Top

Clinical Oral Investigations

Published in:

26-09-2023 | Research

Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow

Authors: Adolfo Di Fiore, Carlo Monaco, Edoardo Stellini

Published in: Clinical Oral Investigations | Issue 11/2023

Abstract

Objectives

To evaluate the clinical performance of monolithic zirconia restorations with feather-edge margins fabricated by digital impressions.

Materials and methods

All participants that present monolithic zirconia restorations with feather-edge margins realized with digital workflow were evaluated during scheduled periodontal maintenance between February and September 2022 according to predetermined inclusion criteria. Clinical performance was assessed using the modified USPHS and periodontal parameters. Overall survival was calculated for monolithic zirconia restorations. Technical and biologic complications were reported. Descriptive statistical analysis and life-table analyses were performed for all data.

Results

A total of 1472 monolithic zirconia FDPs (1279 on abutments and 193 on pontics) placed in 1189 patients (982 males and 490 females) from February 2017 to September 2020 were analyzed. The mean follow-up was 44 months (range 36–61 months), and the overall survival rate was 98.5%. There were 931 single crowns, 96 were 3-unit FDPs, 33 were 4-unit FDPs, 11 were 5-unit FDPs, and 6-unit FDPs. Three single crowns had irreparable cracks, and 6 single crowns and one 4-unit FDP were fractured. One 3-unit FDP failed due to tooth fracture and 5 single crowns failed due to endodontic failure. The loss of retention was noted in 25 monolithic zirconia FDPs and hypersensitivity in 44 single crowns. Biologic complications were uncommon.

Conclusions

Based on the results and its limitations, the monolithic zirconia FPDs and digital impressions represent a favorable prosthetic treatment similar to that reported with other margin designs

Clinical relevance

Monolithic zirconia restorations on vertical-margin abutments fabricated using a digital workflow demonstrate excellent clinical performance. The digital clinical workflow without the use of a cast means a reduction in costs, steps, and operating time.

Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I (2018) A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res 29(Suppl 16):199–214. https://doi.org/10.1111/clr.13306CrossRefPubMed

Stawarczyk B, Keul C, Eichberger M, Figge D, Edelhoff D, Lümkemann N (2017) Three generations of zirconia: from veneered to monolithic. Part I. Quintessence Int 48:369–380. https://doi.org/10.3290/j.qi.a38057CrossRefPubMed

Pjetursson BE, Sailer I, Zwahlen M, Hämmerle CH (2017) A systematic review of the survival and complication rates of all-ceramic and metal-ceramic reconstructions after an observation period of at least 3 years. Part I: Single crowns. Clin Oral Implants Res 18(Suppl 3):73–85. https://doi.org/10.1111/j.1600-0501.2007.01467.xCrossRef

Zhang Y, Lawn BR (2018) Novel zirconia materials in dentistry. J Dent Res 97:140–147. https://doi.org/10.1177/0022034517737483CrossRefPubMed

Blatz MB, Vonderheide M, Conejo J (2018) The effect of resin bonding on long-term success of high-strength ceramics. J Dent Res 97:132139. https://doi.org/10.1177/0022034517729134CrossRef

Arena A, Prete F, Rambaldi E, Bignozzi MC, Monaco C, Di Fiore A, Chevalier J (2019) Nanostructured zirconia-based ceramics and composites in dentistry: a state-of-the-art review. Nanomaterials (Basel) 9(10):1393. https://doi.org/10.3390/nano9101393CrossRefPubMed

Passia N, Stampf S, Strub JR (2013) Five-year results of a prospective randomised controlled clinical trial of posterior computer-aided design-computer-aided manufacturing ZrSiO4 -ceramic crowns. J Oral Rehabil 40:609–617. https://doi.org/10.1111/joor.12075CrossRefPubMed

Di Fiore A, Vigolo P, Graiff L, Stellini E (2018) Digital vs conventional workflow for screw-retained single-implant crowns: a comparison of key considerations. Int J Prosthodont 31:577–579. https://doi.org/10.11607/ijp.5938CrossRefPubMed

Wu L, Sun Z, Zhao J, Zheng Y (2022) Retrospective clinical study of monolithic zirconia crowns fabricated with a straightforward completely digital workflow. J Prosthet Dent 128:913–918. https://doi.org/10.1016/j.prosdent.2021.01.018CrossRefPubMed

10.

Pontevedra P, Lopez-Suarez C, Pelaez J, Garcia-Serdio S, Suarez MJ (2021) Prospective clinical evaluation of posterior monolithic zirconia fixed partial dentures using a complete digital workflow: two-year follow-up. J Prosthodont 30:298–304. https://doi.org/10.1111/jopr.13251CrossRefPubMed

11.

Li R, Chen H, Wang Y, Sun Y (2021) Performance of stereolithography and milling in fabricating monolithic zirconia crowns with different finish line designs. J Mech Behav Biomed Mater 115:104255. https://doi.org/10.1016/j.jmbbm.2020.104255CrossRefPubMed

12.

Miura S, Kasahara S, Yamauchi S, Egusa H (2018) Effect of finish line design on stress distribution in bilayer and monolithic zirconia crowns: a three-dimensional finite element analysis study. Eur J Oral Sci 126:159–165. https://doi.org/10.1111/eos.12402CrossRefPubMed

13.

Loi I, Di Felice A (2013) Biologically oriented preparation technique (BOPT): a new approach for prosthetic restoration of periodontically healthy teeth. Eur J Esthet Dent 8:10–23PubMed

14.

Serra-Pastor B, Loi I, Fons-Font A, Solá-Ruíz MF, Agustín-Panadero R (2019) Periodontal and prosthetic outcomes on teeth prepared with biologically oriented preparation technique: a 4-year follow-up prospective clinical study. J Prosthodont Res 63:415–420. https://doi.org/10.1016/j.jpor.2019.03.006CrossRefPubMed

15.

