1.Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up
Hye-Seon LEE ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
The Journal of Advanced Prosthodontics 2025;17(2):59-69
PURPOSE:
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS:
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS:
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.
2.Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up
Hye-Seon LEE ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
The Journal of Advanced Prosthodontics 2025;17(2):59-69
PURPOSE:
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS:
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS:
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.
3.Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up
Hye-Seon LEE ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
The Journal of Advanced Prosthodontics 2025;17(2):59-69
PURPOSE:
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS:
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS:
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.
4.Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up
Hye-Seon LEE ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
The Journal of Advanced Prosthodontics 2025;17(2):59-69
PURPOSE:
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS:
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS:
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.
5.Effect of Occlusal and Margin Design on the Fracture Load of Zirconia-Lithium Disilicate Bi-layered Posterior Crowns: An in Vitro Study
Sung-Hoon KIM ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
Journal of Korean Dental Science 2025;18(1):1-11
Purpose:
The opacity of zirconia sometimes requires a veneering material; thus lithium disilicate, a veneer material with excellent strength, can be used. This study investigated the fracture resistance of zirconia–lithium disilicate (Zr-LS2) bi-layered crowns according to the design of the substructure.
Materials and Methods:
Five groups of posterior Zr-LS2 restorations (Zirtooth and Amber LiSi-POZ) were fabricated with different zirconia substructure coverage (control group, groups half occlusal zirconia coverage; 1/2OZ, and three-quarter occlusal zirconia coverage; 3/4OZ) and margin designs (control group, groups collar margin; C-M, and collarless margin; Cl-M). All restorations were cemented with self-adhesive resin cement followed by 24-h water storage and thermocycling (10,000 cycles, 5°C and 55°C). The fracture load was measured, and failure mode analysis, fractography, and elemental analysis were performed. The one-way analysis of variance and Fisher’s exact test were performed for statistical analyses (α=.05).
Results:
A significant difference was found in the fracture load of Zr-LS2 restorations according to the zirconia coverage of the occlusal area and margin design (P<.05). Group 3/4OZ was significantly larger than the control group C and 1/2OZ (P<.05). The C-M group had greater fracture loads based on margin design than the control group C and Cl-M (P<.05).
Conclusion
The fracture resistance of posterior Zr-LS2 restorations increased with the zirconia coverage, occlusal thickness, and collar margin.
6.Effect of Occlusal and Margin Design on the Fracture Load of Zirconia-Lithium Disilicate Bi-layered Posterior Crowns: An in Vitro Study
Sung-Hoon KIM ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
Journal of Korean Dental Science 2025;18(1):1-11
Purpose:
The opacity of zirconia sometimes requires a veneering material; thus lithium disilicate, a veneer material with excellent strength, can be used. This study investigated the fracture resistance of zirconia–lithium disilicate (Zr-LS2) bi-layered crowns according to the design of the substructure.
Materials and Methods:
Five groups of posterior Zr-LS2 restorations (Zirtooth and Amber LiSi-POZ) were fabricated with different zirconia substructure coverage (control group, groups half occlusal zirconia coverage; 1/2OZ, and three-quarter occlusal zirconia coverage; 3/4OZ) and margin designs (control group, groups collar margin; C-M, and collarless margin; Cl-M). All restorations were cemented with self-adhesive resin cement followed by 24-h water storage and thermocycling (10,000 cycles, 5°C and 55°C). The fracture load was measured, and failure mode analysis, fractography, and elemental analysis were performed. The one-way analysis of variance and Fisher’s exact test were performed for statistical analyses (α=.05).
Results:
A significant difference was found in the fracture load of Zr-LS2 restorations according to the zirconia coverage of the occlusal area and margin design (P<.05). Group 3/4OZ was significantly larger than the control group C and 1/2OZ (P<.05). The C-M group had greater fracture loads based on margin design than the control group C and Cl-M (P<.05).
Conclusion
The fracture resistance of posterior Zr-LS2 restorations increased with the zirconia coverage, occlusal thickness, and collar margin.
7.Effect of Occlusal and Margin Design on the Fracture Load of Zirconia-Lithium Disilicate Bi-layered Posterior Crowns: An in Vitro Study
Sung-Hoon KIM ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
Journal of Korean Dental Science 2025;18(1):1-11
Purpose:
The opacity of zirconia sometimes requires a veneering material; thus lithium disilicate, a veneer material with excellent strength, can be used. This study investigated the fracture resistance of zirconia–lithium disilicate (Zr-LS2) bi-layered crowns according to the design of the substructure.
