Are zirconia-based restorations clinically successful?


A new critical summary of a 2010 systematic review  by Al-Amleh et al  on zirconium use in dentistry is now available from the ADA Centre for evidence based dentistry.

The summariser notes that three types of zirconium ceramics are currently used in dentistry. The original review’s aim was evaluate these restorations in relation to framework fracture and veneering porcelain chipping, and which milling method yields the best results. They also higlighted  that the review was limited to English and important methodological details regarding data abstraction and  quality assessment were not detailed.   Of the 17  included studies  only 3 were randomised controlled trials . Only two papers had a follow up period of 5 years.

The review found that porcelain chipping is an ongoing problem with all-ceramic restorations  but  zirconia is suitable for single crowns, fixed partial dentures (FPD), and implant abutments but is not recommended for inlay-retained FPDs and cantilever FPDs. However, this is based on a  small number of studies of limited quality so the data should be viewed with caution.


ADA-CEBD Summary – Chipping of the veneering porcelain is an ongoing problem with all-ceramic restorations  by Viviana Avila-Gnau

Al-Amleh B, Lyons K, Swain M. Clinical trials in zirconia: a systematic  review. J Oral Rehabil. 2010 Aug;37(8):641-52. Epub 2010 Apr 9. Review. PubMed PMID: 20406352.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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