Monolithic zirconia reconstructions supported by teeth and implants: 1- to 3-year results of a case series

Objective: Today, only scarce information is available on monolithic zirconia reconstructions. The objective of this study was to evaluate the performance of monolithic zirconia for tooth- and implant-borne reconstructions. Method and Materials: Monolithic zirconia single crowns (SCs) and fixed dental prostheses (FDPs) supported by implants or teeth were included in this study. Implant placement and prosthetic treatment were done in the same clinical setting. One technician performed all laboratory work using the same CAD/CAM workflow (DentalDesigner, Ceramill Motion 2, Amann Girrbach). The endpoints were technical outcome, color match, marginal adaptation, anatomical form, and biologic aspects. The modified United States Public Health Service (USPHS) criteria and periodontal parameters were applied for the clinical evaluation by two independent examiners. Descriptive statistics and nonparametric tests were used for statistical comparisons. Results: Forty patients (17 men, 23 women, mean age 59.1 ± 14.7 years) with 109 reconstructions (74 SCs, 35 FDPs) supported by 38 implants and 71 teeth were assessed, resulting in a total of 238 monolithic zirconia units (including 62 pontics and 18 cantilevers). Median follow-up time was 23.8 months (12 to 36 months). No technical failures were observed. The total prosthesis survival rate was 99.6% (teeth, 100%; implants, 98.4%) due to the loss of one implant. The periodontal/peri-implant parameters stand for healthy tissue, and caries was not detected. The records obtained by the USPHS revealed good clinical outcomes. Conclusion: These short-term results indicate that monolithic zirconia reconstructions for teeth and implants may be a satisfactory treatment option, particularly in the posterior region. Keywords: fixed dental prosthesis, implants, monolithic, single crowns, technical complications, zirconia