Digitally fabricated posterior ceramic crowns versus conventionally fabricated cast crowns: a split-mouth retrospective cohort study.

BACKGROUND: This retrospective cohort study aimed to investigate the effectiveness of posterior ceramic crowns fabricated using digital technology compared to those fabricated via conventional elastomer impressions and casting methods at an academic institution. METHODS: A split-mouth design was employed, wherein each participant received both a posterior ceramic crown (lithium disilicate or zirconia) fabricated using digital workflows and a cast crown fabricated conventionally. Of 45 potential participants treated between 2015 and 2023, 31 were included after excluding anteriors (7), < 1-year follow-ups (5), and bridge abutments (2). Patient- and tooth-related data were collected. Wilcoxon signed-rank and chi-square tests, Kaplan-Meier survival analysis, and the log-rank test were conducted to compare the ceramic and cast crown groups. RESULTS: 62 teeth from 15 men and 16 women were observed for 1-8 years. The mean observation periods did not differ between the ceramic and cast groups (3.3 versus 4 years; p = 0.123). No significant differences were found in the distributions of root canal treatments, clinical crown lengthening procedures, and post-insertions (p > 0.05), nor in the probability of tooth survival (p = 0.14) between the two groups. The insertion of the ceramic crowns was significantly expedited from making the final impression compared to the cast crowns (21 versus 41 days; p = 0.0006). There were no significant differences in the complication rates and tooth loss between the two groups (p > 0.05), with most extractions due to endodontic reasons. CONCLUSION: The ceramic crowns demonstrated notable effectiveness over the cast crowns, completing the procedure in significantly fewer days, while resulting in a comparable prognosis with similar complication rates compared to the cast crowns.