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J Am Dent Assoc, Vol 139, No suppl_4, 8S-13S.
© 2008 American Dental Association
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ARTICLES

The Clinical Success Of All-Ceramic Restorations

Alvaro Della Bona, DDS, MMedSci, PhD, FADM and J. Robert Kelly, DDS, MS, DMedSc


   ABSTRACT
TOP
 ABSTRACT
VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
 CONCLUSIONS
 REFERENCES
 
Background. The authors conducted a comprehensive literature review to compile and compare clinical evidence for the treatment of teeth using all-ceramic restorations.

Types of Studies Reviewed. The authors searched the English-language peer-reviewed literature using MEDLINE and PubMed with a focus on research published between 1993 and 2008. They also conducted a hand search of relevant dental journals. They reviewed randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies and longitudinal retrospective studies.

Results. Evidence suggests that for veneers, intracoronal restorations and complete-coverage restorations for single-rooted anterior teeth, clinicians may choose from any all-ceramic system on the basis of esthetic needs (many systems have had greater than 90 percent success at six years). Well-studied molar restorations include those made of alumina and, increasingly, zirconia and bonded lithium disilicate. Reasonable evidence has shown the effectiveness of anterior three-unit fixed partial dentures made of lithium disilicate, alumina and zirconia. For three-unit restorations involving a molar, expert consensus suggests that only zirconia-based systems are indicated.

Clinical Implications. Available evidence indicates the effectiveness of many all-ceramic systems for numerous clinical applications. Bonding has been shown to increase clinical success. Studies of zirconia prostheses indicate problems with porcelain cracking.

Key Words: Literature review; zirconina; alumina; survival rate

Abbreviations: CAD/CAM: Computer-aided design/computer-aided manufacturing. • FPDs: Fixed partial dentures.

Some basic concepts are useful in understanding all-ceramic systems.1,2 It is universally true that the stronger (and tougher) ceramics are more opaque (thus, less translucent) than esthetic porcelains.3 Therefore, in patients whose tooth restoration involves esthetic demands without much structural need, the clinician can use single (that is, monolithic) layers of tooth-colored porcelains. When structural demands require stronger materials, the clinician uses copings and frameworks made of less esthetic ceramic materials that are veneered (that is, layered) with tooth-colored porcelains. The dentist also uses layered ceramics to mask discolored preparations.

Clinical data strongly suggest that clinicians achieve higher success rates when they can bond ceramics to teeth (for example, resin-based cement versus glass ionomer or zinc phosphate).3 Bonding requires that the ceramic contain filler particles that can be removed selectively via etching to create micromechanical adherence features. Manufacturers routinely provide cementation directions that should be followed.

In this review, we emphasize restorations rather than the ceramic systems. We begin with the most well-studied and successful restorations (that is, veneers bonded to enamel and inlays/onlays) and end with the least well-studied restorations (that is, multiunit posterior prostheses). We have kept this review brief to make it accessible to the widest possible clinical audience.


   VENEER RESTORATIONS
TOP
 ABSTRACT
 VENEER RESTORATIONS
INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
 CONCLUSIONS
 REFERENCES
 
Ceramics are particularly well-suited for veneer restorations, which have failure rates, including loss of retention or fracture, of less than 5 percent at five years.4,5 In one of the earliest clinical studies, which examined 83 veneers (IPS Empress, Ivoclar Vivadent, Amherst, N.Y. [now IPS Empress Esthetic Veneer]), the authors reported a success rate of 98.8 percent after six years.6 Two recent reports on feldspathic porcelain veneers (n = 3,047 and n = 1,828) showed similar long-term survival rates (according to Kaplan-Meier statistics): 96 percent at five to six years, 93 percent at 10 to 11 years and 91 percent at 12 to 13 years in one study7 and 94.4 percent at 12 years in the second study.8 Mechanical and biological complications that did occur were associated with esthetics (31 percent), mechanical complications (31 percent), periodontal support (12.5 percent), loss of retention (12.5 percent), caries (6 percent) and tooth fracture (6 percent).7 We should point out that both periodontal support and secondary caries are biological responses that likely are not related to the materials used in fixed prostheses.


