title: Ten-year survival and complication rates of lithium-disilicate (Empress 2) tooth-supported crowns, implant-supported crowns, and fixed dental prostheses.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. Electronic address: mteichmann@ukaachen.de.
authors.forename: Maren
authors.initials: M
authors.lastname: Teichmann
authors.affiliation: Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Göckler
authors.affiliation: Dental laboratory Impladent GmbH, Kullenhofstraße 30, 52074, Aachen, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Weber
authors.affiliation: Dental practice profdent, Wilhelmstraße 23-25, 52349, Düren, Germany.
authors.forename: Murat
authors.initials: M
authors.lastname: Yildirim
authors.affiliation: Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Wolfart
authors.affiliation: Department of Prosthodontics, Ludwig-Maximilians-University, Goethestr. 70, 80336, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Edelhoff
mesh_terms: D000328:Adult; D002484:Cementation / Q000379:methods; D002516:Ceramics; D003442:Crowns / Q000706:statistics & numerical data; D015921:Dental Implants / Q000706:statistics & numerical data; D003764:Dental Materials; D003776:Dental Porcelain / Q000737:chemistry*; D019094:Dental Prosthesis, Implant-Supported / Q000706:statistics & numerical data; D019232:Dental Restoration Failure / Q000706:statistics & numerical data*; D003793:Dental Restoration, Permanent; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008094:Lithium / Q000737:chemistry; D018020:Lithium Compounds / Q000737:chemistry*; D008297:Male; D016876:Metal Ceramic Alloys / Q000737:chemistry*; D014070:Tooth
chemical_list: D015921:Dental Implants; D003764:Dental Materials; C118557:Empress 2; D018020:Lithium Compounds; D016876:Metal Ceramic Alloys; C493120:lithia disilicate; D003776:Dental Porcelain; C023506:Glass ceramics; D008094:Lithium
keywords: Ceramics; Clinical research; Material sciences; Prosthodontics; Survival analysis