Analysis of Different Lithium Disilicate Ceramics According to Their Composition and Processing Technique—A Systematic Review and Meta-Analysis

Abstract

Lithium disilicate ceramics (LDSs) are widely used in restorative dentistry for their excellent aesthetic and mechanical properties. Variants like zirconia-reinforced lithium silicate (ZLS) and advanced lithium disilicate (ALD) were developed to enhance these characteristics. However, differences in their physical and optical properties, as well as the influence of processing techniques (heat pressing vs. CAD-CAM), remain unclear. This study aimed to evaluate the physical and aesthetic properties of LDS, ZLS, and ALD ceramics. A systematic review and meta-analysis following PRISMA guidelines were conducted. Studies published in the last ten years were retrieved from PubMed, Web of Science, Scopus, Cochrane, and Scielo. The inclusion criteria encompassed in vitro studies analyzing LDS, ZLS, and ALD ceramics with quantitative data on mechanical and aesthetic properties. Meta-analyses were performed using a random-effects model, with subgroup analyses based on ceramic type and processing technique. Twenty-two studies met the inclusion criteria. Meta-analyses showed significant differences in flexural strength, hardness, surface roughness, wear, and translucency. The processing technique influenced these properties, with CAD-CAM materials exhibiting distinct performance compared to heat-pressed ceramics. Publication bias was assessed using Egger’s test and the Trim and Fill method, and heterogeneity via meta-regression. LDS showed the highest fracture resistance and least wear, while ALD had greater roughness depth. Heat pressing enhanced hardness and reduced roughness, whereas CAD-CAM improved flexural strength. Considering these findings and study limitations, LDS appears the most suitable option for clinical use due to its superior mechanical performance.