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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)

Report in Brief (PDF)                                         Full Report (PDF)

Key Findings

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

  • 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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