Zheng Jenny, Aarts John M, Ma Sunyoung, Waddell John Neil, Choi Joanne Jung Eun
Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
J Prosthodont. 2023 Feb;32(2):108-115. doi: 10.1111/jopr.13519. Epub 2022 Apr 28.
To perform a systematic review that provides an overview of the current literature on fatigue behavior of removable partial denture (RPD) clasp materials based on different retentive areas.
The review followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Electronic searches were done via PubMed, Scopus, and OVID for studies reporting on RPD clasps and the fatigue failure of clasp materials. Inclusion criteria were English language with full text and in vitro studies only. Exclusion criteria were studies that did not assess the fatigue of RPD clasp materials. A quality assessment and selection of full-text articles were performed according to Consolidated Standards of Reporting Trials criteria.
A total of 182 articles were initially identified and screened. After applying inclusion and exclusion criteria, 15 articles were selected for the final analysis. Seven of the included studies utilized a vertical insertion/removal testing approach. Ten studies used the constant deflection test. Three studies used untapered specimens, and 12 studies used tapered specimens. Ten studies performed post-test analysis.
Cobalt-chromium (CoCr) is the strongest material in terms of fatigue in relation to the undercut depth and the modern, digitally manufactured RPD clasp materials also exhibit comparable fatigue behavior. Recent RPD clasp materials such as polyetheretherketone (PEEK) or laser sintered CoCr, however, require further study in terms of their fatigue behavior. In order to improve the quality of future studies, a standardized and calibrated fatigue testing method is needed with standardized specimen size and shape, which will reduce the risk of bias and enable meta-analysis for bulk comparison between studies.
进行一项系统评价，概述当前关于基于不同固位区域的可摘局部义齿（RPD）卡环材料疲劳行为的文献。
本评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。通过PubMed、Scopus和OVID进行电子检索，以查找报告RPD卡环及卡环材料疲劳失效的研究。纳入标准为仅英文全文和体外研究。排除标准为未评估RPD卡环材料疲劳的研究。根据报告试验的统一标准对全文文章进行质量评估和选择。
最初共识别和筛选出182篇文章。应用纳入和排除标准后，选择了15篇文章进行最终分析。其中7项纳入研究采用垂直插入/取出测试方法。10项研究使用恒定挠度测试。3项研究使用非锥形标本，12项研究使用锥形标本。10项研究进行了测试后分析。
就与倒凹深度相关的疲劳而言，钴铬合金（CoCr）是最强的材料，现代数字化制造的RPD卡环材料也表现出类似的疲劳行为。然而，最近的RPD卡环材料，如聚醚醚酮（PEEK）或激光烧结CoCr，在其疲劳行为方面需要进一步研究。为了提高未来研究的质量，需要一种具有标准化标本尺寸和形状的标准化和校准的疲劳测试方法，这将降低偏倚风险，并能够进行Meta分析以对研究之间进行整体比较。
