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Internal fit of lithium disilicate crowns: A systematic review and meta-analysis comparing heat-pressed and
Aspasia Pachiou1, Alexis Ioannidis1, Nikitas Sykaras2
1Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.
Purpose:
The aim of the current systematic review was to compare the internal fit of lithium disilicate crowns, fabricated using conventional heat-pressing versus CAD-CAM milling techniques.
Study Selection:
A comprehensive literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library up to December 2025, following PRISMA guidelines and registered in the Open Science Framework. Eleven studies met the inclusion criteria (nine in vitro studies and two clinical trials), of which nine were included in the quantitative synthesis.
Results:
The random-effects meta-analysis demonstrated no statistically significant difference in internal fit between heat-pressed and CAD-CAM-milled crowns, although substantial heterogeneity was observed (I2=95%). Sensitivity analysis excluding five methodologically heterogeneous studies revealed a statistically significant pooled effect favoring heat-pressed crowns (MD=-18.92 μm; 95% CI: -29.77 to -8.07; P = 0.008), with markedly reduced heterogeneity (I2=19%). Subgroup analysis suggested that elastomeric impressions may be associated with better internal fit compared with digital workflows, although heterogeneity remained high.
Conclusions:
The current evidence does not demonstrate a consistent difference in internal fit between heat-pressed and CAD-CAM-milled lithium disilicate crowns. Further well-designed, standardized clinical studies are needed to confirm these findings.
