Tsirogiannis Panagiotis, Reissmann Daniel R, Heydecke Guido
Postgraduate student, Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Associate Professor, Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Prosthet Dent. 2016 Sep;116(3):328-335.e2. doi: 10.1016/j.prosdent.2016.01.028. Epub 2016 Apr 7.
In existing published reports, some studies indicate the superiority of digital impression systems in terms of the marginal accuracy of ceramic restorations, whereas others show that the conventional method provides restorations with better marginal fit than fully digital fabrication. Which impression method provides the lowest mean values for marginal adaptation is inconclusive. The findings from those studies cannot be easily generalized, and in vivo studies that could provide valid and meaningful information are limited in the existing publications.
The purpose of this study was to systematically review existing reports and evaluate the marginal fit of ceramic single-tooth restorations after either digital or conventional impression methods by combining the available evidence in a meta-analysis.
The search strategy for this systematic review of the publications was based on a Population, Intervention, Comparison, and Outcome (PICO) framework. For the statistical analysis, the mean marginal fit values of each study were extracted and categorized according to the impression method to calculate the mean value, together with the 95% confidence intervals (CI) of each category, and to evaluate the impact of each impression method on the marginal adaptation by comparing digital and conventional techniques separately for in vitro and in vivo studies.
Twelve studies were included in the meta-analysis from the 63 identified records after database searching. For the in vitro studies, where ceramic restorations were fabricated after conventional impressions, the mean value of the marginal fit was 58.9 μm (95% CI: 41.1-76.7 μm), whereas after digital impressions, it was 63.3 μm (95% CI: 50.5-76.0 μm). In the in vivo studies, the mean marginal discrepancy of the restorations after digital impressions was 56.1 μm (95% CI: 46.3-65.8 μm), whereas after conventional impressions, it was 79.2 μm (95% CI: 59.6-98.9 μm)
No significant difference was observed regarding the marginal discrepancy of single-unit ceramic restorations fabricated after digital or conventional impressions.
在现有的已发表报告中,一些研究表明数字印模系统在陶瓷修复体的边缘精度方面具有优势,而另一些研究则表明传统方法提供的修复体边缘适合性优于全数字制作。哪种印模方法能提供最低的边缘适应性平均值尚无定论。这些研究的结果不易推广,并且现有出版物中能够提供有效和有意义信息的体内研究有限。
本研究的目的是系统回顾现有报告,并通过荟萃分析结合现有证据,评估数字或传统印模方法后陶瓷单颗牙修复体的边缘适合性。
本系统评价出版物的检索策略基于人群、干预、对照和结局(PICO)框架。对于统计分析,提取每项研究的平均边缘适合性值,并根据印模方法进行分类,以计算平均值以及每类的95%置信区间(CI),并通过分别比较体外和体内研究中的数字技术和传统技术来评估每种印模方法对边缘适应性的影响。
在数据库检索后的63条已识别记录中,有12项研究纳入了荟萃分析。对于体外研究,传统印模后制作陶瓷修复体,边缘适合性的平均值为58.9μm(9