Since we published The Illusion of the 12-Minute Miracle, we have been amazed by the response. Colleagues, clinicians, and lab partners have all contributed to what has become a genuinely meaningful conversation, and we are grateful for that.
The original piece examined the growing enthusiasm surrounding chairside printed crowns, especially those produced in under 15 minutes during live demonstrations. It resonated because it raised a question many of us were already asking: What are we giving up to gain that kind of speed?
In this follow-up, we shift our focus from workflow to longevity. Specifically, does pursuing ultra-fast chairside production align with what long-term clinical evidence supports?
In theory, printed resin-ceramic hybrids provide speed and convenience. In practice, their long-term clinical validation remains limited. Much of the current enthusiasm is based on workflow demonstrations, not decade-long survival data.
The rush to adopt these materials is understandable. However, the assumption that they match the performance of monolithic zirconia or metal-ceramic frameworks is unproven, and current evidence gives us reason to be cautious.
Crowns placed chairside with short-form hybrid materials have not earned the same track record. If they're failing faster, as many labs and clinicians are now quietly reporting, every “fast” crown carries a slow, silent cost.
We refer to one of the most reliable sources available to explore that. In 2022, Hawthan et al. published a large-scale retrospective clinical study in the European Journal of Oral Sciences [PMC9546353], analysing the performance of over 1,000 tooth-supported single crowns across a follow-up period of up to 30 years.
This isn’t hypothetical. It’s real-world, longitudinal evidence that provides a clear survival benchmark. As printable hybrid materials become more common, data like this reminds us to anchor innovation in clinical reality. Speed matters, but so does staying power.
Here’s the trajectory:
Key findings:
What This Study Doesn’t Say And Why That Still Matters
The Hawthan et al. study does not directly evaluate chairside-printed hybrid crowns. Instead, it concentrates on conventional materials such as gold ceramic, monolithic zirconia, lithium disilicate, and others that have established track records in clinical use.
So why bring it into this discussion?
Studies like this establish a benchmark, demonstrating how even well-tested materials perform under real-world clinical conditions over 5, 10, or more than 20 years. They identify the risks that persist even when the workflow is standardised, the material is proven, and experienced clinicians deliver the treatment.
Now, apply that same perspective to chairside-printed hybrid crowns, materials that have not yet surpassed the five-year threshold in most published data sets.
Suppose failures like retention loss, fractures, and tooth loss persist with traditional crowns after 10 years of use. What occurs when these clinical conditions are combined with resin-hybrid, chairside-printed materials that have not yet been validated for a decade-long wear?
The answer is: we don’t know, which is precisely the issue.
This isn’t about resisting change. It’s about insisting on clarity. The clinical risk profile of chairside crowns using hybrid printable materials remains untested, mainly in long-term follow-up studies. That doesn’t make them wrong, but it does make them uncertain.
Hybrid materials risk faster degradation through:
When the entire workflow is sold on speed, we owe it to patients to ask: Are we solving for minutes or decades?
The Hawthan et al. study provides a long-view reality check. While it doesn’t directly include chairside resin materials, it fulfils the purpose of good clinical literature: setting the bar for survival and highlighting the risks that marketing fails to address.
Until printable materials can meet or exceed that bar, we must treat them for what they are: emerging workflows that still lack robust long-term data.
Efficiency Shouldn't Mean Fragility
We're not arguing against digital workflows or modernised chairside options. We embrace them. However, responsible adoption is key. It's about understanding where the evidence supports efficiency and where it begins to undermine quality. It's about being aware of the potential risks and not compromising on quality to pursue efficiency. This responsible approach is what sets us apart in our field.
To put it plainly:
The stakes extend beyond clinical outcomes. A 1% rise in crown failure costs the NHS £7.8 million annually, and for the profession, 74% of practitioners using hybrid systems report lower professional satisfaction than 41% using traditional methods. This dissatisfaction can lead to turnover and a loss of experienced professionals in the field, potentially impacting patient care quality.
On a deeper level, we risk trading hands-on clinical intuition for machine-led convenience. As Dr. Eleanor Monsees (GDC #094728) puts it, “We risk training a generation who can operate printers but can’t diagnose why they’re failing.”
True innovation fuses technology with timeless principles: material integrity, anatomical mastery, and the irreplaceable value of skilled hands guiding machines, not the other way around. The mouth isn't a production line; it's a legacy.
The purpose of this follow-up is not to criticise new technology but to anchor the conversation in evidence. We want to thank Dr. Mohammed Hawthan and his co-authors for their extensive contributions to the field. Their research reminds us of something increasingly easy to forget in a world of demos, cartridges, and timelines:
Crowns aren’t products; they’re promises. Promises to endure. Promises to perform. Promises to protect.
The most successful practices are still outsourcing crown production to highly regarded labs, not because they can't print, but because they understand the value of traditional methods. They appreciate the expertise and experience these methods bring and know that this ultimately benefits their patients. This reassurance in our tried-and-tested methods keeps us at the forefront of our field.
