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International Journal of Paediatric... Jan 2022Preformed metal crowns (PMCs) have been the restoration of choice for paediatric dentistry; however, PMCs have a non-aesthetic appearance, which has become a point of... (Review)
Review
BACKGROUND
Preformed metal crowns (PMCs) have been the restoration of choice for paediatric dentistry; however, PMCs have a non-aesthetic appearance, which has become a point of concern. Recently, prefabricated zirconia crowns (PZCs) have been increasingly used as an aesthetic restorative material for primary teeth, as they have pleasing properties.
AIM
This systematic review summarises the clinical results for PZCs in the primary dentition, including wear on the opposing dentition, retention, fracture resistance, parental satisfaction, gingival health, and cementation materials.
MATERIALS AND METHODS
Electronic database searches were conducted using PubMed, Google Scholar, Web of Science, and the Cochrane Library. Clinical trials, observational studies, and case reports/series were included. The quality of the studies was analysed using the Cochrane tool and the domain-based evaluation for non-randomised studies of interventions.
RESULTS
The search retrieved 166 references, of which 14 studies were included for qualitative analyses. The risk of bias varied from low to unclear. The included studies indicated that prefabricated zirconia crowns are retentive and are not associated with accelerated wear on the opposing dentition. They also exhibit a high fracture resistance, satisfy the parents and are compatible with gingival health. There is, however, inconclusive evidence with regard to cementation materials.
CONCLUSION
Prefabricated Zirconia Crowns appear to be a good alternative to preformed metal crowns in term of esthetics, retention, resistance to fracture, parent satisfaction, and gingival health.
Topics: Child; Crowns; Dental Materials; Humans; Tooth, Deciduous; Zirconium
PubMed: 33772904
DOI: 10.1111/ipd.12793 -
Journal of Esthetic and Restorative... May 2018This systematic review aimed to evaluate the longevity of ceramic onlays and identify the factors that influence their survival. (Review)
Review
OBJECTIVE
This systematic review aimed to evaluate the longevity of ceramic onlays and identify the factors that influence their survival.
MATERIALS AND METHODS
An electronic search was conducted through PubMed (MEDLINE), Google Scholar and Cochrane Library, up to August 2017. The literature search aimed to retrieve all the clinical studies on the longevity of ceramic onlays. Ceramic onlay was defined as any partial ceramic restoration that covers at least one cusp.
RESULTS
A total of 21 studies met the selection criteria and were deemed suitable for this review. The medium-term studies (2-5 years) indicated a survival rate of 91-100%, and the long term studies (more than 5 years) showed a survival rate of 71-98.5%. The most common reason of failure was fracture, followed by debonding and caries. The most common patterns of deterioration were loss of margin integrity and discoloration. Onlay longevity can be enhanced if the preparation allows for at least 2 mm occlusal ceramic thickness and incorporates additional retentive features. Restoring teeth that are nonvital, teeth in a more posterior region, or teeth for patients with parafunctional habits appears to be associated with greater ceramic failure. Fabrication materials and methods, and adhesive bonding system did not seem to influence onlay longevity.
CONCLUSIONS
The clinical performance of the ceramic onlay appears acceptable regardless of the follow-up duration. Fracture of the ceramic onlay is the predominant cause of failure, and the most observed form of deterioration was associated with the restoration margin.
CLINICAL SIGNIFICANCE
Ceramic onlay appears to be a reliable option to restore posterior teeth. The most common pattern of failure is fracture of the ceramic material. The risk of ceramic onlay failure seems to increase if the restored tooth is nonvital and the patient demonstrates parafunctional habits.
Topics: Ceramics; Dental Porcelain; Dental Restoration Failure; Humans; Inlays; Tooth; Tooth, Nonvital
PubMed: 29676497
DOI: 10.1111/jerd.12384 -
The International Journal of... 2016The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers.
MATERIALS AND METHODS
A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity.
RESULTS
Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates.
CONCLUSION
Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.
