TABLE 3a.
Summary of included RCTs.
| No. | Author, year | Study type | Initial no. of patients | Final no. of patients | Drop‐outs | FU (month) | Restoration type | Material | Workflow | Tooth vitality | Placed no. of restorations |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Fasbinder et al. 2020 | RCT | 86 | 86 | 0 | 60 | Onlay | LRGC (IPS Empress CAD, Ivoclar), RMC (Lava Ultimate, 3MESPE) | Digital workflow: CEREC Bluecam, MCX mill (Dentsply Sirona) | Vital | Empress CAD: 60, Lava Ultimate: 60 |
| 2 | Ferrari Cagidiaco et al. 2019 | RCT | 60 | 60 | 0 | 36 | Partial crown | LDS (IPS e.max Press, Ivoclar), LDS (Initial LiSi Press, GC Co.) | Conventional workflow: PVS (Exa'lence, GC Co.), lost‐wax technique | Vital | e.max Press: 30, Initial Lisi Press: 30 |
| 3 | Ferrari Cagidiaco et al. 2020 | RCT | 105 | 96 | 9 | 48 | Partial crown | LDS (IPS e.max Press, Ivoclar), LDS (Initial LiSi Press, GC Co.) | Conventional workflow: PVS (Exa'lence, GC Co.), lost‐wax technique | Vital | e.max Press: 85, Initial Lisi Press: 85 |
| 4 | Ferrari Cagidiaco et al. 2024 | RCT | 120 | 120 | 0 | 48 | Partial crown | LDS (Initial LiSi Press, GC Co.), LDS (Initial LiSi Block, GC Co.) | Conventional and conventional‐digital workflow: PVS (Exa'lence, GC Co.), Fabrication: Initial Lisi Press: conventional (according to manufacturer's instructions); Initial LiSi Block: CAD/CAM (milling machine: n4 Plus) | Vital | Initial LiSi Press: 30, Initial LiSi Block: 30 |
| 5 | Ferrari et al. 2019 | RCT | 120 | 120 | 0 | 36 | Partial crown | LDS (Lisi Press, CG Co.) | Conventional workflow: PVS (Exa'lence, GC Co.), lost‐wax technique | Non‐vital | 120 |
| 6 | Guess et al. 2013 | RCT | 25 | 14 | 11 | 84 | Partial crown | LDS (IPS e.max Press (Ivoclar), LRGC (Pro CAD, Ivoclar) | Conventional and conventional‐digital workflow: Polyether (Permadyne, 3MESPE), fabrication according to manufacturer's instructions (ProCAD: CEREC InLab, e.max Press: lost‐wax technique) | Vital | e.max Press: 40, Pro CAD: 40 |
| 7 | Hassan et al. 2024 | RCT | 20 | 20 | 0 | 24 | Onlay | LDS (IPS e.max CAD, Ivoclar), RMC (Grandio CAD, Voco Dental) | Conventional‐digital workflow: PVS (Elite HD, Zhermack), Milling machine (imes‐icore CORiTEC 350i, imes‐icore GmbH) | Vital | e.max CAD: 20, Grandio CAD: 20 |
| 8 | Pfister et al. 2023 | RCT | 43 | 19 | 24 | 176 | Partial crown | FC (Vita Mark II, Vita Zahnfabrik) | Conventional‐digital workflow: conventional impression (C‐silicone (Silaplast & Silasoft, Detax), scan of impressions and fabrication (CEREC 3, Dentsply Sirona) | nr | 68 |
| 9 | Rinke et al. 2022 | RCT | 45 | 40 | 5 | 56 | Partial crown | LS (Suprinity, Vita Zahnfabrik) | Digital workflow: CEREC Omnicam, MC XL milling unit (Dentsply Sirona) | Vital | 61 |
| 10 | Schlichting et al. 2022 | RCT | 11 | 11 | 0 | 27 | Occlusal veneer | LDS (e. max CAD, Ivoclar), RMC (Lava Ultimate, 3MESPE) | Digital workflow: CEREC Bluecam, inLab software (Dentsply Sirona), milling machine nr | Vital | e. max CAD: 24, Lava Ultimate: 36 |
| 11 | Souza et al. 2021 | RCT | 20 | 20 | 0 | 12 | Onlay | LDS (IPS e.max CAD, Ivoclar), RMC (Lava Ultimate, 3 M Oral Care) | Conventional‐digital workflow: PVS (Express 2 Penta H and Express 2 Light Body, 3 M Oral Care), Fabrication: MCL Compact milling unit (Dentsply Sirona) | Vital | e. max CAD: 20, Lava Ultimate: 20 |
| 12 | van den Breemer et al. 2019 | RCT | 30 | 30 | 0 | 12 | Onlay | LDS (IPS e.max Press, Ivoclar) | Conventional workflow: PVS (Heavy and Ultralight Body Aquasil (Dentsply Sirona), lost wax‐technique | Vital | 60 |
