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Journal of Personalized Medicine Feb 2024No systematic review or meta-analysis has been identified that provides a clinician's perspective on the shade selection process for ceramic restorations. The aim of the... (Review)
Review
BACKGROUND
No systematic review or meta-analysis has been identified that provides a clinician's perspective on the shade selection process for ceramic restorations. The aim of the present systematic review is to find and systematize the available knowledge by referring to the methods to assess the color of dental ceramics.
METHODS
The final search was performed on 10 December 2023 in six search engines. The keywords used in the search strategy were as follows: ("color matching" OR "shade matching" OR "color measurement" AND "porcelain" OR "dental ceramics") AND "dentistry" AND "accuracy".
RESULTS
The search strategy identified 139 potential articles. After the screening process, sixteen articles were included in the review.
CONCLUSIONS
In conclusion, the most common method, the visual method, has lower accuracy and repeatability. Devices like spectrophotometers and colorimeters provide precise, repeatable, and objective measurements, but fail to be widely applied in everyday clinical practice. Clinicians should not rely solely on their senses for shade determination, but should turn to quantitative methods. Colorimetric devices connected to mobile applications are an interesting and useful tool. Software and apps based on artificial intelligence are emerging as promising tools, but they require further research.
PubMed: 38540994
DOI: 10.3390/jpm14030252 -
Dental Materials : Official Publication... Mar 2024Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed... (Review)
Review
OBJECTIVES
Nonthermal atmospheric or low-pressure plasma (NTP) can improve the surface characteristics of dental materials without affecting their bulk properties. This study aimed to systematically review the available scientific evidence on the effectiveness of using NTP for the surface treatment of etchable, silica-based dental ceramics before cementation, and elucidate its potential to replace the hazardous and technically demanding protocol of hydrofluoric acid (HF) etching.
METHODS
A valid search query was developed with the help of PubMed's Medical Subject Headings (MeSH) vocabulary thesaurus and translated to three electronic databases: PubMed, Web of Science, and Scopus. The methodological quality of the studies was assessed according to an adapted version of the Methodological Index for Non-Randomized Studies (MINORS).
RESULTS
Thirteen in vitro study reports published between 2008 and 2023 were selected for the qualitative and quantitative data synthesis. The implemented methodologies were diverse, comprising 19 different plasma treatment protocols with various device settings. Argon, helium, oxygen, or atmospheric air plasma may significantly increase the wettability and roughness of silicate ceramics by plasma cleaning, etching, and activation, but the treatment generally results in inferior bond strength values after cementation compared to those achieved with HF etching. The technically demanding protocol of plasma-enhanced chemical vapor deposition was employed more commonly, in which the surface deposition of hexamethyl disiloxane with subsequent oxygen plasma activation proved the most promising, yielding bond strengths comparable to those of the positive control. Lack of power analysis, missing adequate control, absence of examiner blinding, and non-performance of specimen aging were common methodological frailties that contributed most to the increase in bias risk (mean MINORS score 15.3 ± 1.1).
SIGNIFICANCE
NTP can potentially improve the adhesive surface characteristics of dental silicate ceramics in laboratory conditions, but the conventional protocol of HF etching still performs better in terms of the resin-ceramic bond strength and longevity. More preclinical research is needed to determine the optimal NTP treatment settings and assess the aging of plasma-treated ceramic surfaces in atmospheric conditions.
Topics: Dental Porcelain; Dental Bonding; Surface Properties; Resin Cements; Ceramics; Silicates; Oxygen; Materials Testing; Hydrofluoric Acid; Silanes
PubMed: 38281846
DOI: 10.1016/j.dental.2024.01.001 -
Journal of Clinical and Experimental... Mar 2024The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane... (Review)
Review
BACKGROUND
The aim of this systematic review is to determine the effectiveness of self-etching primers in comparison to the conventional protocol with hydrofluoric acid and silane treatment for bonding lithium disilicate ceramics.
MATERIAL AND METHODS
The formulated PICO question for this research was: "Does self-etching silane primer surface treatment in lithium disilicate ceramics present a similar bond strength value compared to conventional hydrofluoric acid and silane treatment?". Combinations of words and appropriate truncations were adapted for each database. For the selection, duplicate articles were systematically eliminated using Mendeley software. The Cohen's Kappa statistic was then computed, RoBDEMAT questions were addressed, and the meta-analyses were conducted using RevMan 5.4, at a significance level of 5%.
