Bento VA, et al. J Adv Prosthodont. 2025 Aug;17(4):247-258. https://doi.org/10.4047/jap.2025.17.4.247

Background/Objectives: This systematic review aimed to quantify the extent of wear of opposing posterior natural enamel in patients with single-unit ceramic crowns. Methods: A comprehensive search was conducted in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ProQuest through September 2025. A meta-analysis was performed using the inverse variance method. Results: Nine clinical studies (5 randomized controlled trials and 4 prospective studies) involving 203 patients (2015–2025) were included. All studies evaluated monolithic zirconia; two also assessed monolithic lithium disilicate, and three included metal-ceramic restorations with feldspathic veneering. Follow-up ranged from 6 to 24 months. Meta-analysis revealed significant enamel wear from zirconia (p < 0.05; MD: −1.32; 95% CI: −2.06 to −0.57; I² = 94%) and lithium disilicate (p < 0.05; MD: −0.45; 95% CI: −0.71 to −0.19; I² = 2%). Feldspathic ceramics did not show significant enamel wear (p = 0.06; MD: −2.77; 95% CI: −5.66 to 0.13; I² = 96%). Conclusions: Ceramic materials generally cause greater wear on opposing posterior natural enamel than enamel-to-enamel contact. Monolithic zirconia and lithium disilicate crowns produced higher antagonist wear, whereas metal-ceramic restorations with feldspathic veneering appeared more conservative for preserving posterior enamel.

Immediate implant placement combined with immediate provisionalization may preserve peri-implant tissue contours and reduce the esthetic impact of the healing period. This case report describes the rehabilitation of tooth 21 in a systemically healthy 36-year-old man with a vertical root fracture after trauma and endodontic treatment. Minimally traumatic extraction was performed, followed by immediate implant placement in a palatal position with an insertion torque of 40 Ncm and filling of the buccal gap with a xenogeneic biomaterial. The extracted clinical crown was separated from the root, converted into a veneer, and bonded to a provisional titanium cylinder with flowable composite resin, allowing fabrication of a screw-retained provisional restoration. The emergence profile was adjusted to support the soft tissues, and sutures were unnecessary. At 90 days, uneventful healing, a favorable peri-implant contour, and maintenance of the gingival architecture were observed. Within the limitations of the short follow-up, the technique proved to be a conservative and esthetic alternative for selected cases in the anterior maxilla.