Universidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, São Paulo, Brasil.
Universidad de Especialidades Espíritu Santo (UEES), Samborondón, Ecuador.
J Appl Oral Sci. 2023 Aug 25;31:e20230054. doi: 10.1590/1678-7757-2023-0054. eCollection 2023.
Currently, there is no consensus on the indications and clinical performance of implant-supported overdentures (IODs) involving computer-aided design and manufacturing (CAD-CAM) bars.
To evaluate the performance of IODs involving CAD-CAM bars.
A comprehensive search of studies published until May 2023 was conducted in many databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The population, intervention, comparison, outcome (PICO) question was: "How do IODs retained by bars fabricated by CAD-CAM technology perform in daily clinical practice?" The meta-analysis included clinical studies based on effect size and a two-tailed null test with a 95% confidence interval (CI).
Ten studies were included in the meta-analysis. Among them, nine reported a 100% implant survival rate for all CAD-CAM milled bars. Complications were reported in two studies with CAD/CAM-milled titanium bars, and one study reported more fractures in soldered gold bars used in maxillary rehabilitation. However, no fractures were observed in IODs retained by PEEK and zirconia bars. According to six studies, biological complications, including peri-implantitis, were minimal in the BioHPP and PEEK bar groups, while no cases were reported in the titanium or zirconia bar groups. CAD-CAM-milled zirconia bars had higher plaque and bleeding indices compared with titanium bars, as evidenced by findings from five studies. All four studies that evaluated Oral Health Impact Profile (OHIP) scores showed a positive effect of IODs retained by CAD-CAM milled titanium bars on quality of life. Patient satisfaction and acceptance by prosthodontists were significantly high, according to the results of five studies.
Overdentures retained with CAD-CAM milled titanium bars show great potential for use in daily clinical practice. Moreover, patient and practitioner satisfaction was very high when this method was used.
评估涉及计算机辅助设计和制造 (CAD-CAM) 杆的覆盖义齿 (IOD) 的性能。
在许多数据库中进行了截至 2023 年 5 月发表的研究的全面搜索，包括 PubMed/MEDLINE、Web of Science、Cochrane 图书馆和 SciELO，遵循系统评价和荟萃分析的首选报告项目 (PRISMA)。人群、干预、比较、结果 (PICO) 问题是：“由 CAD-CAM 技术制造的杆保留的 IOD 在日常临床实践中的表现如何？”荟萃分析包括基于效应量的临床研究和双侧零假设检验，置信区间为 95%。
共有 10 项研究纳入荟萃分析。其中，有 9 项研究报告了所有 CAD-CAM 铣削杆的 100%种植体存活率。有两项研究报告了 CAD/CAM 铣削钛杆的并发症，一项研究报告了上颌修复中使用的焊接金杆骨折更多。然而，在由 PEEK 和氧化锆杆保留的 IOD 中未观察到骨折。根据六项研究，生物并发症，包括种植体周围炎，在 BioHPP 和 PEEK 杆组中最小，而在钛或氧化锆杆组中未报告。与钛杆相比，五项研究结果表明，CAD-CAM 铣削氧化锆杆的菌斑和出血指数更高。四项评估口腔健康影响概况 (OHIP) 评分的研究均表明，由 CAD-CAM 铣削钛杆保留的 IOD 对生活质量有积极影响。五项研究的结果表明，患者满意度和修复医师的接受度非常高。
由 CAD-CAM 铣削钛杆保留的覆盖义齿在日常临床实践中具有很大的应用潜力。此外，当使用这种方法时，患者和医生的满意度非常高。
