Clinical Evaluation of Lithium Disilicate Veneers Manufactured by CAD/CAM Compared with Heat-pressed Methods: Randomized Controlled Clinical Trial

Abstract

Clinical Relevance Lithium disilicate veneers for esthetic restorations show great accuracy and similarity, regardless of the type of fabrication technique. SUMMARY Objectives: This study aimed to evaluate and compare the clinical performance of two different ceramic veneer methods: CAD/CAM (IPS e.max CAD) and heat-press (IPS e.max Press) at 6 and 12 months of follow-up, and the level of patient satisfaction after treatment. Methods and Materials: Patients were selected according to eligibility criteria, with a minimum of two and a maximum of six veneers per patient, for a total of 178 veneers randomized in two groups. A split-mouth, longitudinal, interventional, double-blind and single-center study was carried out according to the fabrication technique. Scores were attributed to the veneers according to the criteria of the United States Public Health Service (USPHS) regarding marginal adaptation, color change, marginal discoloration, restoration fracture, tooth fracture, restoration wear, antagonist tooth wear, presence of caries, and postoperative sensitivity. All patients answered a satisfaction questionnaire using the Visual Analogue Scale (VAS). Statistical significance was determined using two-way ANOVA and Tukey test, with a significance level of 5%. Results: The marginal adaptation criterion showed statistical difference between periods (p=0.017), regardless of the processing method (baseline means: CAD=1.056, PRESS=1.067, 6- to 12-month follow-up: CAD=1.089, PRESS=1.078). The other evaluated criteria showed no statistical differences between baseline and after 6 to 12 months. The level of satisfaction assessed by the VAS before and after treatment was 7.06 and 9.5, respectively. Conclusions: The two methods presented similar clinical performance after 12 months, and the patient’s level of satisfaction was considered high.