Monaco C, Caldari M, Scotti R, AIOP Clinical Research Group (2013) Clinical evaluation of 1,132 zirconia-based single crowns: a retrospective cohort study from the AIOP clinical research group. Int J Prosthodont 26:435–442. https://doi.org/10.11607/ijp.3099CrossRefPubMed

16.

Poggio CE, Dosoli R, Ercoli C (2012) A retrospective analysis of 102 zirconia single crowns with knife-edge margins. J Prosthet Dent 107:316–321. https://doi.org/10.1016/S0022-3913(12)60083-3CrossRefPubMed

17.

Di Fiore A, Monaco C, Brunello G, Granata S, Stellini E, Yilmaz B (2021) Automatic digital design of the occlusal anatomy of monolithic zirconia crowns compared to dental technicians’ digital waxing: a controlled clinical trial. J Prosthodont 30:104–110. https://doi.org/10.1111/jopr.13268CrossRefPubMed

18.

Di Fiore A, Vigolo P, Monaco C, Graiff L, Ferrari M, Stellini E (2019) Digital impression of teeth prepared with a subgingival vertical finish line: a new clinical approach to manage the interim crown. J Osseointegration 11:544–547. https://doi.org/10.23805/JO.2019.11.03.14CrossRef

19.

Schmitz JH, Valenti M (2020) Interim restoration technique for gingival displacement with a feather-edge preparation design and digital scan. J Prosthet Dent 123:580–583 https://doi.org/10.1016/j.prosdent.2020.06.018CrossRefPubMed

20.

The glossary of prosthodontic terms: ninth edition (2017) J Prosthet Dent 117:e1–e105. https://doi.org/10.1016/j.prosdent.2016.12.001CrossRef

21.

Ferrari Cagidiaco E, Zarone F, Discepoli N, Joda T, Ferrari M (2021) Analysis of the reproducibility of subgingival vertical margins using intraoral optical scanning (IOS): a randomized controlled pilot trial. J Clin Med 10:941. https://doi.org/10.3390/jcm10050941CrossRefPubMedPubMedCentral

22.

Kina JR, Dos Santos PH, Kina EF, Suzuki TY, Dos Santos PL (2011) Periodontal and prosthetic biologic considerations to restore biological width in posterior teeth. J Craniofac Surg 22:1913–1916. https://doi.org/10.1097/SCS.0b013e31822ea701CrossRefPubMed

23.

Dumbrigue HB (2003) Composite indirect-direct method for fabricating multiple-unit provisional restorations. J Prosthet Dent 89:86–88. https://doi.org/10.1067/mpr.2003.8CrossRefPubMed

24.

Zhang R, Ding Q, Sun Y, Zhang L, Xie Q (2018) Assessment of CAD-CAM zirconia crowns designed with 2 different methods: a self-controlled clinical trial. J Prosthet Dent 120:686–692. https://doi.org/10.1016/j.prosdent.2017.11.027CrossRefPubMed

25.

Cvar JF, Ryge G (2005) Reprint of criteria for the clinical evaluation of dental restorative materials. 1971. Clin Oral Investig 9:215–232. https://doi.org/10.1007/s00784-005-0018-zCrossRefPubMed

26.

Silness J (1970) Periodontal conditions in patients treated with dental bridges. J Periodontal Res 5:60–68. https://doi.org/10.1111/j.1600-0765.1970.tb01839.xCrossRefPubMed

27.

Comlekoglu M, Dundar M, Ozcan M, Gungor M, Gokce B, Artunc C (2009) Influence of cervical finish line type on the marginal adaptation of zirconia ceramic crowns. Operative Dent 34:586–592. https://doi.org/10.2341/08-076-LCrossRef

28.

Beuer F, Aggstaller H, Edelhoff D, Gernet W (2008) Effect of preparation design on the fracture resistance of zirconia crown copings. Dent Mater J 27:362–367. https://doi.org/10.4012/dmj.27.362CrossRefPubMed

29.

Cehreli MC, Kkat AM, Aka K (2009) CAD/CAM Zirconia vs. slip cast glass-infiltrated alumina/zirconia all-ceramic crowns: 2-year results of a randomized controlled clinical trial. J Appl Oral Sci 17:49–55. https://doi.org/10.1590/s1678-77572009000100010CrossRefPubMedPubMedCentral

30.

Ortorp A, Kihl M, Carlsson G (2009) A 3-year retrospective and clinical follow-up study of zirconia single crowns in a private practice. J Dent 37:731–736. https://doi.org/10.1016/j.jdent.2009.06.002CrossRefPubMed

31.

Groten M, Huttig F (2010) The performance of zirconium oxide crowns: a clinical follow-up. Int J Prosthodont 23:429–423PubMed

Title: Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow
Authors: Adolfo Di Fiore
Carlo Monaco
Edoardo Stellini
Publication date: 26-09-2023
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 11/2023
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05262-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 11/2023

The effect of individual drilling sleeves on the precision of coronectomy tooth sections. An in vitro 3D-printed jaw model experiment

Correction to: Systemic inflammatory markers following adjunctive Nd:YAG (1064 nm) laser irradiation to step 2 of periodontal therapy: a 12‑month, randomized, controlled trial

Discriminant validity of the current gingivitis classification in adolescents: a cohort study

Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro—histomorphometric study)

Gastric acid challenge of lithium disilicate–reinforced glass–ceramics and zirconia-reinforced lithium silicate glass–ceramic after polishing and glazing—impact on surface properties

Antineoplastic therapy in childhood cancer patients presents a negative impact in the periodontal tissues: a cohort study