Esthetic and Functional Posterior Rehabilitation With Lithium Disilicate Ceramics for the Replacement of Gold Alloy and Metal-Ceramic Restorations: A Clinical Case With a 10-Year Follow-Up.

Objective: This case report illustrates a clinical scenario of a patient with insufficient crowns, gold onlays and localized tooth pain in the posterior teeth, treated with partial and full coverage lithium disilicate restorations.

Clinical considerations: A female patient presented in the clinics, complaining about tooth pain and unesthetic metal restorations. After a thorough examination, diagnosis and treatment plan, the existing restorations were removed, and a defect-oriented preparation was done to preserve as much as possible of the remaining tooth structure. Final partial and full coverage lithium disilicate restorations were delivered. After a 10-year follow-up no biological complications were observed. Nevertheless, one major chipping was observed in one of the upper molars. This technical complication was resolved with the fabrication of a new ceramic restoration.

Conclusion: Lithium disilicate ceramic posterior full- or partial-coverage restorations are a reliable and predictable treatment option not only for the replacement of tooth structure lost due to caries but also for the replacement of insufficient restorations.

Clinical significance: The following key factors are to be considered to pursue long-term success with ceramic restorations: patient selection, minimal invasive tooth preparation, appropriate material selection and cementation. Nevertheless, complications are to be expected, and the patient should be informed accordingly.