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Background: Dental applications of CAD/CAM concept have been available for almost 30 years. They have allowed dentists to work with novel materials with better properties. One of these materials is zirconia ceramic.

Aim: To evaluate prospectively the longevity of CAD/CAM indirect zirconia restorations of severely destroyed vital molars and to study the risk factors associated with restoration failures.

Materials and methods: Thirty-two indirect zirconia restorations were made in 19 patients. The treated teeth were extremely destroyed vital molars. Thermal and electrical tests for pulp vitality were performed for all teeth. Radiographs were made pre-operatively, post-operatively, and at the 6-month recall. Cvar and Ryge criteria were used for direct clinical evaluation of each restoration at the 6-month recall.

Results: All 32 zirconia restorations were evaluated at 6 months. As per Cvar and Ryge criteria, discrepancies were found in two of the cases: postoperative sensitivity in only one of the teeth immediately after cementing the restoration; a partial fracture of one of the restorations after six months. Good marginal and gingival adaptation of the indirect restorations, good periodontal condition and no periapical lesions were observed clinically and radiographically. The thermal and electrical pulp tests were within the normal range for vital posterior teeth.

Conclusions: The present study suggests that the new restorative zirconia materials are promising clinical alternative. They can give the clinicians a broader scope of opportunities in the treatment of their patients, aiming at more sustained and improved results.