22 October 2026

---

A 3-Year Split-Mouth Randomized Non-Inferiority Controlled Trial Comparing Cement-Retained Monolithic CAD-CAM Zirconia and Lithium Disilicate Crowns for Single Posterior Implant Restorations.

---

This peer-reviewed implantology article summarizes clinical evidence from Clinical oral implants research (2026). It focuses on findings that may help dental professionals evaluate treatment decisions, patient outcomes, or clinical protocols.

Abstract

OBJECTIVES: To evaluate whether monolithic CAD-CAM lithium disilicate (LS 2 ) crowns are non-inferior to monolithic CAD-CAM zirconia (ZrO 2 ) crowns with respect to clinical and radiographic outcomes in single posterior implant restorations.

MATERIALS AND METHODS: Patients with bilateral single-tooth implants at homologous posterior sites were enrolled. Each implant was randomly assigned to receive either a monolithic CAD-CAM ZrO 2 crown (Control) or a LS 2 crown (Test), both cemented onto customized titanium abutments. Marginal bone level change (ΔMBL) was the primary outcome. Non-inferiority of LS 2 relative to ZrO 2 was evaluated using a prespecified margin of -0.5 mm for the paired difference in ΔMBL (LS 2 -ZrO 2 ). Implant and prosthesis survival, biological and technical complications, periodontal parameters, and FIPS were assessed as secondary outcomes.

RESULTS: A total of 40 patients completed the 3-year follow-up. The survival rates were 97.5% for ZrO 2 and 100% for LS 2 , with one implant loss in the ZrO 2 group. Biological complication rates were 5% for ZrO 2 and 15% for LS 2 (p = 0.219), while technical complication rates were 2.5% and 5% (p = 1.000), respectively. No crown fractures, chipping, or debonding were found in either group. The ΔMBL was -0.62 ± 1.22 mm for ZrO 2 and -0.36 ± 1.07 mm for LS 2 . The paired mean difference in ΔMBL (LS 2 -ZrO 2 ) was 0.26 mm (95% CI: -0.17 to 0.70 mm). The lower confidence limit remained above the prespecified non-inferiority margin of -0.5 mm, demonstrating non-inferiority of LS 2 with respect to ΔMBL. No statistically significant differences were observed in mSBI, mPLI, or FIPS between the two groups (p = 0.106, 0.201, 0.825).

CONCLUSIONS: Monolithic CAD-CAM LS 2 crowns exhibit non-inferior clinical and radiographic outcomes to ZrO 2 crowns over a 3-year follow-up period. Customized titanium abutments with cemented monolithic all-ceramic crowns represent a reliable treatment option for single posterior implant-supported restorations in the medium term.

TRIAL REGISTRATION: Chinese Clinical Trial Registry (chictr.org.cn): ChiCTR2200062023.

Key takeaway

Key takeaway: Because the evidence comes from a clinical trial design, the findings may be especially useful when comparing treatment approaches in daily practice.

Introduction from full text

The introduction of the new generation of particle-filled and high strength ceramics, hybrid composites and technopolymers in the last decade has offered an extensive palette of dental materials broadening the clinical indications in fixed prosthodontics, in the light of minimally invasive dentistry dictates. Moreover, last years have seen a dramatic increase in the patients’ demand for non-metallic materials, sometimes induced by metal-phobia or alleged allergies. Therefore, the attention of scientific research has been progressively focusing on such materials, particularly on lithium disilicate and zirconia, in order to shed light on properties, indications and limitations of the new protagonists of the prosthetic scene.

Peer-reviewed source

Xiaosong Yi, Donghao Wei, Shuman Quan, Yingjie Kong, Xi Huang, Xi Jiang, Ye Lin, Ping Di

Clinical oral implants research. 2026

DOI: 10.1111/clr.14151

PMID: 42387309

PubMed: https://pubmed.ncbi.nlm.nih.gov/42387309/

Image: Peter Kasprzyk (Unsplash)