Do sleep bruxism patients experience higher complication or failure rates with monolithic lithium disilicate or zirconia molar crowns?

Abstract

Bomicke W, Schmitter M, Waldecker M, et al. Ceramic crowns and sleep bruxism: 3-year results of a randomized controlled trial. J Dent 2026;170:106691. https://doi.org/10.1016/j.jdent.2026.106691 . Prospective randomized controlled clinical trial with a 3-year follow-up evaluating the influence of Sleep Bruxism (SB) on the clinical performance of monolithic ceramic molar crowns. A total of 109 patients requiring a single molar crown were enrolled. SB diagnosis included a structured questionnaire, clinical examination, and portable electromyography device (BruxOFF). Participants were allocated into four groups: lithium disilicate with SB, lithium disilicate without SB, zirconia with SB, and zirconia without SB. Standardized crown preparation, fabrication, and cementation protocols were used. Outcomes assessed were technical complications, survival, and success rates. The study time points were 1 week, 6 months, and 1, 2, and 3 years. Survival was defined as restoration remaining in situ without replacement. Success is defined as restoration without biological or technical complications. Fisher’s exact test was used to compare outcomes between SB and non-SB groups, with statistical significance set at $$\alpha $$ = 0.05. No technical complications occurred during the 3-year observation period. Survival rates remained high across all groups (95.2–100%), while success rates ranged from 81.5% to 95.8% for both ceramic materials. No statistically significant differences were observed between SB and non-SB patients or between lithium disilicate and zirconia crowns. Monolithic lithium disilicate and zirconia molar crowns demonstrated favorable clinical performance over three years, and SB was not associated with increased failure or complication risk.