Clinical evaluation of posterior zirconia-based and porcelain-fused-to-metal crowns with a vertical preparation technique: an up to 5-year retrospective cohort study

• Published in: Journal of dentistry 2024-09, Vol.148, p.104953, Article 104953
• Main Authors: Gonzalez-Bonilla, M, Berrendero, S, Moron-Conejo, B, Martinez-Rus, F, Salido, MP
• Format: Article
• Language: English
• Subjects: Adult; Aged; Cohort Studies; Crown; Crowns; Dental Abutments; Dental Plaque Index; Dental Porcelain - chemistry; Dental Prosthesis Design; Dental Restoration Failure; Female; Follow-Up Studies; Humans; Male; Metal Ceramic Alloys - chemistry; Middle Aged; Periodontal Index; Periodontal parameters; Porcelain-fused-to-metal; Retrospective Studies; Tooth Preparation, Prosthodontic - methods; Treatment Outcome; Vertical preparation; Zirconia; Zirconium - chemistry
• ISSN: 0300-5712; 1879-176X; 1879-176X
• DOI: 10.1016/j.jdent.2024.104953

To evaluate the clinical conditions of single-unit posterior restorations on teeth prepared without finishing line, after 5.6 years of clinical service. 50 crowns (25 zirconia-based (Zr) and 25 porcelain-fused-to-metal (PFM)) were selected from 34 patients. The restorations were evaluated according to the California Dental Association (CDA) Quality Criteria, and periodontal variables were studied in the abutment teeth compared with the unrestored contralateral teeth. Variables were examined using Mann-Whitney and Pearson´s Chi-Square tests (α = 0.05). The success of the prosthesis was calculated using Kaplan-Meier test. CDA Quality Criteria was considered satisfactory-excellent in all restorations except for one of them, due to chipping on a PFM crown. At, 66 months, the success rates for PFM and Zr crowns were 85.7 % and 100 %, respectively. The plaque index (PI) showed that the restored abutment teeth accumulated significantly less plaque than the control teeth, but the gingival index (GI) was statistically higher in the abutment teeth. In 80 % of cases the probing depth (PB) was ≤3 mm. In addition, in 21 % of the cases, gingival recession was less than 2 mm. The restoration material had a statistically significant effect on GI and PB, with Zr crowns showing less inflammation and less deep pockets than PFM restorations. On the contrary, greater gingival recession was found at the margins of the Zr crowns when compared to the PFM. No statistical differences were found between the two materials in the GI. Cemented crowns on vertical preparations show good clinical behavior after 5 years. The periodontal parameters (PI, GI, PD) of the Zr restorations are significantly better than those of PFM, with the exception of gingival recession. The use of restorations on vertically prepared teeth is a suitable alternative to classical horizontal preparations.