Ten-year survival and complication rates of lithium-disilicate (Empress 2) tooth-supported crowns, implant-supported crowns, and fixed dental prostheses

Maren Teichmann; Fabian Göckler; Volker Weber; Murat Yildirim; Stefan Wolfart; Daniel Edelhoff

doi:10.1016/j.jdent.2016.10.017

Ten-year survival and complication rates of lithium-disilicate (Empress 2) tooth-supported crowns, implant-supported crowns, and fixed dental prostheses

J Dent. 2017 Jan:56:65-77. doi: 10.1016/j.jdent.2016.10.017. Epub 2016 Oct 29.

Authors

Maren Teichmann¹, Fabian Göckler², Volker Weber³, Murat Yildirim⁴, Stefan Wolfart², Daniel Edelhoff⁵

Affiliations

¹ Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. Electronic address: mteichmann@ukaachen.de.
² Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
³ Dental laboratory Impladent GmbH, Kullenhofstraße 30, 52074, Aachen, Germany.
⁴ Dental practice profdent, Wilhelmstraße 23-25, 52349, Düren, Germany.
⁵ Department of Prosthodontics, Ludwig-Maximilians-University, Goethestr. 70, 80336, Munich, Germany.

PMID: 27984088
DOI: 10.1016/j.jdent.2016.10.017

Abstract

Objectives: To prospectively evaluate the clinical long-term outcome of tooth-supported crowns (SCs), implant-supported crowns (ISCs), and fixed dental prostheses (FDPs) made of a lithium-disilicate glass-ceramic framework material (IPS Empress 2).

Materials and methods: Between 1997 and 1999, a total of 184 restorations (106 SCs, 32 ISCs, 33 FDPs, and 13 diverse restorations) were placed in 73 patients. Kaplan-Meier estimation was applied for survival and chipping-free rates. Inter-group comparison of both rates was realized by a log rank test and a 2×2 contingency table. Also, SCs and FDPs were compared regarding adhesive vs. conventional cementation, and anterior vs. posterior positioning, for impact on survival.

Results: Due to 14 dropouts (34 restorations) and reasonable exclusion of 19 other restorations, the final dataset included: i) 87 SCs [37 patients, mean observation time 11.4 (±3.8)years]; ii) 17 ISCs [12 patients, mean observation time 13.3 (±2.3)years; and iii) 27 FDPs [19 patients, mean observation time 8.9 (±5.4)years]. The 10-year survival rate/chipping-free rate for SCs were 86.1%/83.4%, for ISCs 93.8%/94.1%, and for FDPs were 51.9%/90.8%. Both ISCs and SCs had a significantly higher survival than FDPs (ISCs vs. FDPs: both tests p=0.001; SCs vs. FDPs: p=0.001 and p=0.005). Differences in the chipping-free rates did not reach significance. Also, neither the cementation mode nor positioning of the restoration had an impact on survival.

Conclusions: SCs had a slightly lower outcome than can generally be expected from single crowns. In contrast, ICSs had a favorable outcome and the FDPs predominantly failed.

Clinical significance: The practitioner's choice of dental materials is based (at best) on long-term experience. The present 10-year results are based on comprehensive data analyses and show the high potential of lithium-disilicate as a reliable material, especially for single-unit restoration.

Keywords: Ceramics; Clinical research; Material sciences; Prosthodontics; Survival analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cementation / methods
Ceramics
Crowns* / statistics & numerical data
Dental Implants* / statistics & numerical data
Dental Materials
Dental Porcelain / chemistry*
Dental Prosthesis, Implant-Supported* / statistics & numerical data
Dental Restoration Failure / statistics & numerical data*
Dental Restoration, Permanent
Female
Humans
Kaplan-Meier Estimate
Lithium / chemistry
Lithium Compounds / chemistry*
Male
Metal Ceramic Alloys / chemistry*
Tooth

Substances

Dental Implants
Dental Materials
Empress 2
Lithium Compounds
Metal Ceramic Alloys
lithia disilicate
Dental Porcelain
Glass ceramics
Lithium