Topics: Aluminum Silicates; Ceramics; Dental Porcelain; Dental Restoration Failure; Dental Veneers; Humans; Potassium Compounds; Surface Properties; Survival Analysis; Treatment Outcome
PubMed: 26757327
DOI: 10.11607/ijp.4315 -
Journal of Esthetic and Restorative... Jan 2022Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP)... (Review)
Review
OBJECTIVES
Several systematic literature reviews have assessed the scientific evidence on resin bonding protocols to conventional 3 mol% ytrria-stabilized zirconia (3Y-TZP) ceramics. It has been widely discussed, however, that the differing composition and physical properties of new high-translucent zirconia generations (4Y-TZP and 5Y-TZP) may require alternative bonding materials and procedures. This paper reviewed in vitro studies on the success and durability of bonding protocols to high-translucent zirconia.
MATERIAL AND METHODS
A systematic search of PubMed and Cochrane Library for in vitro studies on bonding to new zirconia generations published until November 2020 was conducted and complemented by a manual search. Studies selected for review fulfilled the applied inclusion and exclusion criteria. The quality of the included studies was assessed with the Cochrane risk-of-bias tool for randomized trials.
RESULTS
Of 629 screened articles, 18 were included in this review. They investigated different surface pretreatment methods, primers, resin cements, aging procedures, and bond strength test protocols. The limited number of the identified studies and the heterogeneity of the extracted data did not allow to conduct a meta-analysis.
CONCLUSIONS
The available evidence suggests that resin bonding protocols successfully applied to conventional zirconia are also the most successful for high-translucent zirconia. Airborne particle abrasion and special phosphate monomer-containing primers or composite resin cements provide long-term durable resin bonds.
CLINICAL SIGNIFICANCE
Durable bonds can be established between high-translucent zirconia and resin cements. The bonding materials and procedures applied do not compromise their physical properties.
Topics: Ceramics; Dental Bonding; Dental Stress Analysis; Materials Testing; Resin Cements; Surface Properties; Zirconium
PubMed: 35072329
DOI: 10.1111/jerd.12876 -
Dental Materials : Official Publication... Oct 2021The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to analyze the literature on the bond strength of self-etching (SE) adhesives containing 10-MDP or other acidic functional monomers, comparing the bonding performance of both compositions.
METHODS
This study is registered in PROSPERO (CRD42020175715) and it followed the PRISMA Statement. The literature search was performed in PubMed, Web of Science, SciELO, Scopus, LILACS, IBECS, and BBO from the starting coverage date through 30 June 2021. Study eligibility criteria consisted of in vitro studies that evaluated the bond strength (microtensile, microshear, tensile or shear testing) to sound dentin/enamel of a minimum of two distinct SE systems, with at least one material containing 10-MDP and one other being comprised of a distinct acidic composition. Statistical analyses were carried out with RevMan 5.3.5 and using random-effects models with the significance level at p < 0.05. Also, Bayesian network meta-analysis (NMA) was conducted using MetaInsight V3 tool.
RESULTS
From 740 relevant studies evaluated in full-text analysis, 210 were incorporated to the systematic review and 206 in meta-analysis. The majority of studies was classified as having medium risk of bias (56.7%), followed by low (35.2%) and high (8.1%) risk of bias. Data from a total of 64 adhesive systems were collected, which favored the 10-MDP-based group at both dentin (overall effect: 6.98; 95% CI: 5.61, 8.36; p < 0.00001) and enamel (overall effect: 2.79; 95% CI: 1.62, 3.96; p < 0.00001) substrates. Microtensile testing was more frequently used (73.4%) in the included studies. Adhesives based on 10-MDP showed greater bonding performance than adhesives comprised of monomers such as PENTA, 6-MHP, 4-META, 4-MET, pyrophosphate esters, mixed composition or monomers derived from sulfonic acid (p ≤ 0.01); whereas similar bond strength values were verified between 10-MDP-based materials and those containing PEM-F, acrylamide phosphates, 4-AET, MAC-10, or monomers derived from polyacrylic and phosphonic acids (p ≥ 0.05). Adhesives based on GPDM were the only ones that resulted in greater bonding potential than the 10-MDP-based group (p = 0.03). Dental bonds in dentin were favored with the application of 2-step 10-MDP-based adhesives; whereas in enamel the dental bonds were favored for both 2-steps versions of adhesives, regardless of the presence of 10-MDP. Indirect evidence from NMA revealed that 1-step 10-MDP-free and universal 10-MDP-free adhesives seemed to perform worst in dentin and enamel, respectively.
