IADR Abstract Archives
10-year Clinical Performance − 293 PFM, Zirconia, Alumina 3-unit Posterior FPD’s
Objectives: Compare clinical performance– metal vs. zirconia vs. alumina electrophoretic deposition (ED) frameworks and respective veneer ceramics.
Methods: Practice-based randomized controlled clinical trial; 115 dentists; 259 patients; 16 laboratories; and following 5 zirconia, 2 alumina, 3 PFM framework/veneer ceramic combinations: (See Table 1).
Standardized preparations, RMGI cement, double-masked dentist-laboratories, recall yearly for 10 years. Graded in-vivo: fractures, margins, proximal contacts, gingival health, esthetics, caries, endodontic need. Graded in-vitro (gold-sputtered-dies; SEM images): fractures. Statistics: log-rank tests, Fisher’s exact tests.
Results: Framework fractures: Overall 13% of FPD’s (32% of alumina, 4% of zirconia, 2% of metal). Zirconia from three sources not different. Veneer ceramic fractures: Overall 61% of FPD’s (88% of alumina, 67% of zirconia, 42% of metal). NOTE: All alumina FPD’s were replaced at 3 years due to high fracture failures. Following results include 3 PFM and 5 zirconia systems only. At 10 years: Of 259 FPD's placed, 133 were available for recall (51%); 96% recalled. Of 126 FPD's not recalled, 62% had been replaced (6% frame fracture, 42% veneer ceramic fracture, 14% biological problems); 39% could not be recalled. Statistically zirconia and metal framework fractures and survival probabilities were not different (p=0.49; p=0.12 respectively). However, veneer ceramics for zirconia had statistically higher fractures (p=<0.0001); CZR Press had numerically least fractures. Other variables had no statistical differences zirconia vs. metal.
Conclusions: Alumina-ED frameworks are contra-indicated for 3-unit posterior FPD’s. Zirconia and metal frameworks can both serve well for 10 years. Veneer ceramics for zirconia frameworks need improvement to reduce fractures.
Methods: Practice-based randomized controlled clinical trial; 115 dentists; 259 patients; 16 laboratories; and following 5 zirconia, 2 alumina, 3 PFM framework/veneer ceramic combinations: (See Table 1).
Standardized preparations, RMGI cement, double-masked dentist-laboratories, recall yearly for 10 years. Graded in-vivo: fractures, margins, proximal contacts, gingival health, esthetics, caries, endodontic need. Graded in-vitro (gold-sputtered-dies; SEM images): fractures. Statistics: log-rank tests, Fisher’s exact tests.
Results: Framework fractures: Overall 13% of FPD’s (32% of alumina, 4% of zirconia, 2% of metal). Zirconia from three sources not different. Veneer ceramic fractures: Overall 61% of FPD’s (88% of alumina, 67% of zirconia, 42% of metal). NOTE: All alumina FPD’s were replaced at 3 years due to high fracture failures. Following results include 3 PFM and 5 zirconia systems only. At 10 years: Of 259 FPD's placed, 133 were available for recall (51%); 96% recalled. Of 126 FPD's not recalled, 62% had been replaced (6% frame fracture, 42% veneer ceramic fracture, 14% biological problems); 39% could not be recalled. Statistically zirconia and metal framework fractures and survival probabilities were not different (p=0.49; p=0.12 respectively). However, veneer ceramics for zirconia had statistically higher fractures (p=<0.0001); CZR Press had numerically least fractures. Other variables had no statistical differences zirconia vs. metal.
Conclusions: Alumina-ED frameworks are contra-indicated for 3-unit posterior FPD’s. Zirconia and metal frameworks can both serve well for 10 years. Veneer ceramics for zirconia frameworks need improvement to reduce fractures.
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