Postgraduate student, Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil.
Postgraduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil.
J Prosthet Dent. 2024 Nov;132(5):879.e1-879.e13. doi: 10.1016/j.prosdent.2024.05.007. Epub 2024 Jun 6.
Knowledge on the biomechanical behavior of glass-ceramics, their survival rate over time, and their potential failures is essential for decision-making in clinical practice. Systematic reviews and meta-analysis of their survival rates and irreparable failures are lacking.
The purpose of this systematic review and meta-analysis was to evaluate the survival rates and irreparable failures of various monolithic glass-ceramic dental restorations to help determine biomechanical indications.
A comprehensive literature search was conducted across the PubMed, Scopus, Web of Science, and EMBASE databases based on the population, intervention, comparison, and outcome (PICO) question, risk of bias assessment, data extraction, subgroup analysis, and meta-analysis. Both randomized and nonrandomized clinical trials that reported survival rate and irreparable failure were screened. The risk, with a 95% confidence interval, was calculated by using the Mantel-Haenszel method.
A total of 46 articles met the inclusion criteria: 8 for laminate veneers, 20 for partial coverage restorations, 11 for single crowns, and 6 for fixed partial dentures, encompassing 1715 participants rehabilitated with 4209 restorations. The estimated cumulative survival rate for partial coverage restorations was 90% over an average span of 6.2 years, with an irreparable failure occurrence of n=5.9. Laminate veneers had a survival rate of 90.2% over 6.5 years, with an irreparable failure occurrence of n=8.2. Single crowns had a survival rate of 96% over 4.6 years and an irreparable failure of n=2.7. Conversely, fixed partial dentures had a survival rate of 76.1% over 6.5 years with an irreparable failure of n=5.2.
Glass-ceramic materials demonstrate relatively high survival rates, indicating that they provide a safe and reliable option for partial coverage restorations, laminate veneers, and single crowns. However, fixed partial dentures had a higher proportion of irreparable failures and a lower survival rate, and caution is required.
了解玻璃陶瓷的生物力学行为、其随时间的存活率以及潜在的失效模式对于临床实践中的决策至关重要。目前缺乏对其存活率和不可修复性失败的系统评价和荟萃分析。
本系统评价和荟萃分析的目的是评估各种整体式玻璃陶瓷牙科修复体的存活率和不可修复性失败，以帮助确定生物力学适应证。
根据人群、干预、比较和结局（PICO）问题，对 PubMed、Scopus、Web of Science 和 EMBASE 数据库进行全面的文献检索，采用偏倚风险评估、数据提取、亚组分析和荟萃分析进行评估。筛选出报告存活率和不可修复性失败的随机和非随机临床试验。采用 Mantel-Haenszel 方法计算风险，置信区间为 95%。
共有 46 篇文章符合纳入标准：8 篇为层压贴面，20 篇为部分覆盖修复体，11 篇为单冠，6 篇为固定局部义齿，共纳入 1715 名患者，修复体 4209 个。平均随访 6.2 年，部分覆盖修复体的累积存活率估计为 90%，不可修复性失败发生率为 n=5.9。层压贴面 6.5 年的存活率为 90.2%，不可修复性失败发生率为 n=8.2。单冠 4.6 年的存活率为 96%，不可修复性失败发生率为 n=2.7。相反，固定局部义齿 6.5 年的存活率为 76.1%，不可修复性失败发生率为 n=5.2。
玻璃陶瓷材料具有较高的存活率，表明它们是部分覆盖修复体、层压贴面和单冠的安全可靠选择。然而，固定局部义齿的不可修复性失败比例较高，存活率较低，需要谨慎使用。
