Ten-year outcome of three-unit fixed dental prostheses made from monolithic lithium disilicate ceramic

Background. The authors conducted a prospective study to evaluate the long-term outcome of crown-retained fixed dental prostheses (FDPs) made from monolithic lithium disilicate ceramic (IPS e.max Press, Ivoclar Vivadent, Schaan, Liechtenstein). Methods. Faculty dentists at the Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany, placed 36 three-unit FDPs in 28 patients to replace six anterior and 30 posterior teeth. The proximal connector size (height and width) was 4 x 3 millimeters for anterior FDPs and 4 x 4 mm for posterior FDPs. FDPs were cemented either conventionally with glass ionomer cement (n = 19) or adhesively with resin-based composite (n = 17). Patients made annual recall visits. Results. The mean (standard deviation) observation period was 121 (12.8) months. FDPs' survival rate (survival being defined as remaining in place either with or without complications) was 100 percent after five years and 87.9 percent after 10 years, and their success rate (success being defined as remaining unchanged and free of complications) was 91.1 percent after five years and 69.8 percent after 10 years. The cementation method did not affect the outcome. Conclusion. Three-unit FDPs made from monolithic lithium disilicate ceramic showed five- and 10-year survival and success rates that were similar to those of conventional metal-ceramic FDPs. Clinical Implications. If the manufacturer's recommendations are followed, three-unit FDPs made from monolithic lithium disilicate ceramic may be a safe alternative to metal-ceramic FDPs regardless of the cementation method used.