Outcomes of lithium disilicate veneers and overlays in full-mouth rehabilitation for patients with extensive tooth wear: a non-randomized case series of three patients

There are limited data about the clinical performances of pressed lithium disilicate occlusal overlays and labial/palatal veneers in full-mouth rehabilitation. This investigation aimed to assess the survival and potential complications of this therapy. This study was designed as a non-randomized, prospective case series without a concurrent control group. In this prospective case series, full-mouth adhesive reconstruction was performed in three patients with extensive tooth wear, involving the placement of 46 lithium disilicate overlays, 18 labial veneers and 17 palatal veneers (81 restorations clustered within 3 patients). These restorations were assessed annually using modified United States Public Health Service criteria, evaluating: (a) secondary caries, (b) discoloration at the margin, (c) integrity of the margin, (d) integrity of the restoration, (e) retention, (f) proximal contact, (g) endodontic complications, and (h) occlusal wear over a mean observation period of 5 years (52–66 months). Each index was classified into four groups: Alpha, Bravo, Charlie and Delta. Outcomes were summarised descriptively as counts and percentages. At 60 months, no posterior overlays and labial veneers was lost during the follow-up period, with one palatal veneer debonded in one patient (5.9%). Marginal discoloration (B scores) was observed in 31/46 (67.4%) overlays. Occlusal wear (B scores) was noted in 16/46 (34.8%) overlays, 15/18 (83.3%) labial veneers, and 15/17 (88.2%) palatal veneers. No technical complications, such as cracks, chipping, fractures, endodontic complications, or caries were observed. Within the limits of this small case series of three patients, lithium disilicate posterior overlays and anterior veneers remained functionally stable over five years. However, esthetic and surface complications, such as marginal discoloration and occlusal wear, occurred frequently. These preliminary, hypothesis-generating observations require confirmation in adequately powered multi-patient studies before any general recommendation about minimum ceramic thickness can be drawn. The clinical behavior of monolithic lithium disilicate ceramic restorations (labial veneer, palatal veneer, overlay) in the full-mouth rehabilitation therapy for treatment of participants with extensive tooth wear is relatively unknown. The preliminary results of this clinical study can serve as a reference protocol for increasing vertical dimension of occlusion using IPS e.max Press ceramic materials.