Shadid Rola Muhammed
American Board of Oral Implantology; Faculty of Dentistry, Arab American University, Jenin, Palestine.
Private Practice, Jenin, Palestine.
Clin Cosmet Investig Dent. 2025 Mar 26;17:181-200. doi: 10.2147/CCIDE.S510760. eCollection 2025.
The rapid advancement of digital technologies and the introduction of new ceramic materials have largely attributed to the notable transition from metal-ceramic to all-ceramic implant restorations bonded to Ti-bases. The purpose of this review was to evaluate all clinical studies reporting on the bond stability between CAD-CAM implant-supported all-ceramic restorations and Ti-bases. The review was directed according to the PRISMA guidelines to answer the focused question "How much is the stability and durability of the resin bond between implant-supported fixed CAD-CAM ceramic restorations and Ti- bases clinically?". The PubMed, Google Scholar, and Cochrane databases were investigated to identify related clinical studies. Human studies assessing at least 10 patients restored with implant-supported fixed CAD-CAM ceramic restorations luted to prefabricated Ti-bases with a mean follow-up of at least 1 year and published in an English-language up to Sep. 2024 were included. The restorations could be single crown, fixed dental prosthesis, or full-arch fixed prosthesis. The search yielded 5,190 records; of these, 59 full-text articles were evaluated based on eligibility criteria. Ultimately, 40 studies were included. All 40 studies demonstrated low debonding rates from Ti-bases for single copings, multi-unit fixed dental prostheses, and full arch zirconia prostheses. Based on the limited evidence available, different factors were blamed for the debonding incidence, such as Ti-base height, geometry, luting agent, inadequacy of passive fit and biomechanical patient- and prosthesis-related factors. CAD-CAM implant-supported all-ceramic restorations bonded to Ti-bases demonstrated relatively high bond stability during observation period ranging from 1 to 7.5 years. More well-designed clinical research with long-term observation periods is highly recommended.
数字技术的迅速发展和新型陶瓷材料的引入在很大程度上促成了从金属陶瓷到粘结于钛基上的全陶瓷种植体修复体的显著转变。本综述的目的是评估所有报告CAD-CAM种植体支持的全陶瓷修复体与钛基之间粘结稳定性的临床研究。该综述按照PRISMA指南进行，以回答聚焦问题“种植体支持的固定CAD-CAM陶瓷修复体与钛基之间树脂粘结的稳定性和耐久性在临床上如何？”。对PubMed、谷歌学术和Cochrane数据库进行了检索，以确定相关临床研究。纳入了评估至少10例接受种植体支持的固定CAD-CAM陶瓷修复体修复的患者的人体研究，这些修复体粘结于预制钛基上，平均随访至少1年，且截至2024年9月以英文发表。修复体可以是单冠、固定义齿或全牙弓固定修复体。检索共获得5190条记录；其中，根据纳入标准评估了59篇全文文章。最终，纳入了40项研究。所有40项研究均表明，单冠、多单位固定义齿和全牙弓氧化锆修复体与钛基的脱粘率较低。基于现有有限证据，脱粘发生率归因于不同因素，如钛基高度、几何形状、粘结剂、被动适合度不足以及与患者和修复体相关的生物力学因素。在1至7.5年的观察期内，粘结于钛基上的CAD-CAM种植体支持的全陶瓷修复体显示出相对较高的粘结稳定性。强烈建议开展更多设计良好、观察期长的临床研究。