   INLAY AND ONLAY RESTORATIONS
TOP
 ABSTRACT
 VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
 CONCLUSIONS
 REFERENCES
 
Some of the most extensively studied ceramics in dentistry are used for inlay and onlay restorations; they are made of feldspathic ceramic (Vitablocs Mark I and II, Vita Zahnfabrik, Bad Säckingen, Germany) or mica-filled glass-ceramic (Dicor, Dentsply, York, Pa. [no longer on the market]) by using the CEREC computer-aided design/computer-aided manufacturing (CAD/CAM) system (Sirona Dental Systems GmbH, Bensheim, Germany).9–14 Another widely studied ceramic is the hot-pressed leucite-reinforced ceramic from Ivoclar Vivadent (formally IPS Empress, now IPS Empress Esthetic).15–18

Within a private practice setting, Otto and De Nisco12 reported a survival rate (using Kaplan-Meier statistics) of 90.4 percent at 10 years for 200 restorations. Reported failures were related to ceramic fracture (53 percent), tooth fracture (20 percent) and endodontic problems (7 percent). A literature review of six clinical trials that used IPS Empress (Ivoclar Vivadent) for inlay/onlay restorations reported survival rates ranging from 96 percent at 4.5 years to 91 percent at 7 years15; these results are consistent with those of a prospective controlled clinical trial (92 percent at eight years; Kaplan-Meier statistics)16 and a recent evaluation17 of 1,588 IPS Empress inlay/onlay restorations placed on vital teeth (97 percent at 10 years; Kaplan-Meier statistics).

A systematic review of 22 clinical studies that used the CEREC system to produce inlay and onlay restorations and crowns from Vitablocs Mark I and II and Dicor ceramics reported a survival probability of approximately 97 percent at five years and 90 percent at 10 years.13 One of these studies14 reported data about 66 CAD/CAM inlays that had an estimated survival rate of 89 percent after 10 years—77 percent for the inlays luted with a dual-cured resin-based composite and 100 percent for those luted with a chemically cured resin-based composite. This difference in performance on the basis of the cement used was statistically significant.


   SINGLE-UNIT CROWNS
TOP
 ABSTRACT
 VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
MULTIUNIT PROSTHESES
 CONCLUSIONS
 REFERENCES
 
As expected, the first all-ceramic systems to appear on the market have received the most attention in the peer-reviewed literature. These systems are leucite-reinforced glass-ceramic (IPS Empress), glass-infiltrated ceramics (In-Ceram Alumina and In-Ceram Spinell, Vita Zahnfabrik) and polycrystalline alumina (Procera Alumina, Nobel Biocare, Göteborg, Sweden). Despite the differences in their microstructure, composition, processing methods and intraoral area (anterior or posterior), most clinical trials have reported survival rates of greater than 90 percent, irrespective of the time in service; the one exception is a glass-ceramic introduced in the 1980s (Dicor), but it is no longer on the market (Table 1Go19–43).


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  		TABLE 1 Peer-reviewed studies of survival rate of all-ceramic single-unit crowns.

 
In general, fracture rates appear to be lower for anterior crowns than for molar crowns, and the two alumina-based systems are proving to be comparable (that is, In-Ceram Alumina and Procera Alumina). Greater success for anterior teeth also has been the trend for IPS Empress crowns. Fradeani and Redemagni38 reported an overall survival rate of 95.2 percent at 11 years for 125 IPS Empress crowns, which represents 98.9 percent survival in the anterior segment and 84.4 percent survival in the posterior segment.

