Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
Department of Paediatric Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9994619386, e-mail:
J Contemp Dent Pract. 2023 Feb 1;24(2):129-136. doi: 10.5005/jp-journals-10024-3472.
The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications.
Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models.
The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively.
Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term.
The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.
本文进行了系统评价，旨在对计算机辅助设计/计算机辅助制造（CAD/CAM）修复体失败的原因进行描述性分析。本文进行了meta 分析，旨在估计 CAD/CAM 制作的长期生存率和成功率。
使用 PICOS 范式，在 PubMed 和 Cochrane 数据库中进行了系统检索，以确定报告 CAD/CAM 修复体生存数据的随机对照试验（RCT）和前瞻性观察研究。在选择符合预定选择标准的研究后，使用纳入的前瞻性临床研究和 RCT 中的数据进行系统评价，旨在对与 CAD/CAM 修复体失败相关的因素进行描述性分析。纳入的前瞻性临床研究的数据用于 meta 分析，其中使用泊松回归模型估计 5 年和 10 年的生存率和成功率。
系统评价纳入了 9 项 RCT 和 6 项观察性研究的数据，这些研究的中位随访时间分别为 36 个月和 60 个月。纳入的 RCT 中记录了 58 次失败和 118 次技术/生物学并发症，前瞻性临床研究中记录了 9 次失败和 58 次技术/生物学并发症。泊松回归表明，估计的 5 年和 10 年生存率分别为 85.55-100 和 71-100。估计的 5 年和 10 年成功率分别为 74.2-92.75 和 33.3-85.5。
一些技术和生物学并发症会导致 CAD/CAM 修复体失败。然而，使用常规椅旁材料的 CAD/CAM 修复体在长期内可能具有有临床意义的成功率。
本文介绍的结果表明，优化缓解生物学和技术并发症的策略可能会提高修复牙科中 CAD/CAM 制作的成功率。需要开展旨在确定此类策略的研究，以进一步提高 CAD/CAM 修复体的长期成功率。
