A Randomized Controlled Clinical Trial on Lithium Disilicate Veneers Manufactured by the CAD-CAM Method: Digital Versus Hybrid Workflow

Pressed lithium disilicate is largely used for veneer manufacturing, but a new block formulation has recently been released on the market. This study evaluated the clinical performance of milled lithium disilicate veneers (LiSi Block, GC Co., Tokyo, Japan) realized with a fully digital or hybrid workflow using modified United States Public Health Service (USPHS) evaluation criteria and survival rates after 24 months of clinical service together with the patient's satisfaction using the Visual Analog Scale (VAS). A total of 105 veneers on natural anterior teeth were made on twenty-nine patients with LiSi Block (GC, Tokyo, Japan). Patients were randomly divided into three groups: Group 1, 35 veneers realized with a completely digital workflow using Trios 3 (3Shape A/S, Copenhagen, Denmark); Group 2, 35 veneers realized with a completely digital workflow using Experimental IOS (GC, Tokyo, Japan); and Group 3, 35 veneers realized with a hybrid workflow. The restorations were followed up for 24 months, and the modified USPHS evaluation was performed at baseline, 12 months, and 24 months together with periodontal evaluation. Repeated measures two-way ANOVA and the Tukey test were applied to compare the modified USPHS method values (alpha = 0.05). STATISTICA 10.0 software and SIGMAPLOT 12.0 software were used to perform statistical analysis. There were no statistically significant differences between the three groups and with the interaction of group vs. time periods. The satisfaction scores of 7.35 +/- 1.8 and 9.4 +/- 0.37 were recorded before and after treatment, respectively. Milled lithium disilicate veneers showed a good clinical outcome after 2 years of clinical service. No difference was found between fully digital or hybrid workflow.