The main causes of failure reported in all studies were catastrophic fractures (that is, the crown broke into two pieces), chipping of the veneer ceramic and secondary caries. Again, we should point out that secondary caries is a host response likely unrelated to the particular materials used in fixed prostheses. In a four-year study of 80 In-Ceram Alumina crowns (58 anterior [72 percent] and 22 posterior [28 percent]), Haselton and colleagues44 reported that only one molar crown had fractured and the marginal ridge of one premolar crown had chipped. However, another four-year study did not report any bulk fractures for 28 anterior and 68 posterior crowns (In-Ceram Alumina).21

McLaren and White23 conducted a study in a private practice setting and reported that 223 crowns (In-Ceram Alumina) had a survival rate of 96 percent after three years, with anterior crowns trending toward a higher survival rate (98 percent) than pre-molars or molars (94 percent). A retrospective study25 of 546 In-Ceram Alumina restorations (177 anterior and 369 posterior crowns) reported a survival rate of 99.1 percent for both anterior and posterior crowns after six years of service. Furthermore, a recent study of 135 restorations (Procera Alumina) reported a cumulative survival rate of 100 percent in the anterior region and 98.8 percent in the posterior region (one crown fracture) after five and seven years regardless of the cement used (resin-based composite or glass-ionomer cement).33

Restorations composed of lithium disilicate–based glass-ceramic (IPS Empress 2 [now reformulated and optimized as IPS e.max Press], Ivoclar Vivadent) also have had high survival rates. Two recent reports on IPS Empress 2 crowns showed survival rates of 95 percent39 and 100 percent40 after five years.


   MULTIUNIT PROSTHESES
TOP
 ABSTRACT
 VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
CONCLUSIONS
 REFERENCES
 
Two manufacturers have recommended their all-ceramic systems for anterior three-unit pros-theses: a glass-infiltrated alumina (In-Ceram Alumina) and a lithium disilicate–based glass-ceramic (IPS Empress 2 [now IPS e.max Press]).3 Some clinical studies also reported using In-Ceram Alumina for fixed partial dentures (FPDs) involving posterior teeth (Table 2Go19,20,40,41,45–51). In a three-year study of 61 three-unit FPDs (In-Ceram Alumina), Sorensen and colleagues45 reported survival rates of 100 percent for anterior teeth and 83 percent for posterior teeth. Seven of the FPDs fractured through the connector area. All FPDs had been cemented with glass-ionomer cement.45


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  		TABLE 2 Peer-reviewed studies of survival rate of all-ceramic three-unit fixed partial dentures (two conventional retainers).

 
In another study of 42 FPDs (64 percent were cantilevered two-unit FPDs and 36 percent were three-unit FPDs), 62 percent of which involved a posterior tooth, Olsson and colleagues47 reported an overall survival rate of 93 percent at five years and 83 percent at 10 years; however, for the three-unit FPDs only, the survival rate was 88 percent at 10 years. Kern48 also examined cantilevered two-unit (n = 21) and conventional three-unit (n = 16) anterior FPDs (In-Ceram Alumina) in a study that reported a five-year survival rate of 73.9 percent for the three-unit FPDs and 92.3 percent for the two-unit FPDs. The results of this study also showed that when one connector fractured, the other was quite stable when left as a cantilevered unit.48

Three clinical studies reported survival rates for FPDs (IPS Empress 2).40,41,50 A two-year study41 reported that 10 (50 percent) of 20 FPDs experienced catastrophic failures, with five failures (25 percent) occurring within the first year and the other five failures (25 percent) occurring within the second year. However, the other two studies reported survival rates of 70 percent after five years40 and 93 percent after two years of follow-up.50 In the study conducted by Esquivel-Upshaw and colleagues,50 two fractures occurred; one was associated with a short connector height (2.9 millimeters, instead of the recommended 4 mm) and the other was associated with an unusually high occlusal force (1,031 newtons).

Manufacturers recommended two other all-ceramic systems for posterior three-unit prostheses: a glass-infiltrated alumina/zirconia (In-Ceram Zirconia, Vita Zahnfabrik) and a transformation-toughened polycrystalline zirconia (such as Cercon Zirconia, Dentsply Ceramco, York, Pa.; Lava, 3M ESPE, St. Paul, Minn.; In-Ceram YZ, Vita Zahnfabrik).3 Suárez and colleagues49 evaluated the clinical performance of posterior FPDs (In-Ceram Zirconia) (n = 18) after three years of service. They reported only one failure, the result of root fracture, resulting in a survival rate of 94.5 percent. The success rate for the 33 posterior zirconia FPDs (Cercon) was 97.8 percent.51 However, the overall survival rate was 73.9 percent because of other complications, such as secondary caries (21.7 percent) and chipping of the veneering ceramic (15.2 percent).51 These two clinical studies (n = 51) reported only one fracture of the zirconia-based framework, which suggests a promising future for all-ceramic FPDs.


