Arzani Sarah, Khorasani Erfan, Mokhlesi Aida, Azadian Shima, Ghodsi Safoura, Mosaddad Seyed Ali
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran; USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran.
Int Dent J. 2025 Jun 19;75(4):100857. doi: 10.1016/j.identj.2025.100857.
The increasing adoption of digital manufacturing in prosthodontics raises concerns about microbial metabolic activity and adhesion on denture bases fabricated via additive and subtractive methods. This systematic review aimed to compare microbial metabolic activity and microorganism adhesion between 3D-printed and milled complete denture bases. A systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library was conducted up to December 2024. Studies were screened according to predefined eligibility criteria, and data were independently extracted by two reviewers. The standardized mean difference (SMD) was used to compare microbial metabolic activity and cell adhesion outcomes between groups. A random-effects model was applied for meta-analysis, and heterogeneity was assessed using Cochran's Q, I², and τ² indices. Publication bias was evaluated using funnel plots, Egger's test, and the Trim and Fill method. The Quality Assessment Tool for In Vitro Studies (QUIN) was used to assess the risk of bias. Twelve studies met the inclusion criteria. The meta-analysis revealed that microbial activity was significantly higher in 3D-printed compared to milled denture bases (SMD = 1.285, 95% CI: 0.810-1.760, P < .001). Similarly, the microbial cell count was significantly higher in the 3D-printed group (SMD = 1.050, 95% CI: 0.124-1.976, P = .026). Surface roughness was tested as a covariate in meta-regression and was not a significant predictor of microbial activity. 3D-printed denture bases exhibited higher microbial metabolic activity and adhesion than milled counterparts. However, the heterogeneity of studies and variations in fabrication parameters necessitate further research to optimize material selection and processing protocols.
数字化制造在口腔修复学中的应用日益广泛，这引发了人们对通过增材制造和减材制造方法制作的义齿基托上微生物代谢活性和黏附情况的担忧。本系统评价旨在比较3D打印和铣削全口义齿基托之间的微生物代谢活性和微生物黏附情况。截至2024年12月，对PubMed、Scopus、Web of Science、Embase和Cochrane图书馆进行了系统检索。根据预先确定的纳入标准筛选研究，由两名 reviewers 独立提取数据。采用标准化均数差（SMD）比较组间微生物代谢活性和细胞黏附结果。采用随机效应模型进行荟萃分析，并使用Cochran's Q、I²和τ²指数评估异质性。使用漏斗图、Egger检验和Trim and Fill方法评估发表偏倚。使用体外研究质量评估工具（QUIN）评估偏倚风险。12项研究符合纳入标准。荟萃分析显示，与铣削义齿基托相比，3D打印义齿基托的微生物活性显著更高（SMD = 1.285，95% CI：0.810 - 1.760，P <.001）。同样，3D打印组的微生物细胞计数显著更高（SMD = 1.050，95% CI：0.124 - 1.976，P =.026）。在荟萃回归中，将表面粗糙度作为协变量进行了测试，它不是微生物活性的显著预测因子。3D打印义齿基托比铣削义齿基托表现出更高的微生物代谢活性和黏附性。然而，研究的异质性和制造参数的变化需要进一步研究以优化材料选择和加工方案。
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