Liu Xiaoyun, Cameron Andrew B, Haugli Ketil Hegerstrøm, Mougios Adriane Andersen, Heng Nicholas C K, Choi Joanne J E
Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand; School of Medicine and Dentistry, Griffith University, Gold Coast, Australia; Menzies Health Institute Queensland Disability & Rehabilitation Centre, Gold Coast, Australia.
J Dent. 2025 Oct;161:105872. doi: 10.1016/j.jdent.2025.105872. Epub 2025 Jun 5.
To systematically review studies that investigated the accuracy of dental ceramic restorations after subtractive manufacturing.
DATA/SOURCES: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines according to PRISMA, electronic searches were performed via OVID MEDLINE(R), Scopus and PubMed for articles between 2003 and 2023. The search strategy was limited to in vitro peer-reviewed publications in the English language. Studies evaluating lithium disilicate (LD) or polymer-infiltrated ceramic network (PICN) material were selected. Exclusion criteria were articles that did not assess the accuracy of subtractively-manufactured ceramic restorations.
A total of 1824 studies were initially identified. After screening titles and abstracts and assessing full-text, 53 in vitro studies satisfied the inclusion criteria and were selected for analysis. The risk of bias was assessed according to a modified Consolidated Standards of Reporting Trials (CONSORT) checklist.
Forty-five studies measured marginal and internal gaps. For LD ceramics, the marginal and internal discrepancies ranged from 12.7 μm to 200 μm and 11.41 μm to 391 μm, respectively. Manufactured PICN restorations had a marginal gap between 29.48 μm and 163.1 μm but an internal gap between 50.27 μm and 181.83 μm. Nine studies investigated accuracy. The mean trueness of LD restorations ranged from 26.5 μm to 146 μm, and PICN restorations had mean values between 32.69 μm and 83.04 μm.
The accuracy of subtractively-manufactured restorations is influenced by the type of ceramics, tooth preparation, impression digitization, digital design, machining strategy (axis number and instrument tool wear), and post-processing. Heat treatment and adjustment alter the crown fit, and crystallization enlarges the marginal gap but reduces the internal gap of LD restorations.
Multiple factors influence the quality of subtractively-manufactured ceramic restorations. This review highlights the factors that dental practitioners should consider when milling ceramic restorations for the best clinical performance.
系统评价研究减材制造后牙科陶瓷修复体精度的研究。
数据/来源：按照PRISMA的系统评价和Meta分析首选报告项目指南，通过OVID MEDLINE(R)、Scopus和PubMed对2003年至2023年期间的文章进行电子检索。检索策略限于英文的体外同行评审出版物。选择评估二硅酸锂（LD）或聚合物渗透陶瓷网络（PICN）材料的研究。排除标准为未评估减材制造陶瓷修复体精度的文章。
最初共识别出1824项研究。在筛选标题和摘要并评估全文后，53项体外研究符合纳入标准并被选入分析。根据修改后的报告试验统一标准（CONSORT）清单评估偏倚风险。
45项研究测量了边缘和内部间隙。对于LD陶瓷，边缘和内部差异分别为12.7μm至200μm和11.41μm至391μm。制造的PICN修复体边缘间隙在29.48μm至163.1μm之间，但内部间隙在50.27μm至181.83μm之间。9项研究调查了精度。LD修复体的平均准确性在26.5μm至146μm之间，PICN修复体的平均值在32.69μm至83.04μm之间。
减材制造修复体的精度受陶瓷类型、牙体预备、印模数字化、数字设计、加工策略（轴数和器械刀具磨损）以及后处理的影响。热处理和调整会改变冠的适合性，结晶会扩大LD修复体的边缘间隙但减小其内部间隙。
多种因素影响减材制造陶瓷修复体的质量。本综述强调了牙科医生在铣削陶瓷修复体以获得最佳临床性能时应考虑的因素。
