Federal University of Rio Grande do Norte (UFRN), Department of Dentistry, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
University of Zurich, Clinic for Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, Zentrum für Zahnmedizin, Plattenstrasse, 11, 8032 Zurich, Switzerland.
J Dent. 2024 Aug;147:105089. doi: 10.1016/j.jdent.2024.105089. Epub 2024 May 19.
The purpose of this systematic review and meta-analysis was to evaluate the accuracy (trueness and precision), marginal and internal adaptation, and margin quality of zirconia crowns made by additive manufacturing compared to subtractive manufacturing technology.
The investigation adhered to the PRISMA-ScR guidelines for systematic reviews and was registered at the Prospero database (n°CRD42023452927). Four electronic databases, including PubMed, Scopus, Embase, and Web of Science and manual search was conducted to find relevant studies published until September 2023. In vitro studies that assessed the trueness and precision, marginal and internal adaptation, and margin quality of printed crowns compared to milled ones were included. Studies on crowns over implants, pontics, temporary restorations, laminates, or exclusively experimental materials were excluded.
A total of 9 studies were included in the descriptive reporting and 7 for meta-analysis. The global meta-analysis of the trueness (P<0.74,I=90 %) and the margin quality (P<0.61,I=0 %) indicated no significant difference between the root mean square of printed and milled zirconia crowns. The subgroup analysis for the printing system showed a significant effect (P<0.01). The meta-analysis of the crown areas indicated no significant difference in most of the areas, except for the marginal (favoring milled crowns) and axial (favoring printed crowns) areas. For precision and adaptation, both methods showed a clinically acceptable level.
Additive manufacturing technology produces crowns with trueness and margin quality comparable to subtractive manufacturing. Both techniques have demonstrated the ability to produce crowns with precision levels, internal discrepancy, and marginal fit within clinically acceptable limits.
3D printing emerges as a promising and potentially applicable alternative method for manufacturing zirconia crowns, as it shows trueness and margin quality comparable to restorations produced by the subtractive method.
本系统评价和荟萃分析的目的是评估增材制造与减材制造技术相比制造的氧化锆冠的准确性（准确性和精密度）、边缘和内部适应性以及边缘质量。
本研究遵循 PRISMA-ScR 系统评价指南，并在 Prospero 数据库（编号 CRD42023452927）中进行了注册。我们检索了包括 PubMed、Scopus、Embase 和 Web of Science 在内的四个电子数据库，并进行了手工检索，以查找截至 2023 年 9 月发表的相关研究。本研究纳入了评估与铣削冠相比打印冠的准确性和精密度、边缘和内部适应性以及边缘质量的体外研究。排除了关于种植体、桥体、临时修复体、层压体或仅实验材料上的冠的研究。
共有 9 项研究纳入描述性报告，7 项研究纳入荟萃分析。打印和铣削氧化锆冠的真实值（P<0.74，I=90%）和边缘质量（P<0.61，I=0%）的总体荟萃分析表明，两者之间没有显著差异。打印系统的亚组分析显示出显著的效果（P<0.01）。对冠面积的荟萃分析表明，除了边缘（有利于铣削冠）和轴向（有利于打印冠）区域外，大多数区域没有显著差异。对于精密度和适应性，两种方法均表现出可接受的临床水平。
增材制造技术生产的冠具有与减材制造相当的准确性和边缘质量。两种技术都能够生产出具有精度水平、内部差异和可接受临床范围内边缘适合度的冠。
3D 打印作为制造氧化锆冠的一种有前途且潜在适用的替代方法，其准确性和边缘质量可与减法方法制造的修复体相媲美。
