Longevity of metal-ceramic single crowns cemented with self-adhesive resin cement: An update of a prospective analysis with up to 106 months of follow-up

Objectives: To evaluate longevity of metal-ceramic single crowns cemented using a self-adhesive resin cement in a prospective clinical analytical study. Methods: : A total of 152 teeth received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. Next, 93% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analysed considering the loss of crown retention (crown debonding) as the primary outcome. In addition, post debonding, root fracture and tooth loss occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression, with 95% confidence interval was applied for the statistical analysis. Results: : Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (93%), with 8 crown debondings occurring after the evaluation period. For secondary outcomes, 9 root fractures, 4 post debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. Conclusion: The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 93% after an average follow-up of 62 months. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). Clinical Significance: The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns.