J Adv Prosthodont.  2025 Apr;17(2):59-69. 10.4047/jap.2025.17.2.59.

Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up

• Lee HS
• Ko KH
• Park CJ
• Cho LR
• Huh YH

• KMID: 2567929
• DOI: http://doi.org/10.4047/jap.2025.17.2.59

Abstract

PURPOSE
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.

Keyword

Metal-ceramic; Peri-implant mucositis; Prospective clinical study; Survival rate; Zirconia-lithium disilicate