Biocompatibility of Zirconia Crown is superior to Porcelain Fused to Metal (PFM) Crown: A Comparative Study in a Tertiary Care Hospital

Open Access

Abstract

Introduction: Porcelain-fused-to-metal (PFM) crowns are standard solutions for restoring endodontically treated teeth, valued for their durability and aesthetic qualities. Nonetheless, concerns regarding biocompatibility persist, notably metal hypersensitivity and periodontal inflammation, which can compromise patient health. These challenges have driven research toward alternative materials that mitigate such risks. Metal-free zirconia crowns have gained prominence as they offer biocompatibility, strength, and aesthetic appeal without the drawbacks of metal alloys, representing an advancement in dental restoration materials aimed at improving patient outcomes. Objective: This study seeks to compare the biocompatibility of zirconia and PFM crowns placed on endodontically treated teeth among young adults aged 20 to 30 over a 12-month period. Materials & Methods: Conducted at Bangabandhu Sheikh Mujib Medical University and Bangladesh Dental College Hospital, Dhaka, from January to December 2023, this prospective study randomly assigned 60 patients into two groups: 30 received zirconia crowns, and 30 received PFM crowns. Evaluation of biocompatibility involved measuring Gingival Index (GI), Plaque Index (PI), and Probing Pocket Depth (PPD) at baseline, 6 months, and 12 months. A calibrated, blinded examiner performed all assessments. Results: At baseline, no significant differences emerged between the groups. After 12 months, zirconia crowns demonstrated notably superior biocompatibility metrics, with lower GI (0.65±0.25 vs 1.28±0.48, p<0.001), PI (0.62±0.28 vs 1.15±0.41, p<0.001), and PPD (1.85±0.42 mm vs 2.48±0.65 mm, p<0.001) compared to PFM crowns. Additionally, 86.7% of zirconia-restored teeth exhibited normal or mildly inflamed gingiva, versus 33.4% in the PFM group, with no severe inflammation in the zirconia group. Conclusion: Zirconia crowns offer better biocompatibility than PFM crowns for endodontically treated teeth in young adults, supporting their use when both clinical and economic factors favor their selection.