Abstract
Statement of problem
Completely veneered zirconia ceramic (ZC) fixed partial dentures (FPDs) have been
reported to have a higher incidence of ceramic chipping than the standard metal-ceramic
FPDs. However, data from comparative long-term studies are sparse.
Purpose
The purpose of this retrospective study was to compare the long-term survival, chipping-free
survival, and success of ceramic-veneered high noble metal alloy (HN), base metal
alloy (cobalt-chromium alloy) (CC), and ZC FPDs and to isolate risk factors for the
incidence of failure, veneer chipping, and overall complications.
Material and methods
Data from 289 study participants (58.7% women; mean age, 57.97 ±11.51 years) provided
with a total of 400 FPDs comprising 197 (49.3%) HN FPDs, 121 (30.3%) CC FPDs, and
82 (20.5%) ZC FPDs fabricated from presintered 3 mol% yttria-stabilized zirconia (mean
time of service, 6.85 ±3.25 years) were evaluated. Of these, 278 (69.5%) FPDs were
provided by dentists and 122 (30.5%) by dental students. Five- and 10-year survival,
chipping-free survival, and success rates were calculated using the Kaplan–Meier method
and compared with the log-rank test. Risk factors were assessed using Cox regression
analysis. The study was exploratory, so all P values were considered exploratory and descriptive.
Results
The 5- and 10-year survival rates were 94.7% and 77.8% for HN, 93.7% and 81.2% for
CC, and 92.9% and 53.3% for ZC FPDs, respectively, indicating no clear difference
in survival among the framework materials. The 5- and 10-year chipping-free rates
were 94.1% and 82.8% for HN, 96.1% and 78.9% for CC, and 82.6% and 62.2% for ZC FPDs,
respectively, indicating a difference between HN and ZC, and CC and ZC restorations.
The 5- and 10-year success rates were 83.7% and 55.3% for HN, 86.5% and 51.4% for
CC, and 68.9% and 30.2% for ZC FPDs, respectively, indicating a difference between
HN and ZC, and CC and ZC restorations. The Cox regression model indicated framework
material as an influencing risk factor for success, and this influence persisted when
chipping was investigated. Compared with zirconia, the use of a metal alloy reduced
the risk of chipping or the occurrence of complications by up to one-third.
Conclusions
All FPDs showed high 5-year survival rates and acceptable 10-year survival rates with
no strong differences among the materials. Higher success and chipping-free rates
were observed for both HN and CC restorations compared with ZC restorations. Metal
frameworks had a lower risk for complications or veneer chipping than zirconia frameworks.
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Article info
Publication history
Published online: December 01, 2022
Publication stage
In Press Corrected ProofFootnotes
Presented by: Parts of the study were presented as lectures at the 2017 Annual meeting of the Deutsche Gesellschaft für Prothetische Zahnmedizin und Biomaterialien eV (DGPro, Gießen, Germany) and 2018 IADR/PER General Session (London, England).
This study was self-funded by the Department of Prosthetic Dentistry of the University Hospital Heidelberg.
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© 2022 by the Editorial Council for the Journal of Prosthetic Dentistry.
