CISAS "Giuseppe Colombo", University of Padua, Via Venezia, 15, Padua, 35131, Italy.
Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy.
Clin Oral Investig. 2024 Jun 25;28(7):396. doi: 10.1007/s00784-024-05772-6.
The aim of this review was to analyze mechanical and biological properties of resin materials used with subtractive or additive techniques for oral appliances fabrication and compare them to those conventionally manufactured.
The protocol was registered online at Open Science Framework (OSF) registries ( https://osf.io/h5es3 ) and the study was based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). An electronic search was conducted on MEDLINE (via PubMed), Scopus, and Web of Science from 1 February 2022 to 1 May 2022.
in vitro and in vivo studies published in the last 10 years, with CAD-CAM or 3D printed resins for occlusal splints. Data considered homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05) with Stata17 statistical software. Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I = 0%, while statistical analysis was conducted using a random-effects model with I > 0%.
13 studies were included after full-text reading. The mechanical properties most studied were wear, flexural strength, surface hardness and surface roughness, while only 1 study investigated biological properties, performing the XTT viability assay. For the meta-analysis, only surface roughness, volume loss, and flexural strength were selected. Considering surface roughness, the subtractive specimen had a lower average value compared to traditional ones (Hedge's g with 95% CI = -1.25[ -1.84, - 0.66]). No significant difference was detected in terms of volume loss (P > 0.05) between the groups (Hedge's g with 95% CI = -0.01 [-2.71, - 2.68]). While flexural strength was higher in the control group (Hedge's g with 95% CI = 2.32 [0.10-4.53]).
3D printed materials showed properties comparable to conventional resins, while milled splint materials have not shown better mechanical performance compared with conventional heat-cured acrylic resin. Polyetheretherketone (PEEK) have great potential and needs to be further investigated. Biological tests on oral cell populations are needed to confirm the long-term biocompatibility of these materials.
The use of "mixed splints" combining different materials needs to be improved and evaluated in future research to take full advantage of different characteristics and properties.
本综述旨在分析用于制作口腔矫治器的减材或增材技术中使用的树脂材料的机械和生物学性能，并将其与传统制造的材料进行比较。
该方案已在开放科学框架（OSF）注册（https://osf.io/h5es3）上注册，该研究基于系统评价和荟萃分析方案的首选报告项目（PRISMA-P）。从 2022 年 2 月 1 日至 2022 年 5 月 1 日，对 MEDLINE（通过 PubMed）、Scopus 和 Web of Science 进行了电子检索。
过去 10 年发表的关于 CAD-CAM 或 3D 打印树脂用于咬合夹板的体外和体内研究。对同质数据进行荟萃分析（95%置信区间[CI]；α=0.05），使用 Stata17 统计软件。由于所有变量均为连续变量，因此计算了 Hedge g 度量。I=0%时使用固定效应模型，I>0%时使用随机效应模型进行统计分析。
在进行全文阅读后，共有 13 项研究被纳入。最常研究的机械性能是磨损、弯曲强度、表面硬度和表面粗糙度，而只有 1 项研究研究了生物学性能，进行了 XTT 活力测定。对于荟萃分析，仅选择表面粗糙度、体积损失和弯曲强度。就表面粗糙度而言，与传统试件相比，减材试件的平均值较低（Hedge 的 g 95%CI= -1.25[-1.84，-0.66]）。两组之间的体积损失无显著差异（P>0.05）（Hedge 的 g 95%CI= -0.01[-2.71，-2.68]）。而对照组的弯曲强度较高（Hedge 的 g 95%CI= 2.32[0.10-4.53]）。
3D 打印材料表现出与传统树脂相当的性能，而铣削夹板材料的机械性能并未显示优于传统热固性丙烯酸树脂。聚醚醚酮（PEEK）具有很大的潜力，需要进一步研究。需要对口腔细胞群进行生物测试，以确认这些材料的长期生物相容性。
需要在未来的研究中改进和评估“混合夹板”，结合不同的材料，以充分利用不同的特性和性能。
