A patient asks how long the new crown will last, and the honest answer depends on which number you quote. In the big systematic reviews, "survival" means the crown is still in the mouth, even if it was repaired along the way. "Success" means nothing went wrong at all. The two can be far apart.
Below: pooled 5-year estimates for zirconia, lithium disilicate (the material of IPS e.max), metal-ceramic (PFM) and all-metal crowns, on teeth and implants; the 10-year data; each material's complications; and the limits of the evidence.
Key Takeaways
- In a 2026 meta-analysis of 64 studies, estimated 5-year survival of crowns on teeth ranged from 96.8% for monolithic zirconia to 98.5% for monolithic lithium disilicate, with PFM at 97.1%.
- On implants, a review of 35 studies estimated 5-year survival of 98.3% for metal-ceramic and 97.6% for zirconia-ceramic single crowns.
- Survival is not success: in that implant review, 86.7% of metal-ceramic and 83.8% of zirconia crowns stayed free of all complications.
- In a 2021 review, veneered ceramic implant crowns chipped at 1.65% per year, against 0.39% for monolithic crowns.
- Gold is missing from the pooled reviews. In NHS records from England and Wales, 68% of all-metal crowns needed no further treatment at 10 years, against 48% of all-porcelain crowns.
- Monolithic zirconia implant crown studies in a 2021 review averaged 1.6 years of follow-up.
Quick Answer
In a 2026 meta-analysis of 64 studies, estimated 5-year survival of tooth-supported single crowns was 98.5% for monolithic lithium disilicate, 97.3% for veneered zirconia, 97.1% for PFM and 96.8% for monolithic zirconia, which the authors call comparable. Gold is not in these reviews; NHS records from England and Wales favor all-metal crowns. Ten-year evidence is thinner. The clearer difference is in complications: monolithic crowns chip less than veneered ones.
What Do Systematic Reviews Show at 5 Years?
Crowns on teeth
The newest pooled estimate is from Pjetursson, Sailer and colleagues (2026): 64 studies with at least 3 years of mean follow-up, covering 3,509 metal-ceramic and 8,051 all-ceramic single crowns. Monolithic lithium disilicate, veneered zirconia, metal-ceramic and monolithic zirconia all landed between 96.8% and 98.5%. Only four groups were significantly below monolithic lithium disilicate: veneered leucite or lithium disilicate glass-ceramic (95.7%), two alumina ceramics and feldspathic or silica-based ceramic (90.4%).
Estimated 5-year survival of monolithic lithium disilicate crowns on teeth, the highest of eight material groups (Pjetursson et al., 2026).
Crowns on implants
In a 2018 review of 35 studies, all zirconia crowns were veneered; no monolithic zirconia study met its 3-year follow-up and clinical examination criteria. A 2021 review of all-ceramic implant crowns estimated 3-year survival; only resin-matrix ceramic did significantly worse, at 36.3%.
| Material and design | Support | Estimated survival (95% CI) | Outcome and source |
|---|---|---|---|
| Monolithic lithium disilicate | Tooth | 98.5% | 5-year; Pjetursson et al., 2026 (no CI in the abstract) |
| Veneered zirconia | Tooth | 97.3% | 5-year; same |
| Metal-ceramic (PFM) | Tooth | 97.1% | 5-year; same |
| Monolithic zirconia | Tooth | 96.8% | 5-year; same |
| Metal-ceramic (PFM) | Implant | 98.3% (96.8 to 99.1) | 5-year; 4,363 crowns; Pjetursson et al., 2018 |
| Zirconia-ceramic | Implant | 97.6% (94.3 to 99.0) | 5-year; 912 crowns; same |
| Veneered zirconia | Implant | 96.3% (93.9 to 97.7) | 3-year; mean follow-up 3.8 years; Pjetursson et al., 2021 |
| Monolithic zirconia | Implant | 96.1% (93.4 to 97.8) | 3-year; mean follow-up 1.6 years; same |
| Monolithic reinforced glass-ceramic | Implant | 97.0% (94.0 to 98.5) | 3-year; mean follow-up 2.6 years; same |
How these estimates moved since 2007 is covered in Dental Crowns Then and Now.
What About Gold, and What Do 10-Year Data Show?
