Lithium Disilicate Restorations: Overview and A Case Report

Case Report

J Dent & Oral Disord. 2016; 2(9): 1047.

Lithium Disilicate Restorations: Overview and A Case Report

Qamheya AHA¹, Qamheya M¹ and Arisan V¹*

¹Department of Oral Implantology, Istanbul University, Turkey

²Department of Restorative Dentistry, Istanbul University, Turkey

*Corresponding author: Arisan Volkan, Department of Oral Implantology, Istanbul University, Istanbul, Turkey

Received: November 17, 2016; Accepted: December 02, 2016; Published: December 06, 2016


To avoid the shortcoming of conventional metal-based materials and to provide natural-appearing dental restorations, manufacturers introduce different all-Ceram materials to the market, starting with feldspathic porcelain, Dicor material, pressable leucite-reinforced glass ceramic materials and ended with variable generations of zirconium and lithium disilicate. The multifunctional use of lithium disilicate, its translucent optical properties, and its availability as a mono-block, make it as a trending topic in dentistry.

In this overview article, in-vitro and clinical studies regarding lithium disilicate are discussed and one case of implant supported lithium disilicate crown manufactured by CAD/CAM technique is presented.

Keywords: Lithium disilicate; Press; CAD/CAM; Monolithic


FDPs: Fixed Dental Prosthesis; CAD/CAM: Computer- Aided Design and Computer- Assisted Manufacturing; USPHS: United States Public Health Service; AIOP: Italian Academy of Prosthetic Dentistry


The recent innovations in ceramic materials and CAD/CAM technologies are developed in order to enable the accomplishment of high aesthetic demands and to limit the shortcoming of conventional materials and methods; i.e., low tensile strength, sintering shrinkage, excessive brittleness, wear of antagonist, crack propagation [1] and marginal gaps [2].

Recently, lithium disilicate material had been widely marketed, because of the adhesive properties of this material [3] and its preservation of tooth structure [4]. Lithium disilicate restorations are manufactured by heat press-lost wax technique (IPS e.max Press) or by CAD/CAM technique (IPS e.max CAD). The former has a high survival rate based on short [5] and long term [6] survival evidence for each single crown restoration and 3-unit FDP. The latter (IPS e.max CAD) techniques, which produce different crystal characterization, lack enough clinical evaluations and trials thus are still not indicated for multiple units FDP [7,8]. The manufacturer (Ivoclar Vivadent) starting use lithium disilicate as a frame work to increase the strength of veneer such as IPS Empress2, where the veneer material was fluorapatite-based porcelain [9,10]. After that the monolithic blocks of lithium disilicate (IPS e.max CAD, IPS e.max Press) are presented. The second generation of these blocks is used for zirconium core veneering (Vita Suprinity; Vita Zahnfabrick, Bad Säckingen, Germany), while the third generation is used for implantsupported prosthesis due to its ability to be bonded with the titanium base and also to its presence in various shade blocks [7].

Recent literatures spotlight the properties of machinable lithium disilicate (IPS e.max CAD, Ivoclar Vivadent). This product, which is marketed as blue blocks, contains 40% of partially crystallized Lithium metasilicate, which transformed to lithium disilicate crystal after CAD-CAM milling and tempering. After this process, all crystal particles increased in size; so the flexural strength of material increased. The blue color of lithium disilicate blocks change to the tooth color during the oxidation phase in the tempering process [2,7,10]. Although the shrinkage of Lithium Disilicate during the crystallization process does not affect the margin fit [2], this kind of restoration is still not suggested for multi-unit FDP as conducted in AIOP closed meeting in 2013, due to the lower mechanical properties (fracture resistance and flexure strength) when compared with IPS e.max Press [8]. The lithium disilicate restorations cannot be applicable for all type of prosthesis; Table 1 represents the possible clinical uses of lithium disilicate restorations as conducted in AIOP closed meeting [11].