RESULTS
Two independent reviewers conducted a blind and independent analysis of 190219 articles from PubMed, Scopus, Web of Science, and OpenGrey. Subsequently, they extracted data from 21 studies for the systematic review and in 16 the meta-analysis. In all in vitro studies, the most frequently cited concentration of hydrofluoric acid was 5%. In the meta-analysis, no statistical differences were observed between the two treatments concerning bond strength.
CONCLUSIONS
Self-etching silane primers demonstrate promising results in lithium disilicate bonding, suggesting their potential as an alternative surface treatment to hydrofluoric acids + silane. Lithium disilicate, Hydrofluoric acid, Dental Porcelain, Ceramics, Silanes.
PubMed: 38600931
DOI: 10.4317/jced.61369 -
The Journal of Prosthetic Dentistry Jun 2024Computer-aided design and computer-aided manufacturing (CAD-CAM) blocks have evolved rapidly, making it difficult to establish the best clinical protocol for bonding a... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Computer-aided design and computer-aided manufacturing (CAD-CAM) blocks have evolved rapidly, making it difficult to establish the best clinical protocol for bonding a given block and whether an established protocol is appropriate for a newly introduced product.
PURPOSE
This integrative systematic review and meta-analysis aimed to clarify whether the clinician can select the most efficient adhesion protocols for CAD-CAM blocks by reading published in vitro studies and implementing them in daily practice.
MATERIAL AND METHODS
Based on the population, intervention, comparison, and outcome (PICO) strategy, 3 databases were searched for in vitro studies, randomized clinical trials, prospective or retrospective studies, and case reports from January 1, 2015, to July 31, 2021. A meta-analysis analyzed 28 studies to calculate the mean difference between best and worst protocols for each author and block with a random-effects model (α=.05).
RESULTS
From 508 relevant studies, 37 in vitro studies, 2 clinical studies, and 1 clinical report were selected for data extraction and qualitative analysis. Vita Enamic, IPS e.max CAD, LAVA Ultimate, and Vita Mark II blocks were the most studied, and RelyX Ultimate was the most used luting cement. The meta-analysis confirmed the null hypothesis that the evidence-based efficacy of clinical protocols to bond CAD-CAM blocks is still controversial (P<.05).
CONCLUSIONS
There are objective standards for individual in vitro tests, but the studies lack standardization. Some tested protocols were more efficient than others. Randomized clinical trials and well-documented clinical situations were almost nonexistent, making direct application of in vitro findings in clinical practice impossible.
Topics: Computer-Aided Design; Humans; Dental Bonding; Clinical Protocols; Dental Porcelain; In Vitro Techniques; Ceramics
PubMed: 36543700
DOI: 10.1016/j.prosdent.2022.08.024 -
Journal of Prosthodontic Research Jan 2024This study performed a systematic review to assess the biomechanical behavior of all-ceramic endowcrowns fabricated using computer-aided design and computer-aided...
PURPOSE
This study performed a systematic review to assess the biomechanical behavior of all-ceramic endowcrowns fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM) for the restoration of endodontically treated teeth.
STUDY SELECTION
Three electronic databases (PubMed, Web of Science, and Scopus) were searched by operators specializing in health sciences databases searches to answer the following focused question based on the Population, Intervention, Comparison, Outcome (PICO) format: "Whether all-ceramic CAD/CAM endocrowns (Intervention) used to restore human endodontically treated teeth (Population) exhibit superior fracture resistance (Outcome) compared to non-CAD/CAM all-ceramic or non-ceramic endocrowns (Comparison)." The methodological quality assessment was performed using previously conducted systematic reviews of in vitro studies. The outcomes were expressed as the mean ± the standard deviation (SD).
RESULTS
Seventeen in vitro studies were included. The materials used in these studies were lithium disilicate glass-ceramic, polymer-infiltrated ceramic, zirconia-reinforced lithium silicate glass-ceramic, resin/hybrid nanoceramics, zirconia-reinforced lithium silicate ceramics, and feldspathic ceramic. The fracture resistance of endocrowns using different ceramics varied as follows: (i) IPS e.max CAD (2863.62 ± 51.47 N), (ii) Vita Enamic (1952 ± 378 N), (iii) Vita Suprinity (1859 ± 588 N), (iv) Cerasmart (1981 ± 169.5 N), (v) LAVA Ultimate (2484 ± 464 N), (vi) Celtra Duo (1618.30 ± 585.00 N), and (vii) Cerec Blocs (236.29 ± 32.12 N).
CONCLUSIONS
CAD/CAM all-ceramic endocrowns can withstand occlusal forces in the posterior region. All-ceramic endocrowns improve the fracture strength of endodontically treated teeth. Lithium disilicate crowns were commonly and successfully used in the included studies. More in vitro investigations that implement uniformity in material and measurement approaches are required to strengthen the evidence currently available in the literature regarding the durability of all-ceramic endocrowns.
