Background. The use of all-ceramic crowns is increasing, and this trend will continue. However, all-ceramic systems are not all the same. They differ considerably in their relative esthetic potential, their physical properties and evidence base relative to longevity. The use of an all-ceramic system does not guarantee outstanding esthetics.
Conclusions. Some all-ceramic systems can provide superior esthetic results compared with metal-ceramic restorations. Zirconia-cored crowns are the strongest all-ceramic system and may provide improved esthetic results compared with metal-ceramic crowns. No all-ceramic restoration has been shown to have a life span equivalent to that of metal-ceramic restorations. Further clinical trials are needed.
Practice Implications. Clinicians should choose appropriate all-ceramic restorations on the basis of their patients’ needs. Currently available evidence indicates that clinicians should not use all-ceramic crowns on molars; in addition, posterior fixed partial prostheses fabricated with all-ceramic materials have a high likelihood of failure.
