Postgraduate student, Department of Dental Clinical Specialties, Complutense University of Madrid, Spain.
Professor, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University of Madrid, Spain.
J Prosthet Dent. 2024 Nov;132(5):899-912. doi: 10.1016/j.prosdent.2023.07.021. Epub 2023 Aug 9.
Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required.
The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction.
An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022.
The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%]).
Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear.
由于牙科中使用氧化锆相对较新，因此关于该主题的已发表研究数量很少，尽管材料选择是临床性能的一个重要因素。因此，需要对修复体材料、框架设计、饰面材料和制造工艺的影响进行系统评估。
本系统评价和荟萃分析的目的是调查长石瓷贴面氧化锆（VZir）与整体氧化锆（MZir）全桥种植体支持修复体（CAISPs）相比的存活率和成功率。次要目的是评估负载类型、有无悬臂、使用的氧化锆类型、位置和对颌弓对并发症发生率和患者满意度的影响。
对 MEDLINE 数据库（通过 PubMed）、Scopus、Science Direct、Cochrane Library 和 OpenGrey 进行了电子检索。使用系统评价和荟萃分析报告的首选报告项目中描述的标准。搜索限制在 2000 年 1 月至 2022 年 1 月。
系统搜索产生了 20 篇符合既定标准的文章。共有 751 名患者（VZir=302；MZir=449）和 3038 个 CAISPs（VZir=368；MZir=2670）符合条件。MZir CAISPs 的修复体存活率和成功率明显高于 VZir CAISPs（分别为 100%和 95.45%）。荟萃分析发现 MZir 相关并发症明显少于 VZir（9.4%[4.8%-14.1%]）。
根据本系统评价的结果，MZir CAISPs 的存活率和成功率高于 VZir CAISPs，修复体并发症明显较少。功能负载类型、悬臂存在、修复体工作流程中使用的材料、CAISP 位置以及对颌弓类型等因素对 Zir CAISPs 性能的影响尚不清楚。
