PURPOSE: Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS: An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS: There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION: The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.
Ceramics ; Cohort Studies ; Crowns ; Dentistry ; Denture, Partial, Fixed ; Electronics ; Electrons ; Retrospective Studies ; Survival Rate ; Tooth ; Tooth Fractures ; United States Public Health Service ; Zirconium

PURPOSE: The objective of this study was to compare the fracture toughness (KIc) obtained from the single edge V-notched beam (SEVNB) and the fractographic analysis (FTA) of a glass-infiltrated and a zirconia ceramic. MATERIALS AND METHODS: For each material, ten bar-shaped specimens were prepared for the SEVNB method (3 mm x 4 mm x 25 mm) and the FTA method (2 mm x 4 mm x 25 mm). The starter V-notch was prepared as the fracture initiating flaw for the SEVNB method. A Vickers indentation load of 49 N was used to create a controlled surface flaw on each FTA specimen. All specimens were loaded to fracture using a universal testing machine at a crosshead speed of 0.5-1 mm/min. The independent-samples t-test was used for the statistical analysis of the KIc values at alpha=0.05. RESULTS: The mean KIc of zirconia ceramic obtained from SEVNB method (5.4 +/- 1.6 MPa.m1/2) was comparable to that obtained from FTA method (6.3 +/- 1.6 MPa.m1/2). The mean KIc of glass-infiltrated ceramic obtained from SEVNB method (4.1 +/- 0.6 MPa.m1/2) was significantly lower than that obtained from FTA method (5.1 +/- 0.7 MPa.m1/2). CONCLUSION: The mean KIc of the glass-infiltrated and zirconia ceramics obtained from the SEVNB method were lower than those obtained from FTA method even they were not significantly different for the zirconia material. The differences in the KIc values could be a result of the differences in the characteristics of fracture initiating flaws of these two methods.
Ceramics ; Collodion ; Zirconium