J Prosthet Dent. 2026 Mar 9:S0022-3913(26)00142-3. doi: 10.1016/j.prosdent.2026.02.024. Online ahead of print.
ABSTRACT
STATEMENT OF PROBLEM: Comparative studies assessing monolithic zirconia and metal-ceramic for implant-supported fixed prostheses remain limited.
PURPOSE: This retrospective study aimed to compare the survival and success of metal-ceramic and monolithic zirconia implant-supported prostheses using a split-mouth design.
MATERIAL AND METHODS: This study included 112 participants with 302 implant-supported prostheses. All participants had received both metal-ceramic (n=145) and monolithic zirconia (n=157) restorations between January 2018 and January 2024. Mechanical complications were recorded for all restorations. For the split-mouth analysis, the odds ratio was calculated using generalized estimating equations (GEEs). To compare the 5-year cumulative survival rates between groups, the Kaplan-Meier analysis and log-rank test (α=.05) were performed.
RESULTS: The mean follow-up was 36 months. Of the 302 implant-supported prostheses, 12 metal-ceramic and 10 monolithic zirconia restorations failed. The 5-year cumulative survival rates were 90.9% (95% CI, 85.9% to 95.9%) for the metal-ceramic group and 90.0% (95% CI, 81.9% to 98.2%) for the monolithic zirconia group, with no significant difference (P=.653). Similarly, survival rates did not differ significantly for single crown (P=.240) or fixed partial denture (P=.647). According to GEE analysis, the odds ratio for mechanical complications between the groups was 1.11 (95% CI, 0.41 to 2.98). Although complications were more frequent in the metal-ceramic group, the difference was not statistically significant (P=.830).
CONCLUSIONS: In this retrospective split-mouth study, the 5-year cumulative survival rates and the incidence of mechanical complications did not differ significantly between metal-ceramic and monolithic zirconia implant-supported prostheses. Although metal-ceramic showed a higher number of complications, this difference was not statistically significant. Within the limitations of this study, monolithic zirconia may be considered a suitable material for implant-supported prostheses.
PMID:41807167 | DOI:10.1016/j.prosdent.2026.02.024
