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Updated: Jan 13, 2026
Quasistatic Mechanical Testing for Computer-Aided Design and Manufacturing Occlusal Veneers Cemented to Milled Dentin Analog Material
Published on: December 20, 2024
A Systematic Review and Meta-analysis Evaluating the Survival, Failure, and Complication Rates of Metal-Ceramic,
Purpose:
To evaluate five-year survival rates of metal-ceramic, veneered all-ceramic, and monolithic all-ceramic tooth-supported single crowns (SCs) and assess biological and technical complications.
Materials And Methods:
A systematic search of Medline (PubMed), Embase, and CENTRAL (2014-2024) identified clinical studies on tooth-supported fixed dental prostheses (≥3 years mean follow-up). Manual screening and 30 studies from previous reviews were added. Sixty-four studies met inclusion, reporting on 3,509 metal-ceramic and 8,051 all-ceramic SCs. Robust Poisson regression models were used to estimate pooled five-year survival rates.
Results:
Twelve studies investigated metal-ceramic crowns, 49 all-ceramic crowns, and three both. Five-year survival rates were: 98.5% for monolithic lithium-disilicate reinforced glass-ceramic, 97.3% for veneered densely-sintered zirconia, 97.1% for metal-ceramic, 96.8% for monolithic densely-sintered zirconia, 95.7% for veneered leucite/lithium-disilicate reinforced glass-ceramic, 94.5% for densely-sintered alumina, 94.3% for glass-infiltrated alumina, 90.4% for feldspathic/silica-based ceramic. Survival rates of feldspathic/silica-based ceramic (P<0.0001), glass-infiltrated alumina (P=0.019), densely sintered alumina (P=0.002), and veneered leucite/lithium-disilicate reinforced glass-ceramic (P=0.021) were significantly lower than monolithic lithium-disilicate SCs. Except for feldspathic/silica-based ceramic and metal-ceramic crowns, material/design types performed similarly in anterior and posterior regions. Monolithic lithium-disilicate and monolithic zirconia crowns showed significantly fewer ceramic fractures and chipping compared to veneered alternatives.
Conclusions:
Lithium-disilicate and zirconia-based all-ceramic SCs achieve five-year survival rates comparable to metal-ceramic crowns. Monolithic designs reduce fracture and chipping risk, improving long-term clinical outcomes.
