Purpose
To
compare the failure rates and the prevalence of technical complications
between full-coverage tooth-supported monolithic zirconia (MZ) and
porcelain-veneered zirconia (PVZ) fixed dental prosthesis, based on a
systematic literature review.
Methods
An electronic search was performed in three databases, supplemented by hand searching. Several statistical methods were used.
Results
Seventy-four
publications reported 6370 restorations (4264 PVZ; 2106 MZ; 8200
abutment teeth; 3549 patients), followed up until 152 months. A total of
216 prostheses failed, and survival was statistically significant
different between groups. PVZ had higher occurrence of complications
than MZ; the difference was especially greater for either minor or major
chipping. The difference in prevalence of either minor or major
chipping was statistically significant for PVZ prostheses between
cementation with glass ionomer and adhesive resin cement (higher),
adhesive resin and resin-modified glass ionomer cement (RMGIC, higher),
and between RMGIC (higher) and glass ionomer cement. For MZ the
difference was significant only for minor chipping between RMGIC
(higher) and adhesive resin cement. Abutment teeth to PVZ prostheses
more often lost vitality. Decementation was not observed with RMGIC. Air
abrasion did not seem to clinically decrease the decementation risk.
The 5-year difference in the occurrence of minor or major chipping
between MZ and PVZ prostheses was statistically significant, but nor for
catastrophic fracture.
Conclusion
Tooth-supported
PVZ prostheses present higher failure and complication rates than MZ
prosthesis. The difference in complications is striking when it comes to
chipping.
Clinical relevance
Awareness of the outcome differences between different types of zirconia prostheses is important for clinical practice.
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