Restoring Teeth with an Advanced Lithium Disilicate Ceramic: A Case Report and 1-Year Follow-Up

Abstract

Advancements in materials science and bonding protocols as well as new manufacturing methods foster the development of novel ceramic materials to meet the increased demands for highly aesthetic, biocompatible, and long-lasting restorations in fixed prosthodontics. This case report highlights the minimally invasive rehabilitation with a new advanced lithium disilicate (ALD) ceramic block. It is reinforced with virgilite crystals in managing esthetic demand of patient besides having a high flexural strength. According to the manufacturer, the material provides a biaxial strength measured at >700 MPa and improved optical properties. The remarkable speed sintering time of approx. 4.5 minutes makes processing very fast. Time efficiency, predictability, and economically interesting treatment options are of great importance in current dentistry and can be well implemented in CAD/CAM dentistry. The newly introduced ALD ceramic for the "Chairside Economical Restoration of Esthetic Ceramics"/ "CEramic REConstruction" (CEREC) system produces an esthetically pleasing and clinically excellent restoration. The shorter processing time combined with high flexural strength will optimize the chairside workflow. New treatment indication options for lithium disilicate ceramics will expand. Although more evidence from long-term clinical studies is needed to verify the clinical performance and manufacturer recommendations regarding indication, preparation and cementation must be followed very strictly. In the present case report, restorations were indicated for seven posterior teeth, which were prepared, scanned, designed with CEREC-Primescan SW 5.1.3, and fabricated with MCX5. The monolithic restorations were placed adhesively. The rehabilitation with the ALD blocks resulted in an aesthetically pleasing, functional outcome that improved overall treatment time and increased patient and practitioner satisfaction, which remained stable over a one-year follow-up period.

Influences of Different CAD/CAM Ceramic Compositions and Thicknesses on the Mechanical Properties of Ceramic Restorations: An In Vitro Study

“…In comparison to the other lithium disilicate glass ceramics, ALD ceramics showed higher hardness levels that could make them an attractive clinical choice for restorations in high-stress-bearing areas. Moreover, the chairside processing of ALD ceramics is simpler, quicker, and more practical than that of zirconia ceramics [ 60 ].…”

Effect of Surface Treatment and Resin Cement on the Bond Strength of an Advanced Lithium Disilicate

“…Therefore, a shortened final firing cycle saves clinical time to complete its crystallization. 8 A previous study found that ALD presented superior hardness and surface smoothness compared with other evaluated glass ceramics. 2 It was also reported that ALD has a higher resistance to wear and presents similar fracture behavior compared with LD.…”

Effect of Different Scaling Methods on the Surface Topography of Different CAD/CAM Ceramic Compositions

“…The time efficiency, predictability, and economically attractive treatment options are important aspects in CAD/CAM dentistry. CEREC's newly introduced advanced lithium disilicate ceramic produces an esthetically pleasing and clinically excellent restoration when used in conjunction with the chairside economical restoration of esthetic ceramics (Chairside EREC)/ceramic reconstruction (CEREC) system [20].…”

“…Besides having a high flexural strength, advanced lithium disilicate ceramic is reinforced with virgilite crystals in order to satisfy the esthetic demands of patients. A biaxial strength of more than 700 MPa is claimed by the manufacturer, along with improved optical properties with a remarkable sintering speed of approximately four minutes, which provides a shorter processing time and high flexural strength [20], thus, optimizing the chairside workflow. It is anticipated that new treatment options will be available for these advanced lithium disilicate ceramics.…”