Topics: Humans; Ceramics; Computer-Aided Design; Crowns; Dental Porcelain; Lithium; Materials Testing; Silicates; Tooth, Nonvital; Zirconium
PubMed: 37286503
DOI: 10.2186/jpr.JPR_D_22_00296 -
Journal of Esthetic and Restorative... Nov 2019To evaluate the survival rate of ceramic and indirect composite inlays, onlays, and overlays manufactured according to different methods (CAD/CAM, pressable, and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the survival rate of ceramic and indirect composite inlays, onlays, and overlays manufactured according to different methods (CAD/CAM, pressable, and stratified). MEDLINE, EMBASE, and Cochrane Library databases were searched for published articles. Risk of bias, data extraction, subgroup analysis, meta-analysis, and GRADE was performed.
MATERIALS AND METHODS
Prospective, retrospective, or RCT studies, without restriction of language, from 1983 to 2019, with follow-up ≥5 years, reporting survival rates were screened independently by two reviewers in accordance with eligibility criteria.
RESULTS
A total of 13 articles (12 for ceramic, one for indirect composite) met the inclusion criteria. No articles were included regarding crystalline ceramic. The estimated cumulative survival rate for CAD/CAM was 97% after 5 years and 89% after 10 years; for pressable was 95% after 5 years, and for stratified was 88% after 5 years and 93% after 10 years.
CONCLUSIONS
Regardless of the manufacturing method, vitreous ceramic inlays, onlays, and overlays showed high survival, providing evidence that these restorations are a safe treatment.
CLINICAL RELEVANCE
Vitreous ceramic inlays, onlays, and overlays showed high survival, regardless of the manufacturing method, providing evidence that these restorations are a safe treatment.
Topics: Ceramics; Composite Resins; Dental Porcelain; Dental Restoration Failure; Prospective Studies; Retrospective Studies; Survival Rate
PubMed: 31840412
DOI: 10.1111/jerd.12555 -
Journal of Prosthodontic Research Oct 2022This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium... (Meta-Analysis)
Meta-Analysis
PURPOSE
This study systematically reviewed the literature to compare the bond strength of resin composites with that of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD).
STUDY SELECTION
This review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement. This study was registered at the International Prospective Register of Systematic Reviews (CRD42021256900). Studies were searched via PubMed, Web of Science, and Google Scholar databases without language or publication year limits. In vitro studies that evaluated the bond strength of the resin composites to ZLS and LD were included. The risk of bias in all the included articles was evaluated. Statistical analyses were performed using the Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK).
RESULTS
Of the 90 potentially related articles, the full texts of 16 articles were evaluated after screening. Finally, seven studies were included in the qualitative synthesis and meta-analysis. All the studies presented a medium risk of bias. The results showed no significant difference in bond strength between the ZLS and LD groups (P = 0.94, mean difference=0.08, and 95% confidence interval=-1.93 to 2.10). However, a significant difference was found in the subgroup analysis considering different types of aging treatments (P = 0.0008) and different types of bond strength tests (P < 0.00001).
CONCLUSION
The bond strength of resin composites was found to be similar to that of ZLS and LD, but different aging treatments and bond strength tests exhibited varying effects on the bond strength.
Topics: Ceramics; Composite Resins; Dental Porcelain; Dental Stress Analysis; Lithium; Materials Testing; Resin Cements; Silicates; Surface Properties; Zirconium
PubMed: 34853237
DOI: 10.2186/jpr.JPR_D_20_00112 -
Dental and Medical Problems 2020The use of ceramic materials and the computer-aided design/computer-aided manufacturing (CAD/CAM) technology for the fabrication of complete-coverage restorations has...
The use of ceramic materials and the computer-aided design/computer-aided manufacturing (CAD/CAM) technology for the fabrication of complete-coverage restorations has significantly increased in the last decade. The aim of this study was to evaluate the survival rate of anterior and posterior monolithic and bilayered lithium disilicate glass-ceramic (LDGC) CAD/CAM crowns, and to identify the types of complications associated with the main clinical outcomes reported in clinical trials. MEDLINE/PubMed, Embase, Scopus, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched by 2 independent reviewers for clinical studies published between 2006 and 2019, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The electronic search was supplemented by a hand search. Quality assessment for the included studies was performed. Qualitative and quantitative data was extracted from each study. Out of 219 studies, 6 studies that evaluated LDGC CAD/CAM crowns were identified and used for data extraction. The included studies had 154 participants, who received 204 crowns. The shortto medium-term survival and success rates were high. Biological complications occurred more frequently than technical complications. No esthetic complications were reported. This review indicated that the medium-term survival rate of LDGC CAD/CAM crowns was high. Further multicenter studies with longer follow-ups and larger sample sizes are needed in order to augment the data already in existence.