None of these pooled reviews has all-metal crowns as a material group. A 2017 Cochrane review found one randomized trial comparing full-contour zirconia with cast gold single crowns, in 224 participants: no clear difference after one year, some evidence favoring gold after five, and all evidence rated very low quality.
Ten-year numbers come from fewer, more varied sources, each with its own end point.
| Crowns | 10-year result | What ended "survival" | Source |
|---|---|---|---|
| Lithium disilicate, teeth | 96.7% cumulative survival | As reported; mostly 1 study | Review of 12 studies (Pieger et al., 2014) |
| Pressed e.max complete-coverage restorations | 99.6% (95% CI 99.4 to 99.8) | Only bulk fracture or a large chip needing replacement | 1,960 restorations, one private practice (Malament et al., 2019) |
| Zirconia, teeth | 92.9% to 98.7% pooled survival up to 10 years; 46.1% pooled success over 10 years | As defined in the included studies | 66 studies, very low certainty (Ma et al., 2026) |
| High gold metal-ceramic, teeth | 97.08% (favorably rated crowns) | Kaplan-Meier; 101 of 133 failures (up to 25 years) biologic | 2,211 crowns, one specialist practice (Walton, 2013) |
| Noble metal-ceramic, teeth | 94.3% at 8.0 years; 88.8% free of ceramic defects at 11.0 years | Loss of crown or tooth; ceramic defect | 190 crowns, private practices (Reitemeier et al., 2013) |
| All-metal, teeth | 68% (all-porcelain 48%) | Any re-intervention on the tooth | 47,474 crown placements, NHS England and Wales (Burke and Lucarotti, 2009) |
| 12% gold-silver-palladium alloy, first molars | 80.8% (92.5% at 5 years) | Crown removed or separated, or tooth extracted | 603 crowns, 20 offices in Japan (Yoshino et al., 2024) |
| Implant single crowns, all materials | 89.4% (95% CI 82.8 to 93.6) | Crown survival | 46 studies (Jung et al., 2012) |
In the NHS dataset, all-metal crowns outlasted metal-ceramic and all-ceramic crowns before re-intervention. Claims records, one specialist's patients and a meta-analysis are not comparable, so do not rank these rows.
What Does "Survival" Mean, and How Is It Different From Success?
In Pjetursson and Sailer's reviews, survival means the crown remained in situ, with or without modification, for the observation period. Failure means it was lost, removed or remade, for reasons such as ceramic fracture, repeated loss of retention or screw loosening, esthetics or biology. A chip that can be repaired or polished is a complication, not a failure. Success is stricter: no complications at all over the observation period.
In the 2018 implant review, 5-year survival was 98.3% for metal-ceramic and 97.6% for zirconia crowns, but 86.7% and 83.8% stayed complication-free. Metal-ceramic crowns followed in private practices for 20 years had 78.8% survival and 74.2% technical success. For zirconia single crowns, a 2026 meta-analysis reported 46.1% pooled success over 10 years.
Other studies use other end points: the NHS analysis counted any re-intervention on the tooth, the e.max practice study only bulk fractures and large chips. Check what each number counted.
Does Location Matter: Anterior or Posterior?
In the 2026 review of crowns on teeth, material types performed similarly in anterior and posterior regions, except feldspathic or silica-based ceramic and metal-ceramic crowns. The 2015 review had found significantly lower posterior survival for feldspathic and zirconia crowns. On implants, location did not influence survival or chipping in the 2021 review. For lithium disilicate, most failures in the 2014 review were posterior.
Which Complications Come With Each Material?
Survival rates sit close together; complications do not. Each row keeps the paper's own categories, and the rates are separate measures, not to be added.
