Solá-Ruíz María Fernanda, Baima-Moscardó Alejandra, Selva-Otaolaurruchi Eduardo, Montiel-Company José María, Agustín-Panadero Rubén, Fons-Badal Carla, Fernández-Estevan Lucía
Department of Dental Medicine Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag n1, 46010 Valencia, Spain.
J Clin Med. 2020 Apr 2;9(4):997. doi: 10.3390/jcm9040997.
The aim of this systematic review and meta-analysis was to determine the wear sustained in the natural antagonist tooth in cases of full-coverage fixed-base prosthetic restorations or monolithic zirconia tooth-supported crowns, as well as to determine the wear in the restoration itself, both in the short- and medium-term and considering the factors that may influence wear.
A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated wear in antagonist teeth in relation to fixed-prosthesis monolithic zirconia crowns. A total of 5 databases were consulted in the literature search: Pubmed-Medline, Cochrane, Scopus, Embase and Web of Science (WOS). After eliminating duplicated articles and applying the inclusion criteria, eight articles were selected for the qualitative analysis and four for the quantitative analysis.
Mean maximum wear of the antagonist tooth in relation to monolithic zirconia crowns of magnitude 95.45 µm (CI at 95% 79.57-111.33) was observed. By using a meta-regression model (R = 0.92) the significant effect of time in maximum wear rate ( < 0.001) was observed, estimated at 6.13 µm per month (CI at 95% 3.99-8.27). Furthermore, monolithic zirconia crowns are subject to a mean maximum wear of 58.47 µm (CI 95% 45.44-71.50). By using a meta-regression model (R = 0.53) the significant effect of time in the maximum wear value was observed ( = 0.053), estimated at 3.40 µm per month (CI al 95% -0.05-6.85).
Monolithic zirconia crowns lead to a progressive maximum wear of the antagonist tooth over time which is greater than the maximum wear sustained in the crown itself. It is not possible to establish an objective and quantitative objection in relation to natural enamel wear or metal-ceramic crowns.
本系统评价和荟萃分析的目的是确定全冠固定基修复或整体式氧化锆牙支持冠修复病例中天然对颌牙的磨损情况，以及确定修复体本身在短期和中期的磨损情况，并考虑可能影响磨损的因素。
基于系统评价和荟萃分析的首选报告项目（PRISMA）建议，对评估与固定修复整体式氧化锆冠相关的对颌牙磨损的临床研究进行系统文献回顾和荟萃分析。在文献检索中总共查阅了5个数据库：PubMed-Medline、Cochrane、Scopus、Embase和科学网（WOS）。在剔除重复文章并应用纳入标准后，选择8篇文章进行定性分析，4篇文章进行定量分析。
观察到与整体式氧化锆冠相关的对颌牙平均最大磨损量为95.45μm（95%置信区间为79.57 - 111.33）。通过使用元回归模型（R = 0.92），观察到时间对最大磨损率有显著影响（P < 0.001），估计每月为6.13μm（95%置信区间为3.99 - 8.27）。此外，整体式氧化锆冠的平均最大磨损量为58.47μm（95%置信区间为45.44 - 71.50）。通过使用元回归模型（R = 0.53），观察到时间对最大磨损值有显著影响（P = 0.053），估计每月为3.40μm（95%置信区间为 - 0.05 - 6.85）。
随着时间的推移，整体式氧化锆冠会导致对颌牙逐渐出现最大磨损，且该磨损大于冠本身的最大磨损。无法针对天然牙釉质磨损或金属烤瓷冠建立客观定量的评价标准。
