CLINICAL OUTCOMES OF MAXILLARY ANTERIOR RESTORATIONS USING MULTILAYER ZIRCONIA CROWNS FABRICATED WITH CAD/CAM TECHNOLOGY
Main Article Content
Abstract
Background: Restoration of the maxillary anterior teeth requires high esthetic and functional demands. Multilayer zirconia crowns fabricated using CAD/CAM technology enhance precision, esthetics, and biological durability. However, clinical follow-up data are needed to evaluate treatment effectiveness. Objective: To evaluate the clinical outcomes of maxillary anterior restorations using multilayer zirconia crowns fabricated with CAD/CAM technology. Materials and methods: A prospective descriptive study was conducted on 22 patients with 35 teeth receiving fixed restorations from June 2025 to January 2026 at Can Tho University of Medicine and Pharmacy Hospital. Evaluation criteria included esthetics, function, durability, pulp and periapical status, periodontal condition, and patient satisfaction. Results: The mean age of the patients was 35.95 ± 5.75 years, and females accounted for 59.0%. Among the 35 restored maxillary incisors, maxillary central incisors accounted for 77.1%. The main indications for restoration were extensive caries (37.1%) and tooth malformation (28.6%), and vital teeth accounted for 77.1%. Immediately after crown placement, good outcomes were recorded for esthetics in 94.3%, function in 97.1%, pulp and periapical status in 88.9%, and patient satisfaction in 88.6%. At 1, 3, and 6 months, function, absence of secondary caries, and periodontal status were rated good in 100% of cases. Good esthetic outcomes were observed in 94.3% of cases at 1 and 3 months, decreasing slightly to 91.4% at 6 months (p = 0.568). Durability was rated good in 100% of cases at 1 and 3 months and in 97.1% at 6 months (p = 0.672). In the vital teeth subgroup, good pulp and periapical status increased from 92.6% at 1 month to 100% at 3 and 6 months (p = 0.435). Patient satisfaction remained good in 97.1% of cases at all three follow-up time points. Conclusion: Restoration of maxillary anterior teeth with multilayer zirconia CAD/CAM crowns yielded high esthetic and functional outcomes, good stability over 6 months of follow-up, high patient satisfaction, and few biological complications.
Keywords
Restoration, maxillary anterior teeth, multilayer zirconia crown, CAD/CAM
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
2. Robaian A., Alotaibi N.M., Allaboon A.K., AlTuwaijri D.S., Aljarallah A.F., et al. Factors influencing dentists' choice of restorative materials for single-tooth crowns: a survey among saudi practitioners. Med Sci Monit. 2024. 30:e942723. https://doi.org/10.12659/MSM.942723.
3. Pekkan G., Pekkan K., Bayindir B.Ç., Özcan M., and Karasu B. Factors affecting the translucency of monolithic zirconia ceramics: A review from materials science perspective. Dent Mater J. 2020. 39(1), 1-8. https://doi.org/10.4012/dmj.2019-098.
4. Kontonasaki E., Rigos A.E., Ilia C., and Istantsos T. Monolithic zirconia: an update to current knowledge. optical properties, wear, and clinical performance. Dent J (Basel). 2019. 7(3):90. https://doi.org/10.3390/dj7030090.
5. Sailer I., Strasding M., Valente N.A., Zwahlen M., Liu S., et al. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic multiple-unit fixed dental prostheses. Clin Oral Implants Res. 2018. 29 (S16), 184-198. https://doi.org/10.1111/clr.13277.
6. Alshali S.A., Kazim S.A., Nageeb R., and Almarshoud H.S. Comparative evaluation of the translucency of monolithic zirconia. J Contemp Dent Pract. 2020. 21(1), 51-55. https://doi.org/10.5005/jp-journals-10024-2735.
7. Kökat AM, and Kökat AD. Monolithic CAD/CAM restorations esthetic zone applications. J Exp Clin Med. 2021. 38(S2), 180-187. https://doi.org/10.52142/omujecm.38.si.dent.17.
8. Vũ Thị Bích Vân, Trần Thị Phương Đan. Đánh giá chất lượng điều trị phục hồi răng trước trên bằng mão sứ Zirconia. Tạp chí Y Dược học Cần Thơ. 2021, 41:190-197.
9. Zhang C.N., Zhu Y., Zhang Y.J., and Jiang Y.H. Clinical esthetic comparison between monolithic high-translucency multilayer zirconia and traditional veneered zirconia for single implant restoration in maxillary esthetic areas: Prosthetic and patient-centered outcomes. J Dent Sci. 2022. 17(3), 1151-1159. https://doi.org/10.1016/j.jds.2022.01.012.
10. Miura S., Yamauchi S., Kasahara S., Katsuda Y., Fujisawa M., et al. Clinical evaluation of monolithic zirconia crowns: a failure analysis of clinically obtained cases from a 3.5-year study. J Prosthodont Res. 2021. 65(2), 148-154. https://doi.org/10.2186/jpr.JPOR_2019_643.
11. Alfadhli R., Alshammari Y., Baig M.R., and Omar R. Clinical outcomes of single crown and 3unit bi-layered zirconia-based fixed dental prostheses: An up to 6- year retrospective clinical study: Clinical outcomes of zirconia FDPs. J Dent. 2022. 127:104321. https://doi.org/10.1016/j.jdent.2022.104321.
12. Leitão C.I.M.B., Fernandes G.V.O., Azevedo L.P.P., Araújo F.M., Donato H., et al. Clinical performance of monolithic CAD/CAM tooth-supported zirconia restorations: systematic review and meta-analysis. J Prosthodont Res. 2022. 66(3), 374-384. https://doi.org/10.2186/jpr.JPR_D_21_00081.
13. Abu-Naba’a L.A., Almohammed S.N., and Ziyad T.A. An investigation of the mechanical characteristics of four CAD-CAM monolithic zirconia materials. Ceramics. 2025. 8(4):135. https://doi.org/10.3390/ceramics8040135.
14. Hickel R., Mesinger S., Opdam N., Loomans B., Frankenberger R., et al. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig. 2023. 27(6), 2573-2592. https://doi.org/10.1007/s00784-022-04814-1.
15. Kasem A.T., Ellayeh M., Özcan M., Sakrana A.A. Three-year clinical evaluation of zirconia and zirconia-reinforced lithium silicate crowns with minimally invasive vertical preparation technique. Clin Oral Investig. 2023. 27(4), 1577-1588, https://doi.org/10.1007/s00784-02204779-1.