Evaluating Fracture Resistance of Implant-Supported Crowns Using Lithium Disilicate vs. Zirconia Restorations

Authors

  • Anum Kamran Quaid e Azam Medical College, Bahawalpur
  • Muhammad Haseeb Rana College of Dentistry, King Khalid university, Abha, Kingdom of Saudi Arabia
  • Amira Shahid Dental College, University Medical and Dental College/MTH, Faisalabad
  • Samena Memon LUMHS, Jamshoro
  • Muhammad Akram Ramzan Northern Border University, Arar, Saudi Arabia

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/046

Keywords:

Dental Implants, Zirconium, Silicates, Dental Abutments, Dental Prosthesis Design

Abstract

Background: Implant-supported crowns are required to withstand larger occlusal forces, especially in posterior areas. Restorative ceramics, such as lithium disilicate and monolithic zirconia, are popular; however, their mechanical properties differ greatly. The objective of this study was to compare the fracture and fatigue resistance between lithium disilicate and zirconia crowns in simulated oral conditions. Methods: A randomized controlled in vitro study was conducted between January and May 2025 at the Department of Prosthodontics. 120 implant-supported crowns were prepared and randomly divided into two equal groups. Group A included lithium disilicate crowns, and Group B monolithic zirconia crowns. All the crowns were cemented with standardized titanium abutments and were subjected to thermocycling (5,000 cycles) and mechanical loading (100,000 cycles at 100 N). A universal testing machine was used to measure fracture strength and fatigue performance. Statistical analysis, mainly using SPSS version 26.0, included independent t-tests and chi-square tests. Statistical significance was at p < 0.05. Results: The fracture resistance was significantly higher in Group B (zirconia; 1835 ± 225 N) compared to Group A (lithium disilicate; 1325 ± 195 N), p < 0.001. Group B crowns had a 54 (90%) survival rate compared to a 29 (48.3%) survival rate for Group A under fatigue loading, thereby suggesting improved long-term mechanical durability. Conclusion: In implant-supported restorations, the fracture resistance of monolithic zirconia crowns was much higher compared to lithium disilicate. Due to strong masticatory forces, zirconia might be the choice in posterior sections. More clinical trials are needed to confirm the long-term results.

Author Biographies

  • Anum Kamran, Quaid e Azam Medical College, Bahawalpur

    Faculty of Medicine

  • Muhammad Haseeb Rana, College of Dentistry, King Khalid university, Abha, Kingdom of Saudi Arabia


    Department of prosthodontics 

  • Amira Shahid, Dental College, University Medical and Dental College/MTH, Faisalabad

    Department of Operative Dentistry

  • Samena Memon, LUMHS, Jamshoro


    Department of Prosthodontics 


  • Muhammad Akram Ramzan , Northern Border University, Arar, Saudi Arabia


    Faculty of Medical Sciences

References

1. Aldhuwayhi S. Zirconia in Dental Implantology: A Review of the Literature with Recent Updates. Bioengineering (Basel). 2025 May 19;12(5):543. doi: 10.3390/bioengineering12050543.

2. Fouda AM, Atta O, Özcan M, Stawarczyk B, Glaum R, Bourauel C. An investigation on fatigue, fracture resistance, and color properties of aesthetic CAD/CAM monolithic ceramics. Clin Oral Investig. 2023 Jun;27(6):2653-2665. doi: 10.1007/s00784-022-04833-y.

3. Hajaj T, Marian D, Zaharia C, Niculescu ST, Negru RM, Titihazan F, et al. Fracture Resistance of CAD/CAM-Fabricated Zirconia and Lithium Disilicate Crowns with Different Margin Designs: Implications for Digital Dentistry. J Funct Biomater. 2025 Jun 2;16(6):205. doi: 10.3390/jfb16060205.

4. Kim W, Li XC, Bidra AS. Clinical outcomes of implant-supported monolithic zirconia crowns and fixed partial dentures: A systematic review. J Prosthodont. 2023 Feb;32(2):102-107. doi: 10.1111/jopr.13575.

5. Tajti P, Solyom E, Czumbel LM, Szabó B, Fazekas R, Németh O, et al. Monolithic zirconia as a valid alternative to metal-ceramic for implant-supported single crowns in the posterior region: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent. 2024 Nov;132(5):881-889. doi: 10.1016/j.prosdent.2023.05.006.

6. Gseibat M, Sevilla P, Lopez-Suarez C, Rodriguez V, Pelaez J, Suarez MJ. Performance of posterior third-generation monolithic zirconia crowns in a complete digital workflow: A three-year prospective clinical study. J Dent Sci. 2024 Apr;19(2):871-877. doi: 10.1016/j.jds.2023.08.018.

7. Sahebi M, Ghodsi S, Berahman P, Amini A, Zeighami S. Comparison of retention and fracture load of endocrowns made from zirconia and zirconium lithium silicate after aging: an in vitro study. BMC Oral Health. 2022 Feb 16;22(1):41. doi: 10.1186/s12903-022-02072-x.

8. Qamar Z, Alghamdi AMS, Haydarah NKB, Balateef AA, Alamoudi AA, Abumismar MA, et al. In Vitro Evaluation of Lithium Disilicate Endocrowns and Post and Core Crowns-A Systematic Review. J Funct Biomater. 2023 May 14;14(5):276. doi: 10.3390/jfb14050276.

9. Kaenploy J, Li R, Makowka S, Sadid-Zadeh R. Fracture resistance of cement-retained lithium disilicate implant-supported crowns: Effect of material used for two-piece abutments. J Prosthodont. 2024 May 28. doi: 10.1111/jopr.13871.