| 13 | Zhang et al. 2022 | RCT | 128 | 121 | 7 | 36 | Onlay | LDS CAD (brand nr), RMC (brand nr) | Digital workflow: CEREC Omnicam, inLab MC XL milling machine (Dentsply Sirona) | Non‐vital | LDS: 66, RMC: 66 |
| No. | No. of restorations in FU | Total no. of failed units | Total no. of survived units | Definition of survival or failure | Survival /failure rate | Type of statistical model | Preparation (occlusal/axial and occlusal) | Preparation thickness | Restoration thickness |
|---|---|---|---|---|---|---|---|---|---|
| 1 | Empress CAD: 60, Lava Ultimate: 60 | Empress CAD: 4, Lava Ultimate: 3 | Empress CAD: 56, Lava Ultimate: 57 | nr | Kaplan–Meier probability for fracture (5 years): Empress CAD: 0.068 (0.026; 0.171), Lava Ultimate: 0.083 (0.036; 0.189) | Kaplan–Meier survival estimation (missing description of statistical methods) | Occlusal and axial | Functional cusp at least 2 mm, non‐functional cusp at least 1.5 mm | nr |
| 2 | e.max Press: 30, Initial Lisi Press: 30 | e.max Press: 0, Initial Lisi Press: 0 | e.max Press: 30, Initial Lisi Press: 30 | Survival was set when the restoration was still in place at the last recall but with biological or technical complications that needed to be treated and/or the crown to be remade. Failure was set when the restoration was not in place anymore at last recall or, because of mechanical or biological complications, needed to be replaced | Survival rate (3 years): e.max Press and Initial Lisi Press: 100% | Mann–Whitney “U” test | Occlusal and axial | Occlusal reduction 1–1.5 mm | nr |
| 3 | e.max Press: 80, Initial Lisi Press: 81 | e.max Press: 5, Initial Lisi Press: 4 | e.max Press: 80, Initial Lisi Press: 81 | Survival was when the restoration was still in place at the last recall but with a biological or technical complication that needed to be treated but without the need to remake the crown | Failure rate (4 years): e.max Press: 6.25%, Initial Lisi Press: 6.17% | Mann–Whitney “U” test | Occlusal and axial | Occlusal clearance ranged between 0.5–1 and 1–1.5 mm | nr |
| 4 | Initial LiSi Press: 30, Initial LiSi Block: 30 | Initial LiSi Press: 0, Initial LiSi Block: 0 | Initial LiSi Press: 30, Initial LiSi Block: 30 | Survival was set when the restoration was still in place at the last recall but with a biological or technical complication that needed to be treated, but without the need to remake the crown. If the restoration was lost at the last recall or, because of mechanical or biological complications, needed to be replaced, it was classified as Failure | Survival rate (4 years): Initial LiSi Press and Initial LiSi Block: 100% | Mann–Whitney “U” test, Cox regression | Occlusal and axial | Occlusal reduction 1–1.5 mm | nr |
| 5 | 120 | 2 | 118 | Survival was defined as the outcome in the absence of absolute failures. The following parameters were considered as failures: [1] post‐debonding [2], post‐fracture [3], vertical or horizontal root fracture [4], crown dislodgement [5], crown fracture [6], periapical lesions not requiring endodontic re‐treatment (…), and [7] periapical lesions requiring endodontic retreatment | Survival rate (3 years): PCCs on molars with and without posts: 100%; PCCs on premolars without post: 93.3%; (2 years): PCCs on premolars with posts: 100% (3 years not given) | Kaplan–Meier survival estimation, Log rank test, Cox regression | nr | Occlusal clearance: 1–1.5 mm | nr |
