Statement of problem
Metal ceramic restorations are widely used in prosthodontics, but long-term data on
their clinical performance in private practice settings based on prospective trials
are sparse.
Purpose
This clinical trial was designed to provide realistic long-term survival rates for
different outcomes related to tooth loss, crown loss, and metal ceramic defect.
Material and methods
Ninety-five participants were provided with 190 noble metal ceramic single crowns
and 138 participants with 276 fixed dental prosthesis retainer crowns on vital posterior
teeth. Follow-up examinations were scheduled 2 weeks after insertion, annually up
to 8 years, and after 10 years. Kaplan-Meier survival analyses, Mantel-Cox logrank
tests, and Cox regression analyses were conducted.
Results
Because of variations in the time of the last examinations, the maximum observation
period was 12.1 years. For the primary outcome ‘loss of crown or tooth’, the Kaplan-Meier
survival rate was 94.3% ±1.8% (standard error) at 8.0 years (last outcome event) for
single crowns and 94.4% ±1.5% at 11.0 years for fixed dental prosthesis retainer crowns.
The difference between the survival functions was not significant (P>.05). For the secondary outcome ‘metal ceramic defect’, the survival rate was 88.8%
±3.2% at 11.0 years for single crowns and 81.7% ±3.5% at 11.0 years for fixed dental
prosthesis retainer crowns. In Cox regression models, the only significant covariates
for the outcome event ‘metal ceramic defect’ were bruxism in the medical history (single
crowns) and signs and symptoms of bruxism (fixed dental prosthesis retainer crowns)
with hazard ratios of 3.065 (95% CI 1.063 – 8.832) and 2.554 (95% CI 1.307 – 4.992).
Conclusions
Metal ceramic crowns provided in private practice settings show good longevity. Bruxism
appears to indicate a risk for metal ceramic defects.
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© 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
