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

Published on: May 29, 2015
Project Number: RC0657-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report


  1. What is the clinical evidence on the longevity of all-ceramic/porcelain crowns?
  2. What is the clinical evidence on the longevity of porcelain-fused-to-metal crowns?
  3. What is the clinical evidence of the longevity of porcelain-fused-to-metal crowns compared with all-ceramic crowns?
  4. What is the long-term (eight years and longer) cost-effectiveness of porcelain-fused-to-metal crowns compared with all-ceramic crowns?
  5. What are the contextual considerations for all-ceramic crowns or porcelain-fused-to-metal crowns that may affect their clinical or cost-effectiveness?

Key Message

A total of twenty-nine systematic reviews and studies were included, the majority of these studies were based on observational uncontrolled studies. Long term survival (>8 years) of all-ceramic crowns ranged from 84% to 100%, and for porcelain-fused-to-metal crowns ranged from 92% to 96%. Comparative studies showed lower survival rate for all-ceramic crowns (48%) relative to porcelain fused to metal crowns (62%). The cost-effectiveness analysis showed that porcelain-fused-to-metal crowns become more cost-effective than all-ceramic crowns after 10 years of used. None of the identified literature provided reliable evidence about the contextual considerations that may have an influence on the clinical and cost-effectiveness. The authors of one non-randomized study analyzed factors that had an effect on the longevity of crowns, but they did not report separate analyses for different crown materials.


ceramics, crowns, dental prostheses, dental prosthesis, metal ceramic alloys, zirconium, dental, dental prosthetics