All-ceramic dental crowns VS. metal-ceramic dental crowns: what is the clinical and cost effectiveness?
This Rapid Response is produced by the Canadian Agency for Drugs and Technologies in Health (www.cadth.ca)
The short term (< 5 years) survival of all-ceramic crowns when used for anterior teeth is comparable to porcelain fused to metal crowns.
Summary of Findings
Dental Crown Survival
- Posterior all-ceramic crowns fabricated from alumina, reinforced glass-ceramic, zirconia, or lithium disilicate had comparable survival rates to posterior PFM crowns (< 5 years analysis).
- InCeram and glass-ceramic, all-ceramic crowns had statistically significant lower survival rate that PFM crowns when used for posterior teeth.
- When used for anterior teeth all the ceramic crown systems were comparable to the PFM crowns in terms of survival rates at short term.
- Clinical performance generally evaluated esthetic, anatomic and structural integrity, and the occlusal harmony of the dental crowns.
- The clinical performance of all-ceramic crowns differed from PFM crowns only in the color match, which favored all-ceramic crowns and in occlusal wear that favored PFM crowns.
Cost-effectiveness of porcelain-fused-to-metal and all-ceramic crowns
- The cost-effectiveness values at 5 and 10 years of all-ceramic (porcelain jacket) crowns relative to Class I amalgam were higher than those of PFM crowns relative to Class I amalgam. However, this relationship was reversed at the 15 year evaluation, and PFM crowns were more cost-effective than porcelain jacket crowns.
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