Clinical performance of long-span zirconia frameworks for fixed dental prostheses: 5-year results.

The purpose of this prospective cohort study was to assess the performance of tooth-supported, long-span, zirconia fixed dental prostheses (FDPs). Thirty FDPs with span lengths from 36 to 46 mm (mean 40·33 mm), with 4-7 units and with connector dimensions ∼9 mm(2) were inserted (19 in the posterior region, 11 including anterior teeth) using glass-ionomer cement. The performance of the FDPs was assessed (aesthetic evaluation, failures, hypersensitivity/tooth vitality, secondary caries, pocket depth, decementation, and chipping) at baseline and after 5 years. Cox regression analysis was performed to identify risk factors. There were 16 failures after 5 years. Framework fracture occurred for two FDPs, four FDPs had to be re-cemented, one abutment tooth had to be treated endodontically, one abutment tooth fractured and cohesive failure of the veneer occurred for eight. Four FDPs had to be replaced, so survival was 82%. The aesthetics were rated as excellent by the patients at baseline and good at the 5-year recall. Cox regression analysis showed that both length [P = 0·05, exp(B) = 1·22] and location [P = 0·019, exp(B) = 4·09] of the FDP were risk factors for failure. Compared with the previously published 2-year results, the incidence of complications increased dramatically. Additionally, it was shown that long-span FDPs in the molar region are at greater risk of failure than FDPs in the anterior region.

Clinical performance of extended zirconia frameworks for fixed dental prostheses: two-year results.

The purpose of this prospective cohort study was to assess the performance of tooth-supported, extended zirconia, fixed dental prostheses (FDPs). Thirty FDPs with span-lengths between 36 and 46 mm (mean: 40.33 mm), four to seven units and with connector dimensions of approximately 9 mm(2) were inserted (19 in the posterior region, 11 including anterior teeth) using glass-ionomer cement and assessed (aesthetic evaluation, failures, hypersensitivity/tooth vitality, secondary caries, pocket depth, decementation and chipping) at baseline and after 2 years. Differences between baseline and 2-year recall were analysed using the Wilcoxon signed-rank test for matched pairs. There were five failures. One FDP revealed a core fracture at the base of the connector, probably caused by a damage induced during fabrication. Two FDPs had to be recemented, one abutment tooth had to be treated endodontically and one cohesive failure of the veneer was observed. There were no significant changes of pocket depth and hypersensitivity between baseline and 2-year recall. The aesthetics were rated as excellent by the patients at both baseline and recall. Two year clinical results of extended zirconia based FDPs with 9 mm(2) connectors are promising.

Wear of posterior metal-free polymer crowns after 2 years.

The objective of this study was to evaluate the clinical wear behaviour of posterior, metal-free polymer crowns and to compare it with that of metal-ceramic crowns. After randomization, a total of 120 single crowns were set in posterior teeth. These 120 crowns were divided into three groups: 40 polymer crowns with a glass-fibre framework (group 1), 40 polymer crowns without framework stabilization (group 2) and 40 metal-ceramic crowns (control group). Wear was measured by use of gypsum replicas and a 3D laser scanner at baseline and after 2 years. Statistical analysis was performed by use of a mixed-effects regression model. The mean total wear of posterior single crowns was -19.0 mum (+/- 18.5 microm) in group 1, -24.3 microm (+/- 31.5 microm) in group 2 and -7.0 microm (+/- 8.8 microm) in the control group. Statistical analysis revealed the mean total wear of the polymer crowns in groups 1 (P < or = 0.01) and 2 (P < or = 0.01) was significantly greater than in the control group. No significant difference was detected between groups 1 and 2 (P = 0.58). Age, gender and opposing teeth had no significant effect on wear behaviour.