Statement of problem: Clinical studies on the fabrication of monolithic zirconia restorations with a feather-edge tooth preparation from digital scans and a cast-free fully digital workflow are lacking.
Purpose: The purpose of this retrospective multicentric study in private practices was to evaluate the outcomes of monolithic zirconia crowns fabricated with feather-edge margins and a cast-free approach.
Material and methods: A total of 621 teeth were prepared with feather-edge margins and restored with monolithic zirconia crowns fabricated with a fully digital cast-free workflow. Data were analyzed by using the Kaplan-Meier test and descriptive statistics. The clinical evaluation adopted the California Dental Association-modified criteria after recalling all patients between April and July 2021.
Results: The clinical survival of 619 of 621 crowns, including recemented crowns placed in 427 patients (217 men, 220 women) over 5 years (2014 to 2019 with crowns in service between 12 and 85 months), was analyzed. The 2 excluded crowns were delivered to patients who dropped out of the study. Of the 619 crowns, 5 failed during the follow-up period: 4 teeth were extracted because of fracture and 1 restoration fractured. No other technical or biological failures were observed. The mean overall survival time was 84.4 months (standard error, 0.255; 95% confidence interval for the mean, 83.92 to 84.92). The overall survival probability was 99.1% up to 85 months.
Conclusions: The clinical outcomes of the monolithic zirconia crowns with feather-edge margins evaluated were comparable with outcomes reported using other margin designs and materials.
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