Metal-Ceramic FDPs Overview

Metal-Ceramic FDPs

• 5-Year Survival Rate: 94.4% (91.2–96.5% Confidence Interval)
• Annual Failure Rate: 1.15%
• Framework Fractures: Extremely low (0.6%), very durable and reliable
• Caries on Abutments: Relatively low (1.2%), minimal biological complications
• Periodontal Disease: 0.3%
• Loss of Retention: 2.1%, 5-year failure rate of 2.9%, better than most other materials
• Ceramic Fractures: 5.0%, one of the lowest rates for ceramic-related issues
• Best Use: Long-span FDPs and posterior restorations due to superior durability, considered the gold standard for high strength and reliability, especially in high-stress regions
• Key Features: Most durable and reliable option, low technical and biological complication rates, very low framework fracture rates (0.6%), best for long-term stability, slightly higher ceramic fracture rates (5%) but still among the lowest, highest durability and low failure rate, considered the gold standard for durability and stability, minimal technical complications

Reinforced Glass-Ceramic FDPs (Lithium Disilicate)

• 5-Year Survival Rate: 89.1% (80.4–94.0% Confidence Interval)
• Annual Failure Rate: 2.31%
• Framework Fractures: Higher than metal-ceramic (8.0%), susceptible to fractures
• Caries on Abutments: Lowest rates (0.5%), suitable for patients with high caries risk
• Periodontal Disease: 2.9%
• Loss of Retention: 2.9%, 5-year failure rate of 2.9%
• Ceramic Fractures: 6.5%, slightly higher than metal-ceramic, within acceptable limits
• Best Use: Superior esthetics, ideal for anterior restorations where appearance is important, good choice for patients needing short-span FDPs, especially where esthetics is the priority
• Key Features: Excellent esthetic results, ideal for anterior restorations, higher fracture rate (8.0%) compared to metal-ceramic, less durable in high-stress areas, lower caries and periodontal rates (0.5% and 2.9%) compared to other materials, more prone to fractures, best for single crowns or smaller FDPs where stress is lower, known for superior esthetics, making it ideal for anterior restorations, higher risk of fractures compared to metal-ceramic, less suitable for posterior regions with greater stress

Glass-Infiltrated Alumina FDPs

• 5-Year Survival Rate: 86.2% (69.3–94.2% Confidence Interval)
• Annual Failure Rate: 2.97%
• Framework Fractures: Highest of all materials (12.9%), very high failure rate in high-stress applications
• Caries on Abutments: Moderate (2.0%), high susceptibility to periodontal complications (7.6%)
• Periodontal Disease: 7.6%
• Loss of Retention: 2.6%, 5-year failure rate of 7.6%
• Ceramic Fractures: 6.6%, high chipping issues
• Best Use: Suitable for short-span anterior restorations, where lower stress and high esthetics are required
• Not recommended for high-stress posterior regions
• Key Features: Least reliable due to high framework fracture rates (12.9%) and high complication rate, highest rate of periodontal disease (7.6%), higher risk of abutment tooth fractures compared to others, lower survival rates, less favorable choice for long-term restorations, recommended only for short-span FDPs and single restorations, particularly in low-stress areas, least durable with highest fracture rates, especially unsuitable for stress-bearing situations, higher biological complications such as caries and periodontal issues

Densely Sintered Zirconia FDPs

• 5-Year Survival Rate: 90.4% (84.8–94.0% Confidence Interval)
• Annual Failure Rate: 2.02%
• Framework Fractures: Low (1.9%), demonstrates good durability
• Caries on Abutments: Highest among all materials (3.2%), tendency for secondary caries due to marginal fit
• Periodontal Disease: 0.5%
• Loss of Retention: Highest (6.2%), 5-year failure rate of 14.5%
• Ceramic Fractures: 14.5%, highest among all, making it less favorable for highly aesthetic zones
• Best Use: Strong and ideal for posterior restorations, especially in load-bearing areas
• Higher fracture rates make it less reliable in esthetic regions, but its strength is ideal for long-span FDPs
• Key Features: Strength and high resistance to forces, especially in posterior restorations, ceramic fractures (14.5%) are more frequent, making it less suitable for aesthetic applications, higher caries rate on abutments (3.2%), concern for long-term maintenance, best for full-contour crowns and bridges in posterior and load-bearing areas, high strength and resistance, good choice for posterior restorations, higher risk of ceramic fractures, less ideal for anterior esthetic regions

Key Comparative Insights

• Metal-ceramic FDPs lead with 94.4% survival rate, followed by Zirconia, Lithium Disilicate, and Glass-infiltrated Alumina
• Glass-infiltrated alumina has the highest fracture rate (12.9%), while metal-ceramic has the lowest (0.6%)
• Lithium disilicate and Zirconia offer better esthetics but come with higher fracture risks
• Metal-ceramic remains the most durable, especially in high-stress areas, optimal balance of durability and performance.
• Zirconia FDPs show higher ceramic fracture rates and loss of retention, glass-infiltrated alumina has the highest failure rates due to both framework fractures and biological complications
• Metal-ceramic FDPs offer the highest 5-year survival rate (94.4%) and lowest failure rates, best choice for durability and long-term performance
• Although Lithium disilicate offers superior esthetics, it has higher failure rates due to framework fractures
• Glass-infiltrated alumina has the highest framework fracture rate (12.9%) and poorest 5-year survival rate (86.2%), least reliable option, especially in stress-bearing situations