Department of Conservative Dentistry, Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Department of Preventive and Social Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
J Prosthodont Res. 2019 Oct;63(4):389-395. doi: 10.1016/j.jpor.2018.11.006. Epub 2019 Jul 11.
This systematic review and meta-analysis aimed to evaluate the difference in longevity of tooth-supported ceramic prostheses designed by conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques.
Two reviewers searched the Web of Science, PubMed, SCOPUS and LILACS databases between 1966 and October 2017. Clinical studies that compared the survival rate of CAD/CAM against conventional restorations were included.
Eleven randomized controlled trials and three prospective studies were included, n=14. Three types of tooth-supported restorations were searched in the included studies: single crown, multiple-unit and partial ceramic crown. The follow-up of patients in the studies ranged from 24 to 84 months. A total of 1209 restorations had been placed in 957 patients in the included trials, and failures were analyzed by type and material restoration. From a total of 72 restoration failures, the CAD/CAM system resulted in a 1.84 (IC95%: 1.28-2.63) higher risk than conventional manufacturing of ceramic restoration. Nevertheless, when drop-outs were included as a failure risk, the CAD/CAM system resulted in a risk of 1.32 (IC95%: 1.10-1.58). Multilevel analysis of tooth-supported ceramic restorations, considering drop-outs as successes, resulted in rates of 1.48 and 2.62 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively. Considering drop-outs as failures, we found rates of 4.23 and 5.88 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively.
The meta-analysis results suggest that the longevity of a tooth-supported ceramic prostheses made by CAD/CAM manufacturing is lower than that of crowns mad by the conventional technique.
本系统评价和荟萃分析旨在评估传统设计和计算机辅助设计/计算机辅助制造（CAD/CAM）技术设计的牙支持陶瓷修复体的长寿率差异。
两位评审员于 1966 年至 2017 年 10 月期间在 Web of Science、PubMed、SCOPUS 和 LILACS 数据库中进行了搜索。纳入了比较 CAD/CAM 与传统修复体存活率的临床研究。
共纳入 11 项随机对照试验和 3 项前瞻性研究，n=14。纳入研究中搜索了三种牙支持修复体：单冠、多单位和部分陶瓷冠。研究中患者的随访时间从 24 个月到 84 个月不等。纳入试验中共有 1209 个修复体被放置在 957 名患者中，根据修复类型和材料对失败情况进行了分析。在总共 72 个修复失败中，CAD/CAM 系统导致陶瓷修复体的失败风险比传统制造高 1.84（95%CI：1.28-2.63）。然而，当将脱落作为失败风险包括在内时，CAD/CAM 系统导致的风险为 1.32（95%CI：1.10-1.58）。考虑脱落作为成功因素，对牙支持陶瓷修复体进行多层次分析，对照组和 CAD/CAM 组的每 100 个修复年的失败率分别为 1.48 和 2.62。将脱落视为失败时，对照组和 CAD/CAM 组的每 100 个修复年的失败率分别为 4.23 和 5.88。
荟萃分析结果表明，CAD/CAM 制造的牙支持陶瓷修复体的耐用性低于传统技术制造的牙冠。