10. Graf T, Lyko A, Dahmer I, Stimmelmayr M, Dieterich H, Aggstaller H, et al. Clinical performance and risk factors of all-ceramic screw-retained implant crowns in the posterior region based on a retrospective investigation. Clin Oral Implants Res. 2024 Jul;35(7):685-693. doi: 10.1111/clr.14264.

11. Bhardwaj R, Agrawal U, Vashist P, Manna S. Determination of sample size for various study designs in medical research: A practical primer. J Family Med Prim Care. 2024 Jul;13(7):2555-2561. doi: 10.4103/jfmpc.jfmpc_1675_23.

12. Kongkiatkamon S, Booranasophone K, Tongtaksin A, Kiatthanakorn V, Rokaya D. Comparison of Fracture Load of the Four Translucent Zirconia Crowns. Molecules. 2021 Sep 1;26(17):5308. doi: 10.3390/molecules26175308.

13. Sigilião Celles CA, Ferreira I, Valente MDLDC, Dos Reis AC. Osseointegration in relation to drilling speed in the preparation of dental implants sites: A systematic review. J Prosthet Dent. 2025 Feb;133(2):394-401. doi: 10.1016/j.prosdent.2023.03.004.

14. Ziębowicz A, Oßwald B, Kern F, Schwan W. Effect of Simulated Mastication on Structural Stability of Prosthetic Zirconia Material after Thermocycling Aging. Materials (Basel). 2023 Jan 30;16(3):1171. doi: 10.3390/ma16031171.

15. Badr Z, Culp L, Duqum I, Lim CH, Zhang Y, A Sulaiman T. Survivability and fracture resistance of monolithic and multi-yttria-layered zirconia crowns as a function of yttria content: A mastication simulation study. J Esthet Restor Dent. 2022 Jun;34(4):633-640. doi: 10.1111/jerd.12907.

16. Tajti P, Solyom E, Czumbel LM, Szabó B, Fazekas R, Németh O, et al. Monolithic zirconia as a valid alternative to metal-ceramic for implant-supported single crowns in the posterior region: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent. 2024 Nov;132(5):881-889. doi: 10.1016/j.prosdent.2023.05.006.

17. Gehrke P, Burg S, Peters U, Beikler T, Fischer C, Rupp F, et al. Bacterial translocation and microgap formation at a novel conical indexed implant abutment system for single crowns. Clin Oral Investig. 2022 Feb;26(2):1375-1389. doi: 10.1007/s00784-021-04112-2.

18. Afshari A, Mosaddad SA, Alam M, Abbasi K, Darestani MN. Biomaterials and Biological Parameters for Fixed-Prosthetic Implant-Supported Restorations: A Review Study. Adv. Mater. Sci. Eng. 2022 Jan 1;2022(1):2638166. doi: 10.1155/2022/2638166.

19. Abdulrahman S, Von See Mahm C, Talabani R, Abdulateef D. Evaluation of the clinical success of four different types of lithium disilicate ceramic restorations: a retrospective study. BMC Oral Health. 2021 Dec 7;21(1):625. doi: 10.1186/s12903-021-01987-1.

20. Chen Y, Yeung AWK, Pow EHN, Tsoi JKH. Current status and research trends of lithium disilicate in dentistry: A bibliometric analysis. J Prosthet Dent. 2021 Oct;126(4):512-522. doi: 10.1016/j.prosdent.2020.08.012.

21. Shah K, Lawson NC, Sayed Ahmed A, Nizami B, Lawson TJ, Kee E, et al. Wear of lithium disilicate opposed by various ceramic materials. J Esthet Restor Dent. 2024 Feb;36(2):356-362. doi: 10.1111/jerd.13115.

22. Adabo GL, Longhini D, Baldochi MR, Bergamo ETP, Bonfante EA. Reliability and lifetime of lithium disilicate, 3Y-TZP, and 5Y-TZP zirconia crowns with different occlusal thicknesses. Clin Oral Investig. 2023 Jul;27(7):3827-3838. doi: 10.1007/s00784-023-05001-6.

23. Eggmann F, Orta AL, Abdulmajeed A, Att W, Beuer F, Bergler M, et al. Interdisciplinary Delphi study by PROSEC North America: Recommendations on single indirect restorations made from ceramic and nonmetallic biomaterials for posterior teeth. J Esthet Restor Dent. 2025 Mar;37(3):809-820. doi: 10.1111/jerd.13289.

24. Donmez MB, Diken Turksayar AA, Olcay EO, Sahmali SM. Fracture Resistance of Single-Unit Implant-Supported Crowns: Effects of Prosthetic Design and Restorative Material. J Prosthodont. 2022 Apr;31(4):348-355. doi: 10.1111/jopr.13415.

25. Matta RE, Eitner S, Stelzer SP, Reich S, Wichmann M, Berger L. Ten-year clinical performance of zirconia posterior fixed partial dentures. J Oral Rehabil. 2022 Jan;49(1):71-80. doi: 10.1111/joor.13276.

26. Kunrath MF, Gupta S, Lorusso F, Scarano A, Noumbissi S. Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review. Materials (Basel). 2021 May 25;14(11):2825. doi: 10.3390/ma14112825.

Downloads

Published

2025-09-29

Metrics

How to Cite

1.
Kamran A, Rana MH, Shahid A, Memon S, Ramzan MA. Evaluating Fracture Resistance of Implant-Supported Crowns Using Lithium Disilicate vs. Zirconia Restorations. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 23];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/4216

Similar Articles

1-10 of 257

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)