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Purpose: This study aimed to present the up to 25-year clinical performance and
survival of 2,340 high gold–based metal-ceramic single crowns placed in a specialist
prosthodontic practice. Materials and Methods: All crowns provided to 670 patients
between 1984 and 2008 were sequentially recruited. Each crown/tooth combination was
given a prognostic evaluation at cementation. Patients were recalled in 2008 and 2009
for examination, and patient records were scrutinized for any retreatment. Estimated
cumulative survival, standard error, and differences in survival between groups were
calculated using the Kaplan-Meier method, Greenwood formula, and log-rank test,
respectively. Crown status (six-field classification) was reported within 5-year groupings
and for 7, 10, and 12 years. Results: The up to 10-year and 25-year estimated survival
rates of the 2,211 favorably rated crowns were 97.08% ± 0.45% and 85.40% ± 2.19%,
respectively. The up to 12-year survival for crowns in the postimplant era was 94.4%
± 2.78%. No significant differences related to sex, tooth type, or tooth position were
demonstrated. Nonvital teeth had lower overall survival rates than vital teeth, but not in
crowns placed in the postimplant era. Actual 10-year outcomes closely matched the
estimated 10-year survival. Biologic factors accounted for 101 of the 133 failures, while
mechanical factors accounted for 8 failures and patient concerns accounted for 24
failures. Porcelain fracture requiring replacement occurred in 4 crowns. Conclusions:
The clinical performance of the crowns was excellent. Biologic factors accounted
for the majority of failures. Material stability was excellent. Patient complaints of
unacceptable esthetics resulted in 22 crowns being replaced after a mean clinical
service time of 14 years. Int J Prosthodont 2013;26:151–160. doi: 10.11607/ijp.3136
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