One-year clinical performance of lithium disilicate versus resin composite CAD/CAM onlays

Abstract

To compare the 1-year clinical performance of lithium disilicate and resin composite CAD/CAM onlay restorations. Twenty patients that required two restorations in posterior teeth, with at least one cusp to be covered, received two onlays. One was made with IPS e.max CAD (Ivoclar-Vivadent) and the other with Lava Ultimate (3M Oral Care). Two blind observers evaluated the restorations at baseline and 1 year after the onlays were cemented, according to FDI criteria. At each recall, digital photographs, bite-wing radiographs and impressions of the restorations were taken for SEM evaluation of the interface. Results were analyzed by Mann–Whitney U and Wilcoxon tests (p < 0.05). At baseline and in the 1-year recall, both CAD/CAM materials exhibited excellent results in most criteria with similar esthetic, functional and biological properties (p > 0.05). However, deterioration in surface lustre (p = 0.020) and color match/translucency (p = 0.039) were detected for IPS e.max CAD onlays after 1-year. Under SEM evaluation, there were no statistically differences in micromorphological criteria at baseline nor after a year between IPS e.max CAD and Lava Ultimate onlays. Conclusion: After 1 year of clinical service IPS e.max CAD and Lava Ultimate onlays showed a similar clinical performance that needs to be confirmed in long-term evaluations.

Clinical Evaluation of Resin Composite CAD/CAM Restorations Placed by Undergraduate Students

“…The clinical performance of Lava Ultimate restorations has previously been studied using either the USPHS [37] or FDI criteria [35,36,39,52]. The USPHS criteria used in this study do not fully comply with the modified set proposed by Fasbinder et al [37], who added extra subset scores for most of the criteria except for color match and anatomic form.…”

“…In the study of Zimmerman et al [39], 13% of restorations mimicked the adjacent tooth color, and 87% showed acceptable minor or clear discrepancies in color match. Souza et al [35] assigned a good color match to 25% of Lava Ultimate restorations and a minor or distinct but acceptable color deviation with the adjacent tooth structure to 75%, which was better than the IPS e-max CAD onlays in a split-mouth design. Only Fasbinder et al [37] reported an almost ideal (93%) match between tooth and restoration after 5 years, which was comparable to leucite reinforced ceramic.…”

“…To the best of our knowledge, Zimmerman et al [39] did not use IDS and applied a dual cure adhesive from another brand rather than the restorative material (Variolink II, Ivoclar Vivadent AG, Schaan, Lichtenstein). Both Tunac et al [36] and Souza et al [35] used the 10-MDP containing Rely X Ultimate adhesive system (3M, St. Paul, MN, USA). Fasbinder et al [37] compared the abovementioned luting cements but did not find any significant difference over a 5-year follow-up period.…”

“…The number of clinical studies involving Lava Ultimate restorations, however, is presently limited. In a recent split-mouth study, Souza et al [35] reported a 100% clinical success rate of both lithium disilicate and Lava Ultimate onlays over a 1-year period. When comparing Lava Ultimate and direct composite resin restorations outcomes after 2 years of service, Tunac et al [36] confirmed a 100% retention rate and no significant differences between the materials in any of the clinical criteria.…”

“…Debonding and cohesive fractures have been reported by previous authors and have been linked to the material's resilience, leading to a revision of the clinical indications in 2015. Although Lava Ultimate has been used for over 7 years, independent studies evaluating the clinical performance are scarce [35][36][37][38][39]. Therefore, the purpose of this clinical trial is to evaluate the mid-term outcomes of resin composite intracoronal chairside CAD-CAM restorations up to 44 months using internationally accepted USPHS standards.…”