{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T11:24:58Z","timestamp":1786879498561,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To compare the marginal and internal adaptation and to evaluate the clinical performance and patient satisfaction of CAD\/CAM\u2010fabricated all\u2010ceramic crowns produced from lithium disilicate (LDS) and lithium disilicate\u2013reinforced lithium aluminosilicate (LAS) over a 24\u2010month follow\u2010up period.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n This randomized controlled, single\u2010blinded clinical trial included 59 posterior single crowns placed in 37 patients. Twenty\u2010nine crowns were fabricated from LDS (IPS e.max CAD; Ivoclar Vivadent), and 30 crowns were fabricated from LAS (n!ce Blocks; Institut Straumann AG). Marginal and internal adaptation were assessed before cementation using an in\u00a0vivo silicone replica technique. Clinical performance was evaluated at baseline and after 6, 12, and 24\u2009months using the modified United States Public Health Service (USPHS) criteria together with the Gingival Index (GI), Plaque Index (PI), and patient satisfaction assessed using a visual analogue scale (VAS). Statistical analyses were performed at a significance level of\n p<\/jats:italic>\n \u2009<\u20090.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n No statistically significant differences were observed between the LDS and LAS groups regarding marginal, rounded shoulder, or occlusal gap measurements (\n p<\/jats:italic>\n \u2009>\u20090.05). A statistically significant difference was observed at the axial measurement site (\n p<\/jats:italic>\n \u2009=\u20090.014), with the LDS group exhibiting significantly greater axial internal gap values than the LAS group. During the 24\u2010month follow\u2010up period, six restorations failed because of fracture or debonding, including three LDS and three LAS crowns, resulting in survival rates of 89.7% for LDS, 90.0% for LAS, and 89.8% overall. Gingival and plaque index scores remained low and stable throughout the observation period, and patient satisfaction remained high in both groups, with no statistically significant differences between materials (\n p<\/jats:italic>\n \u2009>\u20090.05). All clinically surviving restorations received Alpha or Bravo scores according to the modified USPHS criteria.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Within the limitations of this study, CAD\/CAM\u2010fabricated LDS and LAS crowns demonstrated comparable marginal adaptation, favorable clinical performance, and high patient satisfaction after 24\u2009months of clinical service. The fully crystallized LAS ceramic appears to be a clinically acceptable and time\u2010efficient alternative for posterior single\u2010crown restorations. Nevertheless, long\u2010term randomized clinical studies with larger sample sizes are required to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jerd.70244","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T10:35:32Z","timestamp":1786876532000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Evaluation of\n CAD<\/scp>\n \/\n CAM<\/scp>\n All\u2010Ceramic Crowns: A Randomized Controlled Study Comparing Lithium Disilicate and Lithium Aluminosilicate"],"prefix":"10.1111","author":[{"given":"Sinem","family":"Ok Toka\u00e7","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Kent University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8271-8870","authenticated-orcid":false,"given":"K\u00fcbra","family":"Y\u0131ld\u0131z Domani\u00e7","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Atlas University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0500-7546","authenticated-orcid":false,"given":"Y\u0131lmaz Umut","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"\u00d6zkan","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry Marmara University Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4047\/jap.2019.11.2.120","article-title":"In Vivo Wear Determination of Novel CAD\/CAM Ceramic Crowns Using 3D Alignment","volume":"11","author":"Alada\u011f A.","year":"2019","journal-title":"Journal of Advanced Prosthodontics"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.4103\/1305-7456.143612","article-title":"Evaluation of the Marginal Fit of Full Ceramic Crowns by Microcomputed Tomography","volume":"8","author":"Demir N.","year":"2014","journal-title":"European Journal of Dentistry"},{"issue":"6","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.4012\/dmj.2016-008","article-title":"The Marginal Fit of IPS e.Max Press and IPS e.Max CAD Lithium Disilicate Restorations: A Critical Review","volume":"35","author":"Mounajjed R.","year":"2016","journal-title":"Dental Materials Journal"},{"issue":"5","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.2341\/08-076-L","article-title":"Influence of Cervical Finish Line Type on the Marginal Adaptation of Zirconia Ceramic Crowns","volume":"34","author":"Comlekoglu M.","year":"2009","journal-title":"Operative