Dentists recognize the favorable fracture resistance and flexural strength properties of zirconia, but restoration removal and shade matching are a struggle for many, according to a Report of the ADA Clinical Review Panel published in the January issue of The Journal of the American Dental Association.
The report includes responses from 277 dentists who are members of the ACE Panel about how zirconia is used in their practices.
“We chose to look at zirconium because of how widespread this material has become. Our study showed that 99% of dentists who use zirconium use it for natural tooth restorations,” said Nathaniel Lawson, DMD, Ph.D., a by the report’s researchers. co-authors and member of the Oversight Subcommittee of the ACE Group of the ADA Council on Scientific Affairs. “In addition, there are now different types of zirconia that have different properties, so dentists can now use zirconia for many different clinical applications.”
Almost all responding dentists (98%) said they use zirconia for posterior crowns, while 61% use it for anterior crowns. When it comes to bridges, 78% use it for back bridges and 57% for front bridges.
Shade matching and translucency (36%) and removal of restoration for replacement (35%) were the top two disadvantages of zirconia cited in the survey. More than half of respondents (57%) cited bending strength or breaking strength as the biggest advantage.
The three most common complications with zirconia compared with metal-ceramic restorations reported by respondents were restoration detachment (52%), opposing tooth wear (31%), and restoration fracture (23%).
“It was surprising that over 50% of dentists had more problems with zirconia crowns loosening than metal-ceramic crowns,” Dr. Lawson said. “Zirconium bonded with a proper protocol can have long-term success, according to studies performed on cantilevered resin-bonded anterior fixed prostheses.”
Ceramic polishes (65%) and fine diamonds (61%) are most often used for polishing and setting zirconia restorations, while coarse diamond rotary tools (51%) and those made specifically for zirconia (43%) are most often used for their removal. restorations.
“The research found that the most common instrument used to remove zirconia crowns was a coarse diamond; however, clinicians should consider that special zirconia diamonds can be more effective,” Dr. Lawson said.
Dentists can view the full ACE Panel report online and download the PDF at JADA.ADA.org .
ACE Panel reports include data from ADA member dentists who have registered to participate in brief surveys related to dental products, practices, and other clinical topics. The ADA Council on Scientific Affairs’ ACE Group Oversight Subcommittee prepares the reports with the staff of the ADA Institute of Science and Research.
The fairs aim to provide ADA members with a way to understand the views of their peers on various dental products and practices, offering insight and awareness of new products and techniques that can benefit patients and the profession.
Members are invited to join the ACE Panel and contribute to upcoming surveys, which occur no more than once every few months and typically take five to 10 minutes to complete.
To learn more or join the ACE panel, visit ADA.org/ACE .
