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Cover of Porcelain-Fused-to-Metal Crowns versus All-ceramic Crowns: A Review of the Clinical and Cost-Effectiveness

Porcelain-Fused-to-Metal Crowns versus All-ceramic Crowns: A Review of the Clinical and Cost-Effectiveness

Rapid Response Report: Summary with Critical Appraisal

Porcelain-fused-to-metal (PFM) crowns have been considered the gold standard for the repair of damaged teeth. PFM crowns have good mechanical properties, satisfactory esthetic results, and an acceptable biological quality needed for periodontal health. However, PFM crowns have some limitations that may limit their use. For example, the esthetic of PFM crowns is limited by the metal framework and the layer of opaque porcelain needed for masking the underlying metal grayish shade. Recently the cost of precious metals has risen markedly making PFM relatively unattractive from an economic standpoint.

All-ceramic crowns have been used over the last four decades as an alternative for PFM crowns to overcome their esthetic limitations. All-ceramic crowns can be made from different types of ceramic, and not all ceramic types have the same physical and esthetic proprieties. Historically, resin-based crowns were the first metal-free crowns to be used, but they were abandoned because of their low fracture resistance. Newer metal-free crowns are increasingly being used in dental practice; these crowns are made from different ceramic materials such as lithium disilicate, zirconia, leucite-reinforced glass, and glass-infiltrated alumina.

Policy makers require information on the relative benefits and costs associated with different types of crown materials in order to support reimbursement decisions. The objective of this review is to evaluate the clinical and cost-effectiveness of dental PFM and all-ceramic crowns.

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.

Copyright © 2015 Canadian Agency for Drugs and Technologies in Health.

Copyright: This report contains CADTH copyright material and may contain material in which a third party owns copyright. This report may be used for the purposes of research or private study only. It may not be copied, posted on a web site, redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright owner.

Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions.

Except where otherwise noted, this work is distributed under the terms of a Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International licence (CC BY-NC-ND), a copy of which is available at http://creativecommons.org/licenses/by-nc-nd/4.0/

Bookshelf ID: NBK304693PMID: 26180882

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