Clinical performance of digitally planned lithium disilicate restorations for peg-shaped maxillary lateral incisors: A 5-year retrospective study.

OBJECTIVE: To evaluate the medium-term clinical performance of digitally planned and fabricated minimally invasive lithium disilicate restorations veneered with feldspathic porcelain for the treatment of peg-shaped maxillary lateral incisors.

METHODS: This retrospective clinical study included patients presenting with unilateral or bilateral peg-shaped maxillary lateral incisors restored using digitally designed, pressed lithium disilicate copings layered with feldspathic ceramic. All restorations were fabricated following a standardized digital workflow involving intraoral scanning, computer-aided-design (CAD), and adhesive cementation. Clinical quality at delivery (T0) and outcomes at a minimum 5-year follow-up (T5) were assessed by two independent calibrated examiners using modified California Dental Association (CDA) and Ryge criteria. Primary outcomes included marginal adaptation, interproximal contacts/occlusion, color matching, and overall esthetic integration at T0. Secondary outcomes included restoration survival and clinical performance (marginal integrity, marginal discoloration, ceramic surface quality, and color stability) at T5.

RESULTS: Twenty-five patients (29 restorations) were included. At delivery, 86.2% of restorations were rated clinically acceptable (Alpha or Bravo). Four restorations were remade due to unacceptable baseline scores. At 5 years, no patients were lost to follow-up. Two restorations (6.9%) were classified as failures (one debonding and one ceramic chipping), resulting in a cumulative survival rate of 93.1%. Among the surviving restorations, 96.3% were rated clinically successful at T5, with stable marginal integrity, color stability, and surface quality.

CONCLUSIONS: Digitally planned and fabricated lithium disilicate restorations veneered with feldspathic ceramic demonstrated favorable medium-term clinical performance and high survival rates in the rehabilitation of peg-shaped maxillary lateral incisors.

CLINICAL RELEVANCE: A minimally invasive, digitally guided approach using lithium disilicate restorations represents a predictable and esthetically reliable treatment option for peg-shaped maxillary lateral incisors when appropriate case selection and standardized protocols are applied.