Clinical outcomes and complications of tooth- and implant-supported lithium (di)silicate based single crowns: an overview of systematic reviews

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Abstract

Objectives: To critically synthesize and evaluate the clinical outcomes, complications, material-specific performance, and methodological quality associated with lithium (di)silicate-based single crowns, in light of current systematic reviews. Data/Sources: MEDLINE via Ovid, Embase via Ovid, Trip Pro Medical Database, Epistemonikos Database and Cochrane Database of Systematic Reviews (via ...

Abstract

Objectives:
To critically synthesize and evaluate the clinical outcomes, complications, material-specific performance, and methodological quality associated with lithium (di)silicate-based single crowns, in light of current systematic reviews.

Data/Sources:
MEDLINE via Ovid, Embase via Ovid, Trip Pro Medical Database, Epistemonikos Database and Cochrane Database of Systematic Reviews (via Cochrane Library/Wiley) without restriction of date of publication or language. Reviews reported on the clinical survival, technical and biological complications, antagonist wear, and fabrication techniques of tooth- and implant-supported lithium (di)silicate single crowns were included. Methodological quality was assessed using the AMSTAR 2 tool.

Study selection:
The systematic search updated in February 2025 identified 1760 records from electronic databases. Ultimately, 28 systematic reviews on approximately 35,000 crowns published between 2007 and 2024 were included in the qualitative analysis. Lithium (di)silicate crowns demonstrated excellent short- and medium-term survival rates (95–100%) in the range of metal-ceramic crowns. Antagonist enamel wear was minimal and similar to that of natural teeth when polished surfaces were ensured. However, substantial methodological heterogeneity, limited long-term data (>5 years), and a concentration of studies on a single product (IPS e.max) were noted, limiting the generalizability of findings. The frequent pooling of diverse materials and restoration types without appropriate subgroup analyses further compromised the reliability of meta-analytic conclusions.

Conclusions:
Lithium (di)silicate crowns show excellent clinical performance in the short- and medium-term. Nevertheless, careful interpretation is warranted due to methodological variability, material-specific differences, and insufficient long-term data for newer lithium (di)silicate systems. Future research should address these gaps through standardized outcome reporting, material-specific studies, and investigation of broader biological effects.

Clinical Relevance:
LiSi(2) ceramics provide an aesthetically and mechanically reliable option for SCs in both anterior and posterior regions. Clinical evidence supports their excellent short- and medium-term survival with minimal antagonist wear, particularly when proper surface finishing protocols are followed. However, clinicians should be aware of material-specific differences among commercially available LiSi(2) systems and be cautious when extrapolating clinical results obtained from specific products to others. In light of limited long-term clinical data, practitioners should communicate both the well-documented short- to medium-term benefits and the remaining uncertainties regarding long-term performance. This overview also emphasizes the importance of critical appraisal of systematic reviews and encourages careful interpretation of pooled results, particularly in the presence of high heterogeneity or inappropriate data aggregation.