Pressable lithium disilicate ceramic versus CAD/CAM resin composite restorations in patients with moderate to severe tooth wear: Clinical observations up to 13 years

Objective: To report the long-term clinical survival and failure rates of single-tooth restorations made of pressable lithium disilicate ceramics (LS2) and CAD/CAM resin composite (RC) by two separate clinical observations. Materials and methods: Twenty-one patients (12 female, nine male) were treated with 436 minimally invasive single-tooth restorations made of 274 pressed LS2 (n = 12; posterior: monolithic IPS e.max Press; anterior: IPS e.max Ceram veneered, Ivoclar) or 162 milled from RC (n = 9; monolithic exp. CAD/CAM resin composite, Ivoclar). The mean age of patients was 44.1 +/- 9.3 years and the mean observation time was 86.2 +/- 13.5 months (7.7 +/- 1.1 years), with 8.5 +/- 2.7 years for LS2 and 6.7 +/- 0.5 years for RC. All restorations were observed for technical/biological failures using the modified criteria of the United States Public Health Service (USPHS). Collected data were analyzed using Kaplan-Meier survival analysis and log-rank test (alpha < 0.025). Results: The 274 LS2 restorations showed a survival of 100% and a total failure rate of 5.5%. The 162 RC restorations showed a survival of 100% and a total failure rate of 25.3%. RC restorations exhibited more material fractures (p = 0.020) and higher discoloration rates (p < 0.001). Conclusions: Pressed LS2 single-tooth restorations showed lower long-term failure rates than restorations made of RC. Clinical significance: Despite the limitations of the clinical observations, single-tooth restorations of both materials can be recommended for permanent use in patients with severe tooth wear.