Abstract
Statement of problem
Although recent studies have reported the success of implant-supported monolithic
restorations, consensus on the use of monolithic ceramic restorations is lacking.
Purpose
The purpose of this systematic review and meta-analysis was to evaluate the survival
and biological and technical complication rates of monolithic single crowns and fixed
partial dentures (FPDs).
Material and methods
An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE,
Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk
of bias tool were used to assess the quality and risk of bias of the included studies.
Meta-analysis was performed by using the R software program.
Results
The search identified 763 articles, 18 of which met the eligibility criteria. A total
of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated
FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate,
461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36
lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated
the proportion of survival, biological, and technical complication rates of 1% (95%
confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively,
for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI:
1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed
a direct comparison between monolithic and veneered ceramic restorations, and no significant
difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91;
P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29).
Conclusions
The use of monolithic ceramic can be considered a favorable treatment for tooth-supported
single crowns and FPDs, with high survival and low complication rates. However, further
randomized controlled trials are needed to reassess these clinical performances, mainly
by comparing them with the performance of veneered restorations.
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Article info
Publication history
Published online: March 19, 2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