Dentistry"},{"issue":"5","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"571","DOI":"10.5005\/jp-journals-10024-2560","article-title":"Evaluation of the Adaptation and Fracture Resistance of Three CAD\/CAM Resin Ceramics: An In\u00a0Vitro Study","volume":"20","author":"Naffah N.","year":"2019","journal-title":"Journal of Contemporary Dental Practice"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"227","DOI":"10.11607\/ijp.4244","article-title":"A New Classification System for All\u2010Ceramic and Ceramic\u2010Like Restorative Materials","volume":"28","author":"Gracis S.","year":"2015","journal-title":"International Journal of Prosthodontics"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/26415275.2019.1708202","article-title":"A Systematic Review on the Accuracy of Zirconia Crowns and Fixed Dental Prostheses","volume":"7","author":"Svanborg P.","year":"2020","journal-title":"Biomaterial Investigations in Dentistry"},{"issue":"2","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.cden.2003.12.015","article-title":"Designing Tooth Preparations for Optimal Success","volume":"48","author":"Goodacre C. J.","year":"2004","journal-title":"Dental Clinics of North America"},{"issue":"5","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s00784-015-1439-y","article-title":"Tooth Preparation for Full\u2010Coverage Restorations: A Literature Review","volume":"19","author":"Podhorsky A.","year":"2015","journal-title":"Clinical Oral Investigations"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1038\/sj.bdj.4802708","article-title":"The Estimation of Cement Film Thickness by an in Vivo Technique","volume":"131","author":"McLean J. W.","year":"1971","journal-title":"British Dental Journal"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12155048"},{"issue":"1","key":"e_1_2_11_13_1","first-page":"16","article-title":"Different Ways to Measure Marginal Fit and Internal Adaptation of Restorations in Dentistry","volume":"12","author":"Ghavami\u2010Lahiji M.","year":"2023","journal-title":"Journal of Dentomaxillofacial Radiology, Pathology and Surgery"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2174\/18742106\u2010v17\u2010e230404\u20102022\u201066"},{"issue":"9","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1007\/s00784-013-0923-5","article-title":"The Clinical Accuracy of Single Crowns Exclusively Fabricated by Digital Workflow: Comparison of Two Systems","volume":"17","author":"Brawek P. K.","year":"2013","journal-title":"Clinical Oral Investigations"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"e629","DOI":"10.1016\/j.prosdent.2025.05.044","article-title":"Marginal Adaptation of Tooth\u2010Supported Fixed Restorations Fabricated Using Digital Scanning Versus Conventional Impression Techniques: An Overview of Systematic Reviews","volume":"134","author":"Porto A. M.","year":"2025","journal-title":"Journal of Prosthetic Dentistry"},{"issue":"5","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1159\/000481864","article-title":"Clinical Outcomes and Predictors of Satisfaction in Patients With Lithium Disilicate All\u2010Ceramic Crowns","volume":"26","author":"Samer M. S.","year":"2017","journal-title":"Medical Principles and Practice"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.1590\/1807-3107\/2018.vol32.0001","article-title":"The Marginal Fit of Lithium Disilicate Crowns: Press Versus CAD\/CAM","volume":"32","author":"Azar B.","year":"2018","journal-title":"Brazilian Oral Research"},{"issue":"5","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1111\/j.1708-8240.2010.00362.x","article-title":"Multifunctional Uses of a Novel Ceramic\u2013Lithium Disilicate","volume":"22","author":"Ritter R. G.","year":"2010","journal-title":"Journal of Esthetic and Restorative Dentistry"},{"issue":"10","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1177\/0022034518779759","article-title":"CAD\/CAM Ceramic Restorative Materials for Natural Teeth","volume":"97","author":"Spitznagel F. A.","year":"2018","journal-title":"Journal of Dental Research"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.prosdent.2024.06.031","article-title":"Over 14\u2010Year Survival of Pressed e.Max Lithium Disilicate Glass\u2010Ceramic Complete and Partial Coverage Restorations in Patients With Severe Wear: A Prospective Clinical Study","volume":"133","author":"Margvelashvili\u2010Malament M.","year":"2025","journal-title":"Journal of Prosthetic Dentistry"},{"key":"e_1_2_11_22_1","first-page":"1","article-title":"Mechanical Properties of a Lithium Disilicate\u2010Strengthened Lithium Aluminosilicate Glass\u2010Ceramic","volume":"97","author":"Laczka M.","year":"2013","journal-title":"Journal of the American Ceramic Society"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/dj10120236"},{"issue":"2","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1590\/S1678-77572012000200019","article-title":"Internal Fit of Two All\u2010Ceramic Systems and Metal\u2010Ceramic Crowns","volume":"20","author":"Martins L. 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