   CONCLUSIONS
TOP
 ABSTRACT
 VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
 CONCLUSIONS
REFERENCES
 
In this review, we presented current evidence suggesting that all-ceramic restorations have an acceptable clinical longevity that accompanies their long-lasting esthetic advantages. Evidence from many clinical studies suggests that clinicians may choose from any all-ceramic system on the basis of patients’ esthetic needs for veneers, intracoronal restorations and full-coverage restorations for single-rooted anterior teeth. Only a few systems have been successful for the restoration of molars, and additional clinical factors such as adequate preparation depth and cementation can outweigh materials considerations.

In the future, transformation-toughened zirconia may stand out as the most successful all-ceramic system, irrespective of the clinical indication. Nevertheless, chipping of the veneering ceramic on zirconia restorations continues to be a problem. The evidence provided here should enable clinicians to enter into informed-consent decisions with their patients who desire all-ceramic restorations.


   FOOTNOTES
 

Dr. Della Bona is a professor and research coordinator, Dental School, University of Passo Fundo, Campus I, BR 285, P.O. Box 611, Passo Fundo, RS 99001-970, Brazil, e-mail "dbona{at}upf.br". Address reprint requests to Dr. Della Bona.


Dr. Kelly is a professor, Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington. He also is the guest editor of this supplement.


Disclosure. Dr. Kelly has served as a consultant for and received research funding from Ivoclar Vivadent, Amherst, N.Y., and Vita Zahnfabrik, Bad Säckingen, Germany. Dr. Della Bona did not report any disclosures.


   REFERENCES
TOP
 ABSTRACT
 VENEER RESTORATIONS
 INLAY AND ONLAY RESTORATIONS
 SINGLE-UNIT CROWNS
 MULTIUNIT PROSTHESES
 CONCLUSIONS
 REFERENCES
 

  1. Kelly JR. Dental ceramics: what is this stuff anyway? JADA 2008;139(9 suppl):4S–7S.[Free Full Text]

  2. Spear F, Holloway J. Which all-ceramic system is optimal for anterior esthetics? JADA 2008;139(9 suppl):19S–24S.[Abstract/Free Full Text]

  3. Kelly JR. Dental ceramics: current thinking and trends. Dent Clin North Am 2004;48(2):viii, 513–530.

  4. Walls AW. The use of adhesively retained all-porcelain veneers during the management of fractured and worn anterior teeth, part II: clinical results after 5 years of follow-up. Br Dent J 1995;178(9):337–340.[Medline]

  5. Peumans M, Van Meerbeek B, Lambrechts P, Vanherle G. Porcelain veneers: a review of the literature. J Dent 2000;28(3):163–177.[Medline]

  6. Fradeani M. Six-year follow-up with Empress veneers. Int J Periodontics Restorative Dent 1998;18(3):216–225.[Medline]

  7. Layton D, Walton T. An up to 16-year prospective study of 304 porcelain veneers. Int J Prosthodont 2007;20(4):389–396.[Medline]

  8. Fradeani M, Redemagni M, Corrado M. Porcelain laminate veneers: 6- to 12-year clinical evaluation—a retrospective study. Int J Periodontics Restorative Dent 2005;25(1):9–17.[Medline]

  9. Bergman MA. The clinical performance of ceramic inlays: a review. Aust Dent J 1999;44(3):157–168.[Medline]

  10. Martin N, Jedynakiewicz NM. Clinical performance of CEREC ceramic inlays: a systematic review. Dent Mater 1999;15(1):54–61.[Medline]

  11. Pallesen U, van Dijken JW. An 8-year evaluation of sintered ceramic and glass ceramic inlays processed by the Cerec CAD/CAM system. Eur J Oral Sci 2000;108(3):239–246.[Medline]

