Little evidence to assess the effect of ceramic crowns on natural tooth wear


Some degree of tooth wear is a result of normal tooth-to-tooth contact. Some restorations have different wear characteristics and have been shown to produce accelerated wear.  The aim of this review was to assess tooth wear against ceramic crowns in posterior region both in vitro and in vivo.

Searching was restricted to the Medline database. In vitro and in vivo studies in English and Dutch that assessed human tooth wear by ceramic crowns for 6 months or longer were considered.

  • Only 5 in vivo studies involving a total of 172 patients were included.
  • All were prospective studies 4 were randomised controlled trials.  3 of the studies were considered to be duplicate publications
  • A qualitative summary was provided

The authors concluded

This review indicated that some all-ceramic crowns are as wear friendly as metal-ceramic crowns. Up to now, it has been impossible to associate tooth wear with any specific causal agent. The role of ceramic surface treatment that might be responsible for the changing in rate of tooth wear seems undetermined as yet through clinical trials. The literature reveals that studies on this topic are subject to a substantial amount of bias. Therefore, additional clinical studies, properly designed to diminish bias, are warranted.


As this review only searched using one database it does not technically meet the definition of a systematic review.  The authors excluded all the in vitro studies as they considerd that none measured tooth wear against ceraminc crwons in the posterior region, the majority using flat specimens against natural teeth. Consequently they only identified a small number of trials and because of concerns that there were some duplicate publications , it meant that effectively there were only 3 small studies available for assessment.  In addition the methods of assessing wear differed. Overall this means that there is precious little good quality evidence available to address the reviews main question.


Hmaidouch R, Weigl P. Tooth wear against ceramic crowns in posterior region: a systematic literature review. Int J Oral Sci. 2013 Oct 18. doi: 10.1038/ijos.2013.73. [Epub ahead of print] PubMed PMID: 24136675



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