Topics: Ceramics; Computer-Aided Design; Crowns; Dental Porcelain; Dental Prosthesis Design; Esthetics, Dental; Humans
PubMed: 32673449
DOI: 10.17219/dmp/115522 -
Medical Science Monitor : International... Dec 2023This systematic review aimed to identify and analyze in vitro studies on the marginal adaptation values of computer-aided-design/computer-aided-manufacturing (CAD/CAM)...
A Comparative Analysis of Marginal Adaptation Values between Lithium Disilicate Glass Ceramics and Zirconia-Reinforced Lithium Silicate Endocrowns: A Systematic Review of In Vitro Studies.
This systematic review aimed to identify and analyze in vitro studies on the marginal adaptation values of computer-aided-design/computer-aided-manufacturing (CAD/CAM) and heat-pressed lithium disilicate glass ceramics and zirconia-reinforced lithium silicates and endocrown restorations. A full literature search was conducted in Web of Science, PubMed/Medline, EMBASE, Scopus, Cochrane Library, Google Scholar, and ProQuest electronic databases. The following keywords: endocrown [(marginal adaption) or (marginal fit) or internal fitting)], endocrown [(molar(s)) or (premolar(s) or (posterior teeth) or (maxillary arch) or (mandibular arch)] and ceramic materials as [(lithium disilicate glass ceramic CAD/CAM) or (zirconia) or (heat-press)] were used. Articles were manually searched utilizing their reference lists. Study selection was restricted or limited to the time of publication but not to the type of tested teeth or ceramic material, endocrown design, system of endocrown construction, abutment scanning, and system of the marginal adaption measurement. A total of 17 in vitro studies published between 2016 and 2023 were included in this systemic review. Less than half of the studies were published during 2023. Most studies used lithium disilicate glass ceramic and zirconia-reinforced lithium silicate all-ceramic materials by CAD/CAM or heat-press systems. Marginal adaptation, or marginal gap, was almost equal in the 2 materials, while it was slightly or marginally higher in the heat-press than in the CAD/CAM system. All-ceramic lithium disilicate glass ceramic and/or zirconia endocrowns fabricated for posterior teeth in both arches using CAD/CAM or heat-press had recorded marginal adaptation values within an acceptable range.
Topics: Lithium; Materials Testing; Ceramics; Dental Porcelain; Silicates; Dental Prosthesis Design
PubMed: 38148601
DOI: 10.12659/MSM.942649 -
Journal of Indian Prosthodontic Society 2023In the present era when interest in digital dentistry is increasing, the published literature is still confusing about whether digital impression provides similar... (Meta-Analysis)
Meta-Analysis
In the present era when interest in digital dentistry is increasing, the published literature is still confusing about whether digital impression provides similar accuracy as provided by a conventional impression for the fabrication of a single-unit ceramic crown. The aim of the study was to systematically review the in vivo studies comparing marginal, axial, and occlusal fit of single-unit ceramic crowns fabricated after digital impressions with the ones fabricated after conventional impressions. The PubMed, Scopus, and Cochrane online databases were searched for studies comparing the digital impression technique with the conventional technique for single-unit ceramic crowns. Data extraction was done for the year of publication, type of study, country, number of patients, impression system (intraoral scanner [IOS] or conventional impression), marginal fit, axial fit, and occlusal fit. Ten studies were included for meta-analysis regarding the discrepancy in marginal fit, axial fit, and occlusal fit. The digital impression proved to be better than the conventional impression. The mean difference for marginal fit was 6.54 μm (heterogeneity P < 0.00001, I = 93%), for axial fit 24.69 μm (heterogeneity P = 0.34, I = 11%), and for occlusal fit 6.99 μm (heterogeneity P = 0.03, I = 59%). The results of meta-analyses suggest that there is no significant difference between the impression systems (marginally favoring digital impression). The digital impression technique provided better marginal and internal fit of single-unit ceramic crowns than the conventional impression technique. The digital workflow using IOS provided a clinically acceptable marginal fit for single-unit crowns.
Topics: Humans; Computer-Aided Design; Crowns; Dental Impression Technique; Dental Marginal Adaptation; Dental Porcelain; Dental Prosthesis Design
PubMed: 37102534
DOI: 10.4103/jips.jips_534_22