A systematic review of the survival and complication rates of zirconia‐ceramic and metal‐ceramic single crowns

作者：Bjarni E, Pjetursson; Nicola A, Valente; Malin, Strasding; Marcel, Zwahlen; Shiming, Liu; Irena, Sailer

来源：Clinical Oral Implants Research, 2018, 29(S16): 199-214.

DOI：10.1111/clr.13306

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>The aim of the present systematic review was to analyze the survival and complication rates of zirconia‐based and metal‐ceramic implant‐supported single crowns (<jats:styled-content style="fixed-case">SC</jats:styled-content>s).</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>An electronic <jats:styled-content style="fixed-case">MEDLINE</jats:styled-content> search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort and retrospective case series on implant‐supported <jats:styled-content style="fixed-case">SC</jats:styled-content>s with a mean follow‐up time of at least 3<jats:bold> </jats:bold>years. Patients had to have been clinically examined at the follow‐up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust <jats:italic>Poisson's</jats:italic> regression models to obtain summary estimates of 5‐year proportions.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The search provided 5,263 titles and 455 abstracts, full‐text analysis was performed for 240 articles, resulting in 35 included studies on implant‐supported crowns. Meta‐analysis revealed an estimated 5‐year survival rate of 98.3% (95% <jats:styled-content style="fixed-case">CI</jats:styled-content>: 96.8–99.1) for metal‐ceramic implant supported <jats:styled-content style="fixed-case">SC</jats:styled-content>s (<jats:italic>n</jats:italic> = 4,363) compared to 97.6% (95% <jats:styled-content style="fixed-case">CI</jats:styled-content>: 94.3–99.0) for zirconia implant supported <jats:styled-content style="fixed-case">SC</jats:styled-content>s (<jats:italic>n</jats:italic> = 912). About 86.7% (95% CI: 80.7–91.0) of the metal‐ceramic <jats:styled-content style="fixed-case">SC</jats:styled-content>s (<jats:italic>n</jats:italic> = 1,300) experienced no biological/technical complications over the entire observation period. The corresponding rate for zirconia <jats:styled-content style="fixed-case">SC</jats:styled-content>s (<jats:italic>n</jats:italic> = 76) was 83.8% (95% CI: 61.6–93.8). The biologic outcomes of the two types of crowns were similar; yet, zirconia <jats:styled-content style="fixed-case">SC</jats:styled-content>s exhibited less aesthetic complications than metal‐ceramics. The 5‐year incidence of chipping of the veneering ceramic was similar between the material groups (2.9% metal‐ceramic, 2.8% zirconia‐ceramic). Significantly (<jats:italic>p</jats:italic> = 0.001), more zirconia‐ceramic implant <jats:styled-content style="fixed-case">SC</jats:styled-content>s failed due to material fractures (2.1% vs. 0.2% metal‐ceramic implant <jats:styled-content style="fixed-case">SC</jats:styled-content>s). No studies on newer types of monolithic zirconia <jats:styled-content style="fixed-case">SC</jats:styled-content>s fulfilled the simple inclusion criteria of 3 years follow‐up time and clinical examination of the present systematic review.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Zirconia‐ceramic implant‐supported <jats:styled-content style="fixed-case">SC</jats:styled-content>s are a valid treatment alternative to metal‐ceramic <jats:styled-content style="fixed-case">SC</jats:styled-content>s, with similar incidence of biological complications and less aesthetic problems. The amount of ceramic chipping was similar between the material groups; yet, significantly more zirconia crowns failed due to material fractures.</jats:p></jats:sec>

• 出版日期2018-10
• 单位北京大学