Comparative reliability analyses of zirconium oxide and lithium disilicate restorations in vitro and in vivo

Abstract

The authors analyzed the in vitro and in vivo performance of lithium disilicate glass-ceramic (LDGC) restorations and yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) (that is, zirconium oxide) restorations with regard to reliability, clinical performance and abrasion resistance. In the in vitro study, four authors subjected samples of LDGC, Y-TZP and metal-ceramic crowns to step-stress fatigue testing. Four investigators assessed the in vivo clinical performance of LDGC and zirconium oxide-based restorations at four and seven years, respectively. In addition, one author conducted a randomized, controlled clinical trial to analyze the volumetric loss of enamel and ceramic antagonist surfaces. The LDGC crowns exhibited the highest fatigue load-to-failure values in the in vitro analysis. The results of the in vivo assessment showed that the clinical performance of the LDGC restorations at four years was comparable to that of the zirconium oxide-based crowns at seven years. The results of the in vivo, randomized, controlled clinical trial showed that LDGC crowns were not only resistant to wear, but also were wear friendly to enamel antagonist surfaces. The LDGC crowns in the in vitro and in vivo studies exhibited high durability, and they were wear friendly to opposing natural dentition. LDGC and zirconium oxide-based crowns are a clinically acceptable means of treating teeth that require full-coverage restorations. In addition, LDGC materials exhibit excellent clinical performance, as well as demonstrate acceptable abrasion compatibility with the opposing natural dentition.