| 6 | e.max Press: 24, Pro CAD: 24 | e.max Press: 0, Pro CAD: 1 | e.max Press: 24, Pro CAD: 24 | Absolute failure was defined by clinical unacceptable fracture and crack development, which required a replacement of the entire restoration, and/or secondary caries as well as endodontic complications | Survival rate (7 years): e.max Press: 100%, Pro CAD: 97% | Kaplan–Meier survival estimation, Random‐intercept logistic regression model | Occlusal and axial | Occlusal reduction: 2 mm | At least 1.5 mm occlusal thickness |
| 7 | e.max CAD: 18, Grandio CAD: 18 | e.max CAD: 2, Grandio CAD: 2 | e.max CAD: 18, Grandio CAD: 18 | nr | Functional survival rate (2 years): e.max CAD: 90%, Grandio CAD: 90% | Kaplan–Meier survival estimation, Chi‐Square, Fischer Test, MC‐Nemar's test | nr | Occlusal reduction: functional cusps 2 mm, non‐functional cusps 1.5 mm | nr |
| 8 | 32 | 27 | nr | Five reasons for Failure were distinguished: “debonding,” fracture,” “caries,” “endodontic treatment,” and “other reasons” | Survival rate (15 years): 78.1% (±7.3%) PCCs with selective enamel etching, 42.9% (±8.4%) PCCs without selective enamel etching | Kaplan–Meier survival estimation, Log rank test | Occlusal and axial | nr | nr |
| 9 | 54 | Group 0.5–0.74 mm thickness: 5, group 0.75–1.0 mm thickness: 0 | 49 | Survival was defined as the restoration being in situ at the time of the follow‐up examination without signs of a total loss (i.e., the in situ criterion) | Survival rate (5 years): group 0.5–0.74 mm thickness: 83% (95% confidence interval (CI): 0.71–0.96), group 0.75–1.0 mm thickness: 100% | Kaplan–Meier survival estimation, Cox Regression | Occlusal and axial | nr | Minimal thickness in central fissure: 0.5–0.74 or 0.75–1.0 mm |
| 10 | e.max CAD: 24, Lava Ultimate: 36 | e.max CAD: 1, Lava Ultimate: 0 | e.max CAD: 23, Lava Ultimate: 36 | Failure was considered whenever a restoration received a Score 4 or 5. Restorations graded 4 were considered unacceptable but still repairable, while restorations graded 5 were considered failures with immediate need of replacement | Estimated survival rate (3 years): e.max CAD:100%, Lava Ultimate: 84.7%; Pooled survival rate: 88.4% | Kaplan–Meier survival estimation, Log rank test | Occlusal | 0.4–0.6 mm (central groove) to 1.0–1.3 mm (cusp tips) | 0.55 mm at the central groove, 0.89 mm at the internal cusp slope, 1.00 mm at the cusp tip, and 0.78 mm at the marginal ridge |
| 11 | e. max CAD: 20, Lava Ultimate: 20 | e. max CAD: 0, Lava Ultimate: 0 | e. max CAD: 20, Lava Ultimate: 20 | nr | Survival rate (1 years): e.max CAD and Lava Ultimate: 100% | Mann–Whitney U test, Wilcoxon signed‐rank test | nr | Occlusal reduction: at least 1.5–2 mm | Occlusal thickness: at least 1.5–2 mm |
| 12 | 60 | 0 | 60 | nr | Survival rate (1 year): 100% | Chi‐square test, Wilcoxon signed‐rank test | Occlusal and axial | At least 1 mm; cusps were covered (1.5 mm) if the remaining tooth structure wall was < 2 mm thick | Occlusal thickness: at least 1 mm |
| 13 | LDS: 51, RMC: 47 | LDS: 4, RMC: 11 | LDS: 51, RMC: 46 | nr | Survival rate (3 years): LDS: 93.5% (95% CI, 90.4%–96.6%), RMC: 83.1% (95% CI, 78.4%–87.8%) | Kaplan–Meier survival estimation, Log rank test, Mann–Whitney test | Occlusal and axial | 2 mm at functional cusps and at least 1.5 mm at nonfunctional cusps | nr |
Abbreviations: CAD‐CAM, computer‐aided design‐computer‐aided manufacturing; FC, feldspar ceramic; FU, follow‐up; LDS, lithium disilicate; LRGC, leucite‐reinforced glass ceramic; LS, lithium silicate; No, number; nr, not reported; PVS, polyvinyl siloxane; RCT, randomized controlled trial; RMC, resin matrix ceramic.