Survival rate of lithium disilicate restorations at 4 years: A retrospective study

Ceramic restorations are frequently being placed due to the esthetic demand and the cost of noble metals that has increased considerably. One major disadvantage of ceramic restoration is failure of the material due to fracture by crack propagation. In vitro studies are of little clinical significance and in vivo studies are too short to support clinical success.

The purpose of this retrospective study was to evaluate the failure rate of lithium disilicate restorations (monolithic and layered) at 4 years.

Data were collected over 45 months from 2 commercial laboratories. Restorations were categorized into monolithic restorations and layered restorations. Each category was further classified into complete coverage single crowns, fixed dental prostheses, e.max veneers, and inlay/onlay restorations. Failure rates were compared and analyzed using Chi-square (α=.05).

A total of 21,340 restorations were evaluated in this study and included 15,802 monolithic restorations and 5538 layered restorations. The failure rate for single crown monolithic restorations was 0.91% and was 1.83% for single crown layered restorations. For fixed dental prostheses, 4.55% of monolithic restorations failed. For e.max veneers, 1.3% of monolithic veneers fractured and 1.53% of layered veneers fractured. Of the inlay/onlay restorations group, 1.01% of monolithic restorations fractured.

In the short term (45 months), restorations fabricated with the lithium disilicate material (IPS e.max) had relatively low fracture rates. Layered single crowns fractured at approximately 2 times the rate of monolithic crowns.