Chair-side generated posterior monolithic lithium disilicate crowns: clinical survival after 6 years

The objective of this prospective clinical study was to evaluate the clinical performance of chair-side generated monolithic lithium disilicate crowns after 72 months.

Forty-one posterior full contour crowns made of lithium disilicate ceramic were inserted in 34 patients with a chair-side CAD/CAM technique. One crown per patient was randomly selected for evaluation at baseline, 6, 12, 24, 36, 48, 60 and 72 months according to the modified US Public Health Service criteria.

After a mean examination time of 73.2 months (SD ± 1.7 months), 25 crowns were available for re-examination. Within the observation period, three failures occurred due to one crown fracture after 2.9 years, an abutment fracture after 6.0 years, and one severe endodontic problem after 6.1 years. One lithium disilicate crown showed a loss of retention after 2 years but could be reinserted. There were two events of caries below the crown margin, one after 24 and another one after 48 months. Both teeth received cervical adhesive composite fillings. Two abutment teeth changed their sensibility perception from positive to negative within the first 13 months. The failure-free rate was 87.6%, and the complication-free rate was 70.1% after 6 years according to the Kaplan-Meier analysis.

Due to the fact that there was only one severe technical complication and the severe biological complications were in a normal range, the clinical performance of monolithic lithium disilicate crowns in the posterior region was completely satisfying.

The chair-side application of monolithic lithium disilicate crowns can be recommended.