Materials and Methods:
Five groups of posterior Zr-LS2 restorations (Zirtooth and Amber LiSi-POZ) were fabricated with different zirconia substructure coverage (control group, groups half occlusal zirconia coverage; 1/2OZ, and three-quarter occlusal zirconia coverage; 3/4OZ) and margin designs (control group, groups collar margin; C-M, and collarless margin; Cl-M). All restorations were cemented with self-adhesive resin cement followed by 24-h water storage and thermocycling (10,000 cycles, 5°C and 55°C). The fracture load was measured, and failure mode analysis, fractography, and elemental analysis were performed. The one-way analysis of variance and Fisher’s exact test were performed for statistical analyses (α=.05).
Results:
A significant difference was found in the fracture load of Zr-LS2 restorations according to the zirconia coverage of the occlusal area and margin design (P<.05). Group 3/4OZ was significantly larger than the control group C and 1/2OZ (P<.05). The C-M group had greater fracture loads based on margin design than the control group C and Cl-M (P<.05).
Conclusion
The fracture resistance of posterior Zr-LS2 restorations increased with the zirconia coverage, occlusal thickness, and collar margin.
8.Effect of Occlusal and Margin Design on the Fracture Load of Zirconia-Lithium Disilicate Bi-layered Posterior Crowns: An in Vitro Study
Sung-Hoon KIM ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
Journal of Korean Dental Science 2025;18(1):1-11
Purpose:
The opacity of zirconia sometimes requires a veneering material; thus lithium disilicate, a veneer material with excellent strength, can be used. This study investigated the fracture resistance of zirconia–lithium disilicate (Zr-LS2) bi-layered crowns according to the design of the substructure.
Materials and Methods:
Five groups of posterior Zr-LS2 restorations (Zirtooth and Amber LiSi-POZ) were fabricated with different zirconia substructure coverage (control group, groups half occlusal zirconia coverage; 1/2OZ, and three-quarter occlusal zirconia coverage; 3/4OZ) and margin designs (control group, groups collar margin; C-M, and collarless margin; Cl-M). All restorations were cemented with self-adhesive resin cement followed by 24-h water storage and thermocycling (10,000 cycles, 5°C and 55°C). The fracture load was measured, and failure mode analysis, fractography, and elemental analysis were performed. The one-way analysis of variance and Fisher’s exact test were performed for statistical analyses (α=.05).
Results:
A significant difference was found in the fracture load of Zr-LS2 restorations according to the zirconia coverage of the occlusal area and margin design (P<.05). Group 3/4OZ was significantly larger than the control group C and 1/2OZ (P<.05). The C-M group had greater fracture loads based on margin design than the control group C and Cl-M (P<.05).
Conclusion
The fracture resistance of posterior Zr-LS2 restorations increased with the zirconia coverage, occlusal thickness, and collar margin.
9.Prospective clinical comparative evaluation of implant-supported zirconia-lithium disilicate bilayered ceramic and metalceramic posterior prostheses: a 3-year follow-up
Hye-Seon LEE ; Kyung-Ho KO ; Chan-Jin PARK ; Lee-Ra CHO ; Yoon-Hyuk HUH
The Journal of Advanced Prosthodontics 2025;17(2):59-69
PURPOSE:
The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years.
MATERIALS AND METHODS:
This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test.
RESULTS:
Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group.
CONCLUSION
This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.
10.Effect of scan path on accuracy of complete arch intraoral scan
Eui-Jun CHOI ; Kyung-Ho KO ; Yoon-Hyuk HUH ; Chan-Jin PARK ; Lee-Ra CHO
The Journal of Advanced Prosthodontics 2024;16(6):319-327
PURPOSE:
This study aimed to compare the accuracy of an alternative scan path with that of traditional scan paths to obtain a more accurate method for complete arch scans.
MATERIALS AND METHODS:
A mandibular stone cast, including tooth preparations for the inlay, crown, and fixed prosthesis, was scanned 10 times using four different scan paths (A, B, C, and D). The scans were converted into stereolithography files, resized, and superimposed onto a control file obtained from a desktop scanner. The scan time, total surface deviation, and local deviation of the mandibular teeth were measured. One-way analysis of variance (ANOVA) and Welch ANOVA were used for statistical analyses (α = .05). The relative standard deviation and standard error of the mean were calculated to evaluate accuracy.
RESULTS:
The total surface deviation differed significantly according to the scanning path despite a similar scan time. Path D had the highest accuracy and the most uniform color maps, showing minimal deformation of the digital model. Meanwhile, no significant differences were found in the local deviations in the individual tooth assessments, likely owing to issues with the superimposition method.
CONCLUSION
Among all scan paths, the scan path with the shortest distance from the starting point to the end point showed the smallest total surface deviation and the highest accuracy. No differences were observed in the deviations of specific teeth based on the scan path.

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