Review Article
A Clinical Assessment of Fracture Incidence in Zirconia Ceramic Crowns: A Systematic Review and Evaluation of Influencing Factors
Issue:
Volume 12, Issue 1, June 2026
Pages:
1-14
Received:
10 December 2025
Accepted:
30 December 2025
Published:
27 January 2026
DOI:
10.11648/j.ijdm.20261201.11
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Abstract: This study utilized the PRISMA 2020 framework alongside the Newcastle-Ottawa Scale (NOS) assessment tool during the screening process to conduct a systematic review of the fracture rates of zirconia (ZrO2) ceramic crowns in clinical practice. The primary objective was to investigate the factors influencing to the failure of zirconia ceramic crowns. The literature search employed targeted keywords including veneered fixed dental prostheses, zirconia, and all-ceramic single crowns. Inclusion criteria encompassed randomized controlled trials (RCTs) and cohort studies with a minimum follow-up duration of three years and at least 20 cases. Non-clinical reports and those exclusively addressing long-span fixed dental prostheses were excluded from the analysis. Of the eleven high-quality reports selected, only three reported crown fracture rates consistent with the clinically recommended threshold of 4.4%. To mitigate fractures in ZrO2 ceramic crowns used in dental restorations, precision is essential in both research and clinical practice. Multiple factors influence fracture incidence in fixed dental prostheses, including ceramic material thickness, connector dimensions, pontic span, type of cementation, and ceramic surface treatment. Preventative strategies focus on reducing occlusal overload by narrowing the occlusal table, decreasing cusp inclination, modifying load direction, minimizing non-axial forces, and selecting lighter occlusal contacts. Additionally, the integration of screw access channels and mechanical circulation in implant-supported prostheses may lower average fracture loads. Lastly, ensuring the precise alignment of the screw access channel at the center of the occlusal surface is critical to avoid off-center occlusal contacts during subsequent evaluations and measurements.
Abstract: This study utilized the PRISMA 2020 framework alongside the Newcastle-Ottawa Scale (NOS) assessment tool during the screening process to conduct a systematic review of the fracture rates of zirconia (ZrO2) ceramic crowns in clinical practice. The primary objective was to investigate the factors influencing to the failure of zirconia ceramic crowns....
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Case Report
Dental Avulsion During Endotracheal Intubation in a Pediatric Patient: A Case Report
Agwu Nnanna Uchechuku*
,
Adejumo Abiola Mosunmade
Issue:
Volume 12, Issue 1, June 2026
Pages:
15-18
Received:
18 February 2026
Accepted:
27 February 2026
Published:
12 March 2026
DOI:
10.11648/j.ijdm.20261201.12
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Abstract: Dental injury is a recognized complication of general anaesthesia, particularly during endotracheal intubation, with the maxillary incisors being most frequently affected. In paediatric patients, a dislodged tooth may result in serious complications such as airway obstruction, aspiration pneumonitis, or lung collapse if aspirated. We report the case of a 6-year-old girl with bilateral Blount’s disease who underwent corrective osteotomy under general anaesthesia. Preoperative assessment did not document any dental abnormality. Following induction, tracheal intubation was performed by a first-year resident using an inappropriately sized laryngoscope blade. Immediately after intubation, a missing upper left incisor was identified. A thorough intraoperative search of the oral cavity and nares failed to locate the tooth, and the surgical procedure proceeded uneventfully. Postoperatively, the patient remained clinically stable with no signs of respiratory distress up to 24 hours after surgery. Radiologic evaluation revealed no evidence of aspiration, and in the absence of clinical or radiologic findings, the tooth was presumed to have been swallowed. This case underscores the importance of careful preoperative dental assessment, appropriate equipment selection, and adequate supervision of trainees during paediatric airway management to minimize preventable dental trauma and its potentially serious consequences.
Abstract: Dental injury is a recognized complication of general anaesthesia, particularly during endotracheal intubation, with the maxillary incisors being most frequently affected. In paediatric patients, a dislodged tooth may result in serious complications such as airway obstruction, aspiration pneumonitis, or lung collapse if aspirated. We report the cas...
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