BruxZir Solid Zirconia Crowns and Bridges (3 yr.)

Consultants’ Comments

• “Beautiful Crown.  Perfect fit and no adjustments.”
• “One of the nicest implant crowns I have seen.”
• “BruxZir is a great choice for worry-free crowns and a good value.”
• “BruxZir is my go-to restoration for posterior teeth; it looks good and I know it will last.”
• “I have been using BruxZir for four years or more and I have not been disappointed – neither have my patients.”

Clinical Recommendations

• THE DENTAL ADVISOR highly recommends the use of BruxZir for three- and four-unit bridges.
• Data on file at THE DENTAL ADVISOR indicate that using a zirconia primer improves the bond strength of adhesive and self-adhesive resin cements to zirconia by up to 50%. It is advisable to prime zirconia crowns prior to cementation.
• It is highly recommended for posterior crowns and three- and four-unit bridges as well as implant supported crowns and bridges.

Description

A total of 822 BruxZir Solid Zirconia Crowns and Bridges have been placed over the past four years. They included single crowns (87%) and three- and four-unit bridges (13%). The restorations were cemented with adhesive and self-adhesive resin cements.

Purpose

The purpose of this evaluation was to report the clinical performance of BruxZir Solid Zirconia Crowns and Bridges at three years.

Clinical Evaluation Protocol

At recall, 632 BruxZir restorations were evaluated, including crowns; three- and four-unit bridges; and implant-supported crowns and bridges (Figure 1). The majority (88%) of the restorations were fabricated by Glidwell Laboratories, while 12% were fabricated by Apex Dental Milling. Of the 632 recalled restorations, 33% were up to 3 years old, 46% were 3-4 years old and 21% were over 4 years old (Figure 2). BruxZir restorations were evaluated in the following categories: esthetics, resistance to fracture or chipping, resistance to marginal discoloration, wear of zirconia and opposing dentition, and retention. The restorations were evaluated on a 1-5 rating scale: 1=poor, 2=fair, 3=good, 4=very good, 5=excellent.

Clinical Observations

Esthetics

The esthetics of BruxZir was rated excellent (Figure 3) when one considers the consistency of the shade and compares the esthetics to other monolithic zirconia restorations. Other zirconia restorations are generally more opaque and lack opalescence. BruxZir restorations were not compared with esthetic ceramic restorations resulting from layered porcelain. BruxZir restorations are perfect for patients desiring more uniform and whiter teeth like a B1 shade. The new BruxZir 16 pre-shaded zirconia, recently introduced by Glidewell Laboratories could further improve esthetics.

Resistance to Fracture/Chipping

The chipping or fracture of BruxZir single crowns has been practically non-existent (Figure 3). One second molar crown did fracture, but it was likely due to lack of occlusal clearance and reduction. Having less than a 1 mm of clearance is not recommended for molars. None of the three- or four-unit bridges have fractured.

Resistance to Marginal Discoloration

None of the restorations exhibited any marginal discoloration at four years (Figure 3). The opacity of the crowns may help camouflage any staining or microleakage.

Wear Resistance

Almost no wear was observed on BruxZir restorations and very minimal wear was observed on opposing natural dentition at four years (Figure 3). More wear was noted on gold crowns opposing BruxZir restorations.

Retention

Twenty-seven out of the 822 BruxZir crowns debonded (3%) and required recementation over the evaluation period (Figure 3). This debonding rate is slightly higher (3% vs 2%) when compared to non-zirconia crowns that THE DENTAL ADVISOR has documented over time

Conclusions

Conclusions Over a three-year evaluation period, BruxZir Solid Zirconia Crowns and Bridges have proven to be excellent restorations with respect to esthetics and dependability. BruxZir Solid Zirconia Crowns and Bridges received a 97% clinical performance rating.