All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part I: Single crowns (SCs).

OBJECTIVE To assess the 5-year survival of metal-ceramic and all-ceramic tooth-supported single crowns (SCs) and to describe the incidence of biological, technical and esthetic complications. METHODS Medline (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL) searches (2006-2013) were performed for clinical studies focusing on tooth-supported fixed dental prostheses (FDPs) with a mean follow-up of at least 3 years. This was complimented by an additional hand search and the inclusion of 34 studies from a previous systematic review [1,2]. Survival and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS Sixty-seven studies reporting on 4663 metal-ceramic and 9434 all-ceramic SCs fulfilled the inclusion criteria. Seventeen studies reported on metal-ceramic crowns, and 54 studies reported on all-ceramic crowns. Meta-analysis of the included studies indicated an estimated survival rate of metal-ceramic SCs of 94.7% (95% CI: 94.1-96.9%) after 5 years. This was similar to the estimated 5-year survival rate of leucit or lithium-disilicate reinforced glass ceramic SCs (96.6%; 95% CI: 94.9-96.7%), of glass infiltrated alumina SCs (94.6%; 95% CI: 92.7-96%) and densely sintered alumina and zirconia SCs (96%; 95% CI: 93.8-97.5%; 92.1%; 95% CI: 82.8-95.6%). In contrast, the 5-year survival rates of feldspathic/silica-based ceramic crowns were lower (p<0.001). When the outcomes in anterior and posterior regions were compared feldspathic/silica-based ceramic and zirconia crowns exhibited significantly lower survival rates in the posterior region (p<0.0001), the other crown types performed similarly. Densely sintered zirconia SCs were more frequently lost due to veneering ceramic fractures than metal-ceramic SCs (p<0.001), and had significantly more loss of retention (p<0.001). In total higher 5 year rates of framework fracture were reported for the all-ceramic SCs than for metal-ceramic SCs. CONCLUSIONS Survival rates of most types of all-ceramic SCs were similar to those reported for metal-ceramic SCs, both in anterior and posterior regions. Weaker feldspathic/silica-based ceramics should be limited to applications in the anterior region. Zirconia-based SCs should not be considered as primary option due to their high incidence of technical problems.

Lithium sources in pore fluids of Peru slope

High Li concentrations, up to a maximum of 1155 µM are observed in the pore fluids of the Peru convergent margin slope sediments. At Ocean Drilling Program Sites 683 and 685 (ca. 9°S), the Li concentration depth gradients are twice as steep as at Site 682 and 688 (ca. 11°S). Within the sediments, the most important Li sources are from aluminosilicate minerals. Biogenic opal-A contains little Li and thus dilutes the Li concentration of the bulk sediments. The sediment compositions and the thermal regimes are similar at 9° and 11°S, suggesting there is an additional, non-sedimentary source for the observed high Li concentrations in the northern pore fluids. At 9°S, the 87Sr/86Sr ratios reach a maximum value of 0.709958. The observed radiogenic 87Sr/86Sr values in the pore fluids support the suggestion that the additional Li may derive from exchange reactions with underlying continental crust. The high concentrations of Li at 11°S may derive from basalt alteration at moderate to high temperatures, as suggested by the non-radiogenic 87Sr/86Sr ratios in these pore fluids, which reach a minimum value of 0.707218. Based on (1) Li concentrations in the pore fluids in slope sediments from Peru and several other margins, and (2) an approximate estimate of fluid flux from continental margins into the ocean, continental margins provide an estimated 1 to 3 * 10**10 moles Li/yr to the ocean. This source of oceanic Li, which has not been considered previously, is of the same order of magnitude as some estimates of hydrothermal and river Li fluxes and may have important consequences for the oceanic Li isotope budget. The sink is unknown for this newly discovered and possibly large Li source, but it may be more pervasive low-temperature alteration of oceanic basement than previously estimated, or burial of mineral phases, such as authigenic clay minerals, or metal oxyhydroxides which may be Li-rich.