  12. Otto T, De Nisco S. Computer-aided direct ceramic restorations: a 10-year prospective clinical study of Cerec CAD/CAM inlays and onlays. Int J Prosthodont 2002;15(2):122–128.[Medline]

  13. Fasbinder DJ. Clinical performance of chairside CAD/CAM restorations. JADA 2006;137(suppl):22S–31S.[Abstract/Free Full Text]

  14. Sjögren G, Molin M, van Dijken JW. A 10-year prospective evaluation of CAD/CAM-manufactured (Cerec) ceramic inlays cemented with a chemically cured or dual-cured resin composite. Int J Prosthodont 2004;17(2):241–246.[Medline]

  15. El-Mowafy O, Brochu JF. Longevity and clinical performance of IPS-Empress ceramic restorations: a literature review. J Can Dent Assoc 2002;68(4):233–237.[Medline]

  16. Krämer N, Frankenberger R. Clinical performance of bonded leucite-reinforced glass ceramic inlays and onlays after eight years. Dent Mater 2005;21(3):262–271.[Medline]

  17. Stoll R, Cappel I, Jablonski-Momeni A, Pieper K, Stachniss V. Survival of inlays and partial crowns made of IPS empress after a 10-year observation period and in relation to various treatment parameters. Oper Dent 2007;32(6):556–563.[Medline]

  18. Lohbauer U, Krämer N, Petschelt A, Frankenberger R. Correlation of in vitro fatigue data and in vivo clinical performance of a glass-ceramic material. Dent Mater 2008;24(1):39–44.[Medline]

  19. Pröbster L. Survival rate of In-Ceram restorations. Int J Prosthodont 1993;6(3):259–263.[Medline]

  20. Pang SE. A report of anterior In-Ceram restorations. Ann Acad Med Singapore 1995;24(1):33–37.[Medline]

  21. Pröbster L. Four-year clinical study of glass-infiltrated, sintered alumina crowns. J Oral Rehab 1996;23(3):147–151.[Medline]

  22. Scotti R, Catapano S, D’Elia A. A clinical evaluation of In-Ceram crowns. Int J Prosthodont 1995;8(4):320–323.[Medline]

  23. McLaren EA, White SN. Survival of In-Ceram crowns in a private practice: a prospective clinical trial. J Prosthet Dent 2000;83(2):216–222.[Medline]

  24. Scherrer SS, De Rijk WG, Wiskott HW, Belser UC. Incidence of fractures and lifetime predictions of all-ceramic crown systems using censored data. Am J Dent 2001;14(2):72–80.[Medline]

  25. Segal BS. Retrospective assessment of 546 all-ceramic anterior and posterior crowns in a general practice. J Prosthet Dent 2001;85(6):544–550.[Medline]

  26. Bindl A, Mörmann WH. An up to 5-year clinical evaluation of posterior In-Ceram CAD/CAM core crowns. Int J Prosthodont 2002;15(5):451–456.[Medline]

  27. Fradeani M, Aquilano A, Corrado M. Clinical experience with In-Ceram Spinell crowns: 5-year follow-up. Int J Periodontics Restorative Dent 2002;22(6):525–533.[Medline]

  28. Bindl A, Mörmann WH. Survival rate of mono-ceramic and ceramic-core CAD/CAM-generated anterior crowns over 2–5 years. Eur J Oral Sci 2004;112(2):197–204.[Medline]

  29. Oden A, Andersson M, Krystek-Ondracek I, Magnusson D. Five-year clinical evaluation of Procera AllCeram crowns. J Prosthet Dent 1998;80(4):450–456.[Medline]

  30. Odman P, Andersson B. Procera AllCeram crowns followed for 5 to 10.5 years: a prospective clinical study. Int J Prosthodont 2001;14(6):504–509.[Medline]

  31. Fradeani M, D’Amelio M, Redemagni M, Corrado M. Five-year follow-up with Procera all-ceramic crowns. Quintessence Int 2005;36(2):105–113.[Medline]

  32. Walter MH, Wolf BH, Wolf AE, Boening KW. Six-year clinical performance of all-ceramic crowns with alumina cores. Int J Prosthodont 2006;19(2):162–163.[Medline]

