University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, Freiburgstrasse 7, 3010 Bern, Switzerland.
Dent Mater. 2022 Oct;38(10):1623-1632. doi: 10.1016/j.dental.2022.08.002. Epub 2022 Aug 26.
The goal of this systemic review and meta-analysis was to evaluate the longevity of indirect adhesively-luted ceramic compared to conventionally cemented metal single tooth restorations.
Randomized controlled trials (RCT) investigating indirect adhesively-luted ceramic restorations compared to metal or metal-based cemented restorations in permanent posterior teeth.
Three electronic databases (PubMed, CENTRAL (Cochrane) and Embase) were screened. No language or time restrictions were applied. Study selection, data extraction and quality assessment were done in duplicate. Risk of Bias and level of evidence was graded using Risk of Bias 2.0 tool and Grade Profiler 3.6.
A total of 3056 articles were found by electronic databases. Finally, four RCTs were selected. Overall, 443 restorations of which 212 were adhesively-luted ceramic restorations and 231 conventionally cemented metal restorations have been placed in 314 patients (age: 22-72 years). The highest annual failure rates were found for ceramic restorations ranging from 2.1% to 5.6%. Lower annual failure rates were found for metal (gold) restorations ranging from 0% to 2.1%. Meta-analysis could be performed for adhesively-luted ceramic vs. conventionally cemented metal restorations. Conventionally cemented metal restoration showed a significantly lower failure rate than adhesively-luted ceramic ones (visual-tactile assessment: Risk Ratio (RR)[95%CI]=0.31[0.16,0.57], low level of evidence). Furthermore, all studies showed a high risk of bias.
Conventionally cemented metal restorations revealed significantly lower failure rates compared to adhesively-luted ceramic ones, although the selected sample was small and with medium follow-up periods with high risks of bias.
本系统评价和荟萃分析的目的是评估间接黏结陶瓷的耐久性与传统黏结金属单牙修复体相比。
本研究纳入了比较间接黏结陶瓷修复体与金属或金属基底黏结修复体用于永久性后牙的随机对照试验（RCT）。
本研究筛选了三个电子数据库（PubMed、CENTRAL（Cochrane）和 Embase）。未对语言和时间进行限制。研究选择、数据提取和质量评估均由两名研究人员进行。使用风险偏倚 2.0 工具和分级报告员 3.6 对风险偏倚和证据水平进行分级。
通过电子数据库共检索到 3056 篇文章。最终，纳入了 4 项 RCT。共有 314 名患者（年龄 22-72 岁）接受了 443 个修复体的治疗，其中 212 个为间接黏结陶瓷修复体，231 个为传统黏结金属修复体。陶瓷修复体的年失败率最高，范围为 2.1%-5.6%。金属（金）修复体的年失败率较低，范围为 0%-2.1%。可对间接黏结陶瓷与传统黏结金属修复体进行荟萃分析。传统黏结金属修复体的失败率明显低于间接黏结陶瓷修复体（视觉触觉评估：风险比（RR）[95%CI]=0.31[0.16,0.57]，低水平证据）。此外，所有研究均存在高偏倚风险。
尽管样本量较小，随访时间中等，且存在高偏倚风险，但与间接黏结陶瓷修复体相比，传统黏结金属修复体的失败率明显更低。
