Limited evidence to compare survival of metal ceramic with porcelain-fused-to-zirconia single crowns


Crowning of teeth has been carried out for many years in order to replace damaged/diseased tooth structure or to improve aesthetics.  Increasing patient demand has helped lead developments in ceramic technology and zirconium is one of the new materials in this field. The aim of this study was to compare the clinical survival rates of porcelain-fused-to-zirconia (PFZ) single crowns on anterior and posterior teeth with metal ceramic (MC) crowns.

Searches in the PubMed database and relevant dental journal were undertaken. Human in-vivo studies published in peer- reviewed journals, written in English, reporting on single crowns with natural teeth abutments, and providing survival rates were included.

  • Nineteen studies with a total of 3621 crowns met the inclusion criteria. 4 studies for PFZ crowns, and 15 for MC crowns.
  • Survival rates for PFZ crowns (total 300) ranged from 92.7% to 100% for a follow-up time of 24 to 39 months,
  • Survival rates for MC crowns (total 3321) ranged from 70% to 100% for a follow-up time of 12 to 298 months.
  • Studies that reported long-term results were found only for the MC crown group.

The authors concluded

The available scientific clinical data to compare PFZ and MC crowns are limited. The survival rates may well be influenced by the selection and appropriate use of the veneering ceramic, and, therefore, additional long-term clinical trials are necessary to draw definitive conclusions.


Only a single database was used for this review and while hand searches were carried out in relevant dental journals the journals searched  are not indicated in the paper.  The use of a single database and the restriction to articles in English only and those articles appearing in peer-reviewed journal is also a limitation, which means that it is likely that some relevant studies were missed. The hand searches of journals were conducted by a single researcher and it is not clear whether study selection and data abstractions were conducted independently by two reviewers. In addition  there was no formal assessment of the quality of the included studies or indication of their study designs.


Takeichi T, Katsoulis J, Blatz MB. Clinical outcome of single porcelain-fused-to-zirconium dioxide crowns: A systematic review. J Prosthet Dent. 2013 Dec;110(6):455-61. doi: 10.1016/j.prosdent.2013.09.015. Epub 2013 Oct  26. PubMed PMID: 24169079.

Dental Elf – 28th June 2012 – Are zirconia-based restorations clinically successful?


Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+