Naik Vishal B, Jain Ashish K, Rao Rahul D, Naik Balaram D
Department of Conservative Dentistry and Endodontics, BVDUDCH, Navi Mumbai, Maharashtra, India.
J Conserv Dent. 2022 Jul-Aug;25(4):347-355. doi: 10.4103/jcd.jcd_184_22. Epub 2022 Jul 5.
Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material knowledge has evolved, new materials have been developed, and no systematic review has answered the question posed by practitioners: Is the clinical efficacy of resin or ceramic better, for inlay, onlay, and overlay in the long run?
The aim of this systematic review and meta-analysis was to evaluate the clinical performance of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes.
Two reviewers (VN and AJ) searched PubMed, Embase, and Cochrane Central registry of controlled trials for published articles between 1983 and 2020 conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews. Only clinical studies which met the following criteria were included (1) studies regarding ceramic and resin inlays, onlays, and overlays were included; (2) randomized controlled trials, retrospective or prospective studies conducted in humans; (3) studies with a dropout rate <50% 4) studies with a follow-up higher than 5 years.
Of 1718 articles, 21 articles were selected. At 5 years, the estimated survival rates for resin ( = 129) was 86%, feldspathic porcelain ( = 1048) was 90%, and glass ceramic ( = 2218) was 92%; at 10 years, the survival of resin was 75% ( = 115), feldspathic porcelain was 91% ( = 1829), and glass ceramic was 89% ( = 1075).
The meta-regression indicated that ceramic partial coverage restorations (feldspathic porcelain and glass-ceramic) outperformed resin partial coverage restorations both at 5-year and 10-year follow-up. When compared between ceramic types, glass ceramics outperformed feldspathic porcelain at 5 years' follow-up and feldspathic porcelain outperformed glass ceramics at 10 years' follow-up. The failures were mostly due to fractures (6.2%), endodontic problems (3%), secondary caries (1.7%), and debonding which was 0.9%.
粘结技术的进步和美学需求的提高增加了牙齿颜色的部分覆盖修复的适应症。最近，材料知识不断发展，新型材料不断涌现，然而尚无系统评价回答临床医生提出的问题：从长远来看，树脂或陶瓷用于嵌体、高嵌体及覆盖体修复的临床疗效哪个更好？
本系统评价和荟萃分析的目的是评估陶瓷和树脂嵌体、高嵌体及覆盖体的临床性能，并确定与主要临床结果相关的并发症类型。
两名研究者（VN和AJ）检索了PubMed、Embase和Cochrane对照试验中心注册库，查找1983年至2020年间发表的符合系统评价和荟萃分析优先报告项目指南的文章。仅纳入符合以下标准的临床研究：（1）纳入关于陶瓷和树脂嵌体、高嵌体及覆盖体的研究；（2）在人类中进行的随机对照试验、回顾性或前瞻性研究；（3）失访率<50%的研究；（4）随访时间超过5年的研究。
在1718篇文章中，筛选出21篇。5年时，树脂（n = 129）的估计生存率为86%，长石质瓷（n = 1048）为90%，玻璃陶瓷（n = 2218）为92%；10年时，树脂的生存率为75%（n = 115），长石质瓷为91%（n = 1829），玻璃陶瓷为89%（n = 1075）。
荟萃回归表明，在5年和10年随访时，陶瓷部分覆盖修复体（长石质瓷和玻璃陶瓷）的表现优于树脂部分覆盖修复体。在不同陶瓷类型之间比较时，玻璃陶瓷在5年随访时表现优于长石质瓷，长石质瓷在10年随访时表现优于玻璃陶瓷。失败主要原因是折裂（6.2%）、牙髓问题（3%）、继发龋（1.7%）以及粘结失败（0.9%）。
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