Prott L S, Pieralli S, Klein P, Spitznagel F A, Ibrahim F, Metzendorf M-I, Carrasco-Labra A, Blatz M B, Gierthmuehlen P C
Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Department of Preventive and Restorative Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Esthet Restor Dent. 2025 Mar;37(3):620-641. doi: 10.1111/jerd.13353. Epub 2024 Nov 19.
To determine the clinical performance of partial coverage restorations (PCR) (onlays, occlusal veneers, and partial crowns) composed of different ceramic and ceramic-based materials to treat extended posterior defects.
MEDLINE, Scopus, CENTRAL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched (inception-February 2024) for randomized controlled trials (RCT) comparing posterior PCRs composed of different ceramic and ceramic-based materials with a minimum follow-up of 1 year.
Six RCTs were included. Resin matrix ceramic (RMC) and lithium disilicate (LDS) restorations had a 3-year survival rate of 89.3% (95% CI 76.4-95.3) and 93.7% (95% CI 83.7-97.7), respectively, and leucite-reinforced glass ceramic (LRGC) restorations a range between 96.1% (95% CI 90.1-98.9) compared with RMC and 98.3% (95% CI 90.8-100) compared with LDS. After 1-3 years of follow-up, LDS slightly outperformed RMC on restoration failure and loss of retention (1.56 more failures and 1.78 more loss of retentions for RMC per 100 restoration-years [low certainty evidence]). No statistically significant differences between ceramic and ceramic-based materials were detected in short-term follow-up (1-3 years of follow-up). The long-term performance of posterior PCRs is uncertain.
The survival of LDS restorations may slightly outperform RMC restorations after 3 years of follow-up across outcomes, except for bulk fracture. RCTs providing medium to long-term data are needed.
Ceramic and ceramic-based PCRs are a reliable treatment option to restore extended posterior defects.
确定由不同陶瓷及陶瓷基材料制成的部分覆盖修复体（PCR）（嵌体、咬合贴面和部分冠）治疗后牙大面积缺损的临床性能。
检索MEDLINE、Scopus、CENTRAL、ClinicalTrials.gov和国际临床试验注册平台（起始时间至2024年2月），查找比较由不同陶瓷及陶瓷基材料制成的后牙PCR且随访至少1年的随机对照试验（RCT）。
纳入6项RCT。树脂基质陶瓷（RMC）和二硅酸锂（LDS）修复体的3年生存率分别为89.3%（95%CI 76.4 - 95.3）和93.7%（95%CI 83.7 - 97.7），白榴石增强玻璃陶瓷（LRGC）修复体与RMC相比生存率在96.1%（95%CI 90.1 - 98.9）之间，与LDS相比生存率为98.3%（95%CI 90.8 - 100）。随访1 - 3年后，LDS在修复体失败和固位丧失方面略优于RMC（每100个修复年RMC的失败例数多1.56例，固位丧失例数多1.78例[低确定性证据]）。在短期随访（1 - 3年）中，未检测到陶瓷及陶瓷基材料之间存在统计学显著差异。后牙PCR的长期性能尚不确定。
随访3年后，除大块折裂外，LDS修复体在各项指标上的生存率可能略优于RMC修复体。需要提供中长期数据的RCT。
陶瓷及陶瓷基PCR是修复后牙大面积缺损的可靠治疗选择。
