Clinical outcomes of translucent monolithic zirconia vs. Lithium base glass ceramic fixed dental prosthesis: a systematic review and meta-analysis.

Current evidence of comparative clinical outcomes between translucent monolithic zirconia and lithium disilicate remains to be obtained to conclusively determine the superior material for fixed single-crown restorations. Objectives: To comprehensively compare the three-year clinical outcomes of translucent monolithic zirconia and lithium disilicate in fixed dental prostheses. Materials and Methods: We searched PubMed, EMBASE, Cochrane CENTRAL, CINAHL, and EBSCO Open Dissertations from inception to November 2023. Randomized controlled trials (RCTs) that compared the clinical outcomes of translucent monolithic zirconia and lithium disilicate in patients requiring fixed prostheses with a minimum follow-up of 6 months were included in this study. This systematic review and meta-analysis were developed and performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and with the guidance of the Cochrane Handbook for Systematic Reviews of Interventions (v.6.2). The risk of bias was assessed by the Cochrane Risk of Bias Tool 2 (RoB-2). This meta-analysis assessed the risk ratio (RR) for the effect size. Statistical analyses were performed via the RevMan5 software program. The protocol was registered with PROSPERO (CRD42023491978). Results Of the 188 articles identified, four trials were included (n=4). The RRs [95% CIs] for all the outcomes were not significantly different between Tran Zr and LDS: survival rate (1.00 [0.98, 1.02], I ² =0%), marginal integrity (0.98 [0.94, 1.02], I ² =2%), absence of anatomical change (1.04 [0.98, 1.10], I ² =0%), absence of dental caries (1.00 [0.99, 1.01], I ² =0%), surface integrity (1.00 [0.92, 1.10], I ² =0%), absence of crown fracture (1.00 [0.99, 1.02], I ² =0%), absence of abutment fracture (0.99 [0.97, 1.01], I ² =0%), and retention (0.98 [0.93, 1.03], I ² =30%). The analysis demonstrated that translucent zirconia and lithium disilicate performed similarly across the evaluated outcomes over the 3-year follow-up period, with no significant differences detected. Conclusions: Translucent zirconia and lithium disilicate have similar three-year survival rates without clinical significance, with either single posterior restorations or heavy bite forces on the multiunit restorations. This review also highlights the knowledge gap in the materials currently used for clinical trials. It requires more supporting evidence from other subjective parameters, such as color match, dentist or laboratory experience, material prices, and patient preferences.