  33. Zitzmann NU, Galindo ML, Hagmann E, Marinello CP. Clinical evaluation of Procera AllCeram crowns in the anterior and posterior regions. Int J Prosthodont 2007;20(3):239–241.[Medline]

  34. Lehner C, Studer S, Brodbeck U, Schärer P. Short-term results of IPS-Empress full-porcelain crowns. J Prosthodont 1997;6(1):20–30.[Medline]

  35. Fradeani M, Aquilano A. Clinical experience with Empress crowns. Int J Prosthodont 1997;10(3):241–247.[Medline]

  36. Sorensen JA, Choi C, Fanuscu MI, Mito WT. IPS Empress crown system: three-year clinical trial results. J Calif Dent Assoc 1998;26(2):130–136.[Medline]

  37. Sjögren G, Lantto R, Granberg A, Sundström BO, Tillberg A. Clinical examination of leucite-reinforced glass-ceramic crowns (Empress) in general practice: a retrospective study. Int J Prosthodont 1999;12(2):122–128.[Medline]

  38. Fradeani M, Redemagni M. An 11-year clinical evaluation of leucite-reinforced glass-ceramic crowns: a retrospective study. Quintessence Int 2002;33(7):503–510.[Medline]

  39. Toksavul S, Toman M. A short-term clinical evaluation of IPS Empress 2 crowns. Int J Prosthodont 2007;20(2):168–172.[Medline]

  40. Marquardt P, Strub JR. Survival rates of IPS Empress 2 all-ceramic crowns and fixed partial dentures: results of a 5-year prospective clinical study. Quintessence Int 2006;37(4):253–259.[Medline]

  41. Taskonak B, Sertgöz A. Two-year clinical evaluation of lithia-disilicate-based all-ceramic crowns and fixed partial dentures. Dent Mater 2006;22(11):1008–1013.[Medline]

  42. Suputtamongkol K, Anusavice KJ, Suchatlampong C, Sithi-amnuai P, Tulapornchai C. Clinical performance and wear characteristics of veneered lithia-disilicate-based ceramic crowns. Dent Mater 2008;24(5):667–673.[Medline]

  43. Sjögren G, Lantto R, Tillberg A. Clinical evaluation of all-ceramic crowns (Dicor) in general practice. J Prosthet Dent 1999;81(3):277–284.[Medline]

  44. Haselton DR, Diaz-Arnold AM, Hillis SL. Clinical assessment of high-strength all-ceramic crowns. J Prosthet Dent 2000;83(4):396–401.[Medline]

  45. Sorensen JA, Kang SK, Torres TJ, Knode H. In-Ceram fixed partial dentures: three-year clinical trial results. J Calif Dent Assoc 1998;26(3):207–214.[Medline]

  46. Vult von Steyern P, Jönsson O, Nilner K. Five-year evaluation of posterior all-ceramic three-unit (In-Ceram) FPDs. Int J Prosthodont 2001;14(4):379–384.[Medline]

  47. Olsson KG, Furst B, Andersson B, Carlsson GE. A long-term retrospective and clinical follow-up study of In-Ceram Alumina FPDs. Int J Prosthodont 2003;16(2):150–156.[Medline]

  48. Kern M. Clinical long-term survival of two-retainer and single-retainer all-ceramic resin-bonded fixed partial dentures. Quintessence Int 2005;36(2):141–147.[Medline]

  49. Suárez MJ, Lozano JF, Paz Salido M, Martínez F. Three-year clinical evaluation of In-Ceram Zirconia posterior FPDs. Int J Prosthodont 2004;17(1):35–38.[Medline]

  50. Esquivel-Upshaw JF, Anusavice KJ, Young H, Jones J, Gibbs C. Clinical performance of a lithia disilicate-based core ceramic for three-unit posterior FPDs. Int J Prosthodont 2004;17(4):469–475.[Medline]

  51. Sailer I, Fehér A, Filser F, Gauckler LJ, Lüthy H, Hämmerle CH. Five-year clinical results of zirconia frameworks for posterior fixed partial dentures. Int J Prosthodont 2007;20(4):383–388.[Medline]




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