title: Practice-based clinical evaluation of ceramic single crowns after at least five years.
abstract: BACKGROUND
  Long-term practice-based clinical evaluations of various contemporary ceramic crown restorations from multiple practitioners are limited.
  
  
  OBJECTIVE
  The aims of this study were to evaluate the clinical performance of ceramic single crowns and to identify factors that influence their clinical performance.
  
  
  METHODS
  Ceramic single crowns that had been placed at the Mayo Clinic and in function since 2005 were identified and included in the study. The restorations were examined clinically, radiographically, and with photographs. Modified United States Public Health Services criteria were used for the clinical evaluation. The ceramic systems evaluated were bilayer and monolayer.
  
  
  RESULTS
  Fifty-nine patients (41 women, 18 men) with 226 single teeth and implants restored with single ceramic crowns were identified. The mean duration from insertion date to study examination date was 6.1 years. Thirteen restorations (6%) were replaced at a mean 3.3 years after insertion date (range, 0.1-6.1 years). Estimated replacement-free survival rates (95% confidence interval [CI]; number of teeth/implants still at risk) at 5 years after insertion date were 95.1% (95% CI, 92.2-98.1; 153) and at 10 years were 92.8% (95% CI, 89.1-96.8; 8). The most common reason for replacement was fracture to the core of posterior layered ceramic crowns. The most commonly used luting agent was resin-modified ionomer cement. Most restorations exhibited clinically acceptable marginal integrity, shade, no caries recurrence, and no periapical pathology.
  
  
  CONCLUSIONS
  The clinical performance of ceramic single crowns at 5 and 10 years supports their application in all areas of the mouth. With the majority of fractures to the core occurring early in the lifetime of layered ceramic posterior crowns, consideration of other monolithic ceramic systems for posterior crowns is advised.
authors: Assistant Professor, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn; and Chief Resident, Prosthodontics and Maxillofacial Prosthetics, Division of Prosthetic and Esthetic Dentistry, Department of Dental Specialties, Mayo Clinic, Rochester, Minn. Electronic address: dhima.matilda@mayo.edu.
authors: Matilda
authors: M
authors: Dhima
authors: Assistant Professor, Department of Dentistry, Faculty of Medicine and University Hospital in Hradec Králové, Charles University in Prague, Prague, Czech Republic.
authors: Vladimira
authors: V
authors: Paulusova
authors: Professor, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn; Chair, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, Rochester, Minn; and Chair, Department of Dental Specialties, Mayo Clinic, Rochester, Minn.
authors: Alan B
authors: AB
authors: Carr
authors: Assistant Professor, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn; and Consultant, Department of Surgery, Division of Oral and Maxillofacial Surgery, Mayo Clinic, Rochester, Minn.
authors: Kevin L
authors: KL
authors: Rieck
authors: Statistician, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn.
authors: Christine
authors: C
authors: Lohse
authors: Professor, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minn; and Consultant, Division of Prosthetic and Esthetic Dentistry, Department of Dental Specialties, Mayo Clinic, Rochester, Minn.
authors: Thomas J
authors: TJ
authors: Salinas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000537:Aluminum Oxide / Q000737:chemistry; D002516:Ceramics / Q000737:chemistry*; D003116:Color; D055812:Community-Based Participatory Research; D003442:Crowns; D003731:Dental Caries / Q000145:classification; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D003776:Dental Porcelain / Q000737:chemistry; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D019279:Resin Cements / Q000737:chemistry; D019233:Retreatment; D013499:Surface Properties; D016019:Survival Analysis; D055815:Young Adult; D015040:Zirconium / Q000737:chemistry
chemical_list: D003764:Dental Materials; D005899:Glass Ionomer Cements; D019279:Resin Cements; C493120:lithia disilicate; D003776:Dental Porcelain; D015040:Zirconium; D000537:Aluminum Oxide; C028541:zirconium oxide