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What does clinical research say about long-term survival of IPS e.max Monolithic?

A long-term clinical study published in the Journal of Prosthetic Dentistry (Malament et al., 2019) examined pressed, acid-etched IPS e.max lithium disilicate restorations in a private practice setting over a period of up to 10.4 years. The findings strongly support the material's reliability.

Study metric Result
Patients evaluated 556 (mean age 62 years, range 17 to 97)
Complete-coverage restorations studied 1,960
Overall 10-year cumulative survival 99.6%
Monolithic restorations 1,410 units, 96.5% cumulative survival at 10.4 years
Bilayered (layered) restorations 550 units, 100% survival at 7.9 years
Overall failure rate Below 0.2% per year
Maxillary survival 98.4% at 10.4 years
Mandibular survival 98.3% at 10.1 years

Of the seven monolithic failures recorded, most occurred in molar teeth (5 of 7), and failures were defined as bulk fracture or a large chip requiring replacement, with an average time to failure of 4.2 years. The authors concluded that tooth position, sex, age, and whether the restoration was monolithic or bilayered had little effect on survival, and that the restorations performed successfully across the variables studied. The margins in the study were prepared in enamel, which supports the value of strong adhesive bonding to enamel for these restorations.

 

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