Survival and Complication Rates of Zirconia-Ceramic and Metal-Ceramic Single Implant-Supported Crowns

Consensus Statement 1: Zirconia ceramic and metal ceramic implants supported SCs exhibit similar 5-year survival rates in both anterior and posterior regions

Zirconia ceramic and metal ceramic implants supported SCs exhibit similar 5-year survival rates. This applies to both anterior and posterior regions. This statement is based on 36 clinical trials (22 Prospective, 14 Retrospective), reporting on 4,363 implant supported metal ceramic SCs, and 912 veneered zirconia implant-supported SCs.

Consensus Statement 2: The overall incidence of biological and technical complication is substantial for implant supported SCs

The overall incidence of biological and technical complication is substantial (13%–16% or 1 SC out of 6) for implant supported SCs. This statement is based on 11 of the included trials (6 Prospective and 5 Retrospective).

Consensus Statement 3: There is no statistically significant difference between the 5-year biological outcomes of zirconia ceramic and metal ceramic implant supported SCs

There is no statistically significant difference between the 5-year biological outcomes of zirconia ceramic and metal ceramic implant supported SCs, that is, peri-implant mucosal lesions and marginal bone loss >2 mm. This statement is based on 36 clinical trials (22 Prospective and 14 Retrospective).

Consensus Statement 4: There is no statistically significant difference in veneering ceramic chipping between the two types of implant supported SCs at 5 years

There is no statistically significant difference in veneering ceramic chipping between the two types of implant supported SCs at 5 years. There is also no difference in other technical complications such as the incidences of fracture of the abutment, abutment screw or occlusal screw and loss of retention (cemented SCs). However, catastrophic core fractures occur significantly more often with zirconia ceramic implant supported SCs. Furthermore, abutment screw or occlusal screw loosening occurs more frequently with metal ceramic implant supported SCs. This statement is based on 36 clinical trials (22 Prospective and 14 Retrospective).

Consensus Statement 5: The risk of aesthetic failure is lower for zirconia ceramic SCs when compared to metal ceramic SCs

The risk of aesthetic failure is lower for zirconia ceramic SCs when compared to metal ceramic SCs. This statement is based on 12 clinical trials (8 Prospective and 4 Retrospective).

1) Both metal ceramic and zirconia ceramic can be recommended for anterior and posterior implant supported SCs

For anterior and posterior implant supported SCs, both metal ceramic and zirconia ceramic can be recommended.

2) Selection of the prosthetic material should be based on the aesthetic expectations

The selection of the prosthetic material should be based on the aesthetic expectations and general demands of the patients.

3) Patient recall visits are highly recommended to reduce the risk of failure

Patients should be informed about the likelihood and incidence of biological and technical complications for both types of crowns, as a substantial amount of time and effort may be needed for maintenance. Patient recall visits are highly recommended to reduce the risk of failure as a consequence of complications.