Flores-Ferreyra Blanca I, Argueta-Figueroa Liliana, Torres-Rosas Rafael, Carrasco-Gutiérrez Rosendo G, Casillas-Santana Miguel A, de Los Angeles Moyaho-Bernal Maria
CONAHCYT Postdoctorant, School of Stomatology, Meritorious Autonomous University of Puebla, Puebla, Mexico.
School of Dentistry, Autonomous University of Mexico State, Av. Paseo Tollocan, Colonia Universidad, Toluca, Mexico, Mexico.
J Prosthodont Res. 2025 Apr 14;69(2):153-162. doi: 10.2186/jpr.JPR_D_23_00263. Epub 2024 Jun 26.
Fixed restorations and dental enamel have different structures that produce different wear on opposing teeth, resulting in clinical problems. Therefore, it is necessary to determine the type of restoration that causes less wear on naturally opposing teeth to make recommendations. The objective of this study was to systematically analyze the evidence from observational studies and clinical trials on enamel wear in different ceramic restorations.
The designs of the included studies were randomized clinical trials (RTCs), non-randomized clinical trials (non-RTCs), and observational studies (OS). The studies must answer the research question, be available in full text, be written in English or Spanish, and have had at least six months of follow-up. Protocol number: CRD42023397759.
After screening 499 records, 20 RTCs were subjected to data extraction, 10 were excluded, 10 were included in the systematic review, and only 5 were included in the network meta-analysis. The risk of bias assessment reported moderate to high risk of bias, quality, and certainty of evidence was evaluated and rated as moderate. Network meta-analysis showed higher enamel wear was observed in natural dental enamel against metal-ceramic antagonists.
Enamel wear occurs in all teeth, even when the antagonist is a natural tooth. The wear is larger on surfaces with the ceramic crown antagonists studied (metal-ceramic, glazed zirconia, and polished zirconia). It is necessary to conduct additional clinical trials with larger follow-up periods and sample sizes.
固定修复体和牙釉质具有不同的结构，会对相对的牙齿产生不同程度的磨损，从而引发临床问题。因此，有必要确定对天然相对牙齿磨损较小的修复体类型，以便给出建议。本研究的目的是系统分析观察性研究和临床试验中关于不同陶瓷修复体牙釉质磨损的证据。
纳入研究的设计类型为随机临床试验（RTC）、非随机临床试验（非RTC）和观察性研究（OS）。这些研究必须回答研究问题，有全文可供获取，以英文或西班牙文撰写，并且随访时间至少为六个月。方案编号：CRD42023397759。
在筛选499条记录后，对20项RTC进行了数据提取，排除了10项，10项纳入系统评价，仅5项纳入网状Meta分析。偏倚风险评估显示存在中度至高度偏倚风险，对证据质量和确定性进行了评估并评为中度。网状Meta分析表明，天然牙釉质相对于金属陶瓷对抗牙会观察到更高的牙釉质磨损。
所有牙齿都会发生牙釉质磨损，即使对抗牙是天然牙。在所研究的陶瓷冠对抗牙（金属陶瓷、釉面氧化锆和抛光氧化锆）表面的磨损更大。有必要开展随访期更长、样本量更大的额外临床试验。