| Material | Main complications | Numbers and source |
|---|---|---|
| Veneered zirconia | Veneer fracture; loss of retention | In the 2015 review, zirconia crowns on teeth were lost more often to veneering ceramic fractures, and lost retention more often, than metal-ceramic (Sailer et al., 2015). On implants, 2.1% failed from material fracture at 5 years, against 0.2% of metal-ceramic (Pjetursson et al., 2018). |
| Monolithic zirconia | Fewer chips; screw loosening on implants | Significantly fewer fractures and chipping than veneered (Pjetursson et al., 2026); highest implant screw-loosening rate, 2.25% per year (Pjetursson et al., 2021). |
| Lithium disilicate | Fracture, mostly posterior | Monolithic: significantly fewer fractures and chipping than veneered (Pjetursson et al., 2026); most failures posterior (Pieger et al., 2014). |
| Metal-ceramic (PFM) | Chipping; on implants, loss of retention, screw loosening, esthetics | On implants at 5 years: chipping 2.9%, loss of retention of cemented crowns 2.0%, screw loosening 3.6%, esthetic failures 1.7% (Pjetursson et al., 2018). |
| All-metal (gold alloy) | Tooth and retention problems | Among 133 failures of 12% gold alloy crowns: abutment tooth extracted 22.6%, separation from the tooth 21.8%, root fracture 18.8%, caries 15.8% (Yoshino et al., 2024). |
A 2026 meta-analysis of zirconia restorations found secondary caries and pulpitis or apical periodontitis the predominant biological complications, and chipping and debonding the most common mechanical ones. In a 2003 review of 50 years of studies, the three most common complications of single crowns were need for endodontic treatment (3%), porcelain veneer fracture (3%) and loss of retention (2%).
What Are the Limits of These Numbers?
Mean follow-up of the 8 monolithic zirconia implant crown studies (394 crowns) in a 2021 meta-analysis; veneered zirconia studies averaged 3.8 years (Pjetursson et al., 2021).
- Short follow-up for newer designs. A review of monolithic zirconia crowns on teeth found a mean exposure time of 1.07 years, with follow-up of 0.3 to 2.1 years.
- 5-year values are model estimates. The reviews divide failures by total crown exposure time and use Poisson models to estimate 5-year proportions. They are not 5-year observations of every crown.
- One product dominates the lithium disilicate data. An overview of 28 systematic reviews, about 35,000 crowns, noted limited data beyond 5 years and a concentration of studies on IPS e.max.
- Low certainty. The 2026 zirconia meta-analysis rated its evidence very low certainty; the Cochrane review rated all its trial evidence very low quality.
How Should This Change Material Choice?
For a single crown on a tooth, survival will not decide between lithium disilicate, zirconia and PFM: the 2026 estimates sit within 1.7 percentage points of each other. Decide on esthetics, space, occlusion and the complication you most want to avoid. Head-to-head comparisons are in Zirconia vs E.max and PFM vs Zirconia Crowns; early failures in Crown Remakes: What Really Causes Them.
Crowns at Elegant Dental Laboratory
- Every case is made in house in Brooklyn by more than 35 technicians; digital scans are reviewed before production.
- Zirconia: solid 3Y, 9-layer 5Y, solid with buccal porcelain, or a zirconia coping with layered porcelain. We follow the brand or grade written on the Rx.
- IPS e.max, pressed only with IPS e.max Press, as full-contour or layered crowns; PFM in base and precious alloys; screw-retained and cement-retained implant crowns.
- 5 business day standard turnaround on most restorative cases, rush options, and up to a 7-year warranty on final restorations (policies and warranties).
- Submit a digital case or send a case: free pickup and delivery by our own drivers in all five New York City boroughs and 13 northern New Jersey counties, and UPS labels anywhere. Call 877-335-5221.
FAQ
What is the difference between crown survival and success?
Survival means the crown is still in place, repaired or not; success means no complications at all. In a 2018 implant review: 97.6% to 98.3% survival at 5 years, 83.8% to 86.7% complication-free.
Which crown material lasts longest?
On teeth, 5-year survival is comparable for lithium disilicate, zirconia and PFM: 96.8% to 98.5% in a 2026 review. In NHS records from England and Wales, all-metal crowns went longest without re-intervention.
Is monolithic zirconia proven long term?
Not yet. Its 5-year estimate on teeth, 96.8%, is close to PFM's 97.1%, but implant crown studies averaged 1.6 years of follow-up.
Do implant crowns last as long as crowns on teeth?
At 5 years, metal-ceramic crowns reached 98.3% on implants and 97.1% on teeth, in separate reviews. At 10 years, implant single crowns reached 89.4%.
Does a root canal or post change crown survival?
Yes. A 2024 review estimated 5-year survival of 97.1% for metal-ceramic crowns on vital teeth and 90.7% on teeth with a cast metal post.
Sources (19)
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Reviewed by Gary Fingerman, founder and CEO of Elegant Dental Laboratory, Brooklyn, New York (founded 2007). Last reviewed: October 1, 2026. Survival and complication values are from published systematic reviews and clinical studies, each with its own definitions and follow-up.
