HOME - Clinical cases - Restorative dentistry
09 June 2021

A systematic review and meta-analysis on survival rate and complications of monolithic ceramic tooth-supported prostheses

Co-authors: A. Comba, F. Del Bianco

Lorenzo Breschi


Nowadays metal free restorations are widely used as an alternative to metal ceramic. However, ceramic chipping is a common complication of Zirconia layered restorations and, for that reason monolithic zirconia or lithium disilicate crowns have become a popular solution to avoid complications . 

Despite  the great use in clinical practice, survival and complication rate of monolithic restorations  remains unclear and consensus on the use of monolithic crowns is lacking in literature.

In this context, Dr Cerri Mazza and a group of Brazilian authors performed a systematic review to evaluate clinical studies investigating the survival rate and the biological and technical complications of monolithic restorations.

Material & Methods

Two independent researchers from the authors group conducted an electronic search on PubMed/MEDLINE, Scopus, and Cochrane Library databases including human clinical trials with at least 10 participants and 12 months follow-up. Dr. Cerri Mazza et al. employed the Newcastle-Ottawa scale and Cochrane risk of bias tool to assess the quality and risk of bias of the included studies. Meta-analysis was performed using the R software program.


The search conducted by the authors identified 763 articles, 18 of which met the eligibility criteria. Dr Cerri Mazza et al. included 1061 monolithic single crowns (524 lithium disilicate, 461  zirconia, and 76 polymer- infiltrated ceramic network [PICN]) and 104 fixed partial dentures (FPDs) (36 lithium disilicate and 68 zirconia). The results of the meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independently from the material used, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. 


From the results obtained the Brazilian researchers concluded that monolithic ceramic restorations can be considered a favorable material for single crowns and FPDs, with high survival and low complication rates. Nevertheless, the authors suggested that further randomized controlled trials are needed in order to compare directly monolithic restorations performances with layered restorations. 

For more informations: Mazza, L. C., Lemos, C. A. A., Pesqueira, A. A., & Pellizzer, E. P. (2021). Survival and complications of monolithic ceramic for tooth-supported fixed dental prostheses: A systematic review and meta-analysis. Journal of Prosthetic Dentistry, 1–9. https://doi.org/10.1016/j.prosdent.2021.01.020

Related articles

Dental implant therapy has been widely used as a treatment for missing teeth.  Although dental implants have demonstrated a high survival rate (over 95%) and 5-year success rate (over 90%),...

The world is ageing rapidly and according to United Nations Population Fund UNFPA, people aged 60 years and more represent 12.3% of the total population, and by 2050, this number will increase to...

Authors: Daniela Sorrentino, Lucrezia Cinquanta, Stefania Pischetola, Niccolò Lombardi, Andrea Sardella, Christian Barbieri, Elena Maria Varoni

Although the decline in the prevalence of severe tooth loss in the last decades, the progressive aging of the population worldwide will sustain the percentage of partial or completely edentulous...

33-year-old male patient with negative medical history, who came for a visit many years after the last dental check-up. He reported pain on chewing of the first upper molar. The physical examination...

Co-authors: A. Comba, F. Florenzano

Ceramic laminate veneers are a predictable and conservative restorative treatment option to solve aesthetic issues in anterior teeth, with high rates of long-term success. Two techniques are...

Read more

Mergers and acquisition firm, Viper Equity Partners, has created a new program, The Phoenix, to speed closure of sales of dental practices. Viper's fund aims to close acquisitions in less than 90...

Authors: Marco Campana, Mariani Umberto, Valeria Martini, Riccardo Bonacina, Sonzogni Aurelio

The Objectives of this work are to propose a literature review from 2008 up to 2018 about oral manifestations of sarcoidosis and scar-sarcoidosis and to introduce a rare case of a primary intraoral...

The zirconia dental materials market is projected to hit $364.3 million by 2028, a market research company. The increase marks a 7.8% CAGR from this year to 2028. Growth in the segment is...

Editorials     04 August 2021

Editorial summer 2021

It has been approximately one and a half year since the Covid-19 pandemic changed the course of the world and influenced the lifestyle of many people, regardless of their background and profession....

Authors: Emanuela Serritella, Paola Di Giacomo, Chiara Vompi, Gianni Falisi, Carlo Di Paolo

Aim: This study aims to compare the epidemiological data of three cohorts of dysfunctional patients attending to the Clinical Gnathology Service of “Policlinico Umberto I University Hospital...


Most popular




Copyright © 2021 - All Rights Reserved
ISSN 2767-1178