Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up

• Published in: Clinical oral investigations 2022-06, Vol.26 (6), p.4327-4335
• Main Authors: Pontevedra, Paula, Lopez-Suarez, Carlos, Rodriguez, Veronica, Pelaez, Jesus, Suarez, Maria J.
• Format: Article
• Language: English
• Subjects: Clinical trials; Dentistry; Dentures; Medicine; Original; Original Article; Patients; Survival; Zirconia
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-022-04396-y

Objectives To evaluate and to compare the clinical performance and survival rate of posterior monolithic and veneered zirconia fixed partial dentures (FPDs). Material and methods Sixty 3-unit posterior FPDs were included in the study. The patients were randomly distributed into two groups ( n  = 30 each) to receive either a monolithic (Zenostar T, Wieland Dental) or veneered zirconia (IPS e.max ZirCAD, Ivoclar Vivadent) FPD. Each patient received only 1 FPD. Tooth preparations were scanned (Trios 3, 3Shape), designed (Dental System 2016, 3 Shape), milled (Zenotec CAM 3.2, Wieland Dental), and cemented with a resin cement. Technical and biological outcomes and periodontal parameters were assessed. Data analysis was made using the Friedman and the Wilcoxon signed-rank tests with the Bonferroni correction and the Mann–Whitney U test. Results The survival rate at 3 years was 100% for veneered and 90% for monolithic zirconia restorations. Three monolithic zirconia FPDs were lost because of biologic complications. The main complication in the veneered zirconia FPDs was the fracture of the veneering ceramic in 4 of the veneered zirconia FPDs. No fracture of the frameworks was observed in any of the groups. All restorations were assessed as satisfactory after 3 years. No differences in periodontal parameters were observed between the groups. Conclusions The results of this study suggest that monolithic zirconia and complete digital flow could be a viable alternative to veneered zirconia in the posterior regions. Clinical relevance The monolithic zirconia restorations with a digital workflow can be a viable alternative in posterior fixed partial dentures, with good periodontal outcomes. Clinical trial registration number ClinicalTrials.gov (Identifier NCT 04,879,498).