A Retrospective Evaluation of Zirconia Ceramic Posts: 10-Year Results

Zirconia posts can be used as an esthetic alternative to metallic posts. Despite their advantages, there is a lack of information about the long-term performance of zirconia posts. Objective: This retrospective clinical study aimed to examine the survival rate, clinical performance and reasons for failure of zirconia ceramic posts after an observation period of 10 years. Methods: Eighty-nine patients received a total of 138 zirconia posts. After a mean observation period of 12.25 years, clinical and radiographic evaluations were carried out for a total 64 posts in 45 patients. Kaplan-Meier Analysis was employed to compute the survival probability. Cox-regression analysis was used to assess the risk of failure and to identify possible covariates. Results: The zirconia posts received 16 ceramic cores (InCeram or Empress II) and 32 direct composite build-ups. Eight posts did not receive a core and the core material in 8 restorations was not identified. During the follow-up period, a total of 13 posts (9.42%) failed. 7 teeth were extracted. Other complications consisted of 1 tooth with hypersensitivity to percussion and periapical radiolucency 3 years after delivery, 3 teeth with periapical radiolucency at the time of examination, 1 restoration fracture after 5 years, and 1 post debonding after 2 years. The overall survival probability for zirconia posts was 80.76% after 10 years. Posts with ceramic cores showed an 88.4% survival probability, compared to 76.5% for posts with composite build-ups. The survival probability of post-and-core restorations was greater in incisors (86.3%) than in premolars (72.7%). Posts with a diameter smaller than ISO50 demonstrated an increased risk for failure. Conclusions: Zirconia posts with ceramic cores have a higher survival probability than those restored with direct composite build-ups. However, due to the high patient dropout rate, careful interpretation of the current results is suggested.