em>=.108). The 10-year cumulative success rate was higher in the monolithic zirconia crown group than in the porcelain-fused zirconia crown group, but the difference was not statistically significant (<em>P</em>=.071). Two risk factors were identified for crown complications alone: a molar rather than premolar crown (<em>P</em>=.014, hazard ratio [HR]=6.012) and a maxillary rather than a mandibular crown (<em>P</em>=.003, HR=9.487).</div></div><div><h3>Conclusions</h3><div>The 2 different types of crowns exhibited application site dependency for crown complications but not for abutment tooth complications.</div></div>","PeriodicalId":16866,"journal":{"name":"Journal of Prosthetic Dentistry","volume":"133 6","pages":"Pages 1475-1483"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Prosthetic Dentistry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022391325000721","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
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Abstract
Statement of problem
Monolithic zirconia crowns and porcelain-fused zirconia crowns have been evaluated with in vitro studies, but clinical evidence of their longevity is limited.
Purpose
The purpose of this retrospective cohort study was to compare the long-term cumulative survival and success rates of posterior monolithic and porcelain-fused zirconia crowns and to investigate risk factors associated with complications.
Material and methods
The study included 235 patients and 255 crowns (dropout rate:10.9%). Clinical data were analyzed for single posterior monolithic zirconia crowns and porcelain-fused zirconia crowns placed consecutively during a 10-year period and for subsequent events during follow-up. Survival curves for the monolithic zirconia crown and porcelain-fused zirconia crown groups were drawn using Kaplan-Meier analysis. Statistical differences between groups were tested using the log-rank test (α=.05). The Cox proportional hazards analysis was used to identify risk factors for crown and abutment tooth complications.
Results
The 10-year cumulative survival rates of the monolithic zirconia crown and porcelain-fused zirconia crown groups were 86.0% (95% CI, 72.8 to 99.1%) and 71.0% (95% CI, 54.6 to 87.9%), respectively. The monolithic zirconia crown group had a higher survival rate than the porcelain-fused zirconia crown group, but the difference was not statistically significant (P=.108). The 10-year cumulative success rate was higher in the monolithic zirconia crown group than in the porcelain-fused zirconia crown group, but the difference was not statistically significant (P=.071). Two risk factors were identified for crown complications alone: a molar rather than premolar crown (P=.014, hazard ratio [HR]=6.012) and a maxillary rather than a mandibular crown (P=.003, HR=9.487).
Conclusions
The 2 different types of crowns exhibited application site dependency for crown complications but not for abutment tooth complications.
期刊介绍：
The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.
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