Comparison of the fracture strengths of single-unit metal-ceramic and monolithic zirconium restorations in the molar region : a systematic review and meta-analysis

[Abstract] Despite the success of monolithic zirconia restorations (MZ), metal-ceramic restorations (MC) are still considered the gold standard for fixed prosthetics in the posterior region. This systematic review and meta-analysis aimed to compare the fracture strengths of single-unit MC and MZ in the molar region. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, 2020) statement. All articles were searched from the PubMed and Web of Science databases until November 18, 2022. All in vitro studies evaluating the fracture strengths of MC and MZ were also included. Statistical analysis was performed with the Comprehensive Meta-Analysis program, with a significance level of 0.05. Out of 753 studies, five were selected. The fracture strengths of MZ and MC did not show any statistically significant difference for both tooth (95%CI - 1.589: 2.118, p=0.779, z=0.280) and implant (95%CI - 2.215: 2.191, p=0.992 z=-0.010) supported restorations. However, different abutment materials (p