SIGNIFICANCE
Adhesives containing 10-MDP showed higher bonding performance than materials formulated with other acidic ingredients, although this result relied on the type of mechanical testing, type of the substrate, acidic composition of the adhesive, and the application category of the SE system. This review summarized the effects of the foregoing factors on the adhesion to dental substrates.
Topics: Bayes Theorem; Dental Bonding; Dental Cements; Dentin; Dentin-Bonding Agents; Materials Testing; Methacrylates; Resin Cements; Tensile Strength
PubMed: 34456050
DOI: 10.1016/j.dental.2021.08.014 -
Clinical Oral Investigations Jan 2022Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome. (Review)
Review
OBJECTIVE
Address oral health-related quality of life (OHRQoL) and patient satisfaction rehabilitated by the all-on-four concept as the primary outcome.
MATERIAL AND METHODS
A search was performed in the PubMed/MEDLINE, Web of Science, and Cochrane databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria (PRISMA). The PICO question was used to address the following specific question: "What is the level of oral health-related quality of life and satisfaction in edentulous patients and with atrophic jaws who received dental implants for full-arch implant-supported restorations following the all-on-four in the mandible or maxilla?"
RESULTS
Eleven studies including 693 patients aged 55 to 71 years were selected. The shortest follow-up period was 3 months and the longest, 7 years. Regarding the OHRQoL assessment method and patient satisfaction, the oral health impact profile (OHIP) and the visual analog scale (VAS) were the most used.
CONCLUSION
OHRQoL and satisfaction in patients whose rehabilitation was based on the all-on-four concept were high. However, the current evidence is still limited by the quality of the available studies, making long-term randomized studies necessary to establish the real effectiveness of this surgical-prosthetic approach.
CLINICAL RELEVANCE
Carefully analyze the aspects related to satisfaction and oral health-related quality of life of rehabilitated patients with implant-supported total prostheses made according to the all-on-four concept, aiming to achieve success through procedures with greater predictability and less complexity, as these are directly associated with recovery oral health of edentulous individuals with less morbidity and minimized costs.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete; Humans; Jaw, Edentulous; Patient Satisfaction; Personal Satisfaction; Quality of Life; Treatment Outcome
PubMed: 34647147
DOI: 10.1007/s00784-021-04213-y -
Clinical Oral Implants Research Sep 2023The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or... (Meta-Analysis)
Meta-Analysis Review
Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area.
OBJECTIVE
The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iS C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes.
METHODS
Electronic and manual searches were performed to identify randomized-, prospective-, and retrospective clinical trials with follow-up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iS Cs. Survival and complication rates were analyzed using robust Poisson's regression models.
RESULTS
Thirty-two studies reporting on 42 study arms were included in the present systematic review. The meta-analysis of the included studies indicated estimated 3-year survival rates of 98.3% (95%CI: 95.6-99.3%) for porcelain-fused-to-metal (PFM) iFDPs, 97.5% (95%CI: 95.5-98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8-99.6%) for monolithic or micro-veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8-99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6-99.3%] vs. 99.1% [95%CI: 97.6-99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iS Cs.
CONCLUSIONS
Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iS Cs showed similarly high short-term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.
Topics: Prospective Studies; Retrospective Studies; Dental Prosthesis Design; Dental Restoration Failure; Dental Porcelain; Ceramics; Zirconium; Crowns; Dental Prosthesis, Implant-Supported
PubMed: 37750526
DOI: 10.1111/clr.14103 -
The European Journal of Prosthodontics... Nov 2022The objective of this systematic review was to compare the longevity of direct amalgam and composite resin restorations, in posterior teeth, through clinical,...
OBJECTIVES
The objective of this systematic review was to compare the longevity of direct amalgam and composite resin restorations, in posterior teeth, through clinical, prospective or retrospective studies, with at least 5 years of follow-up.
MATERIALS AND METHODS
Studies published in the last 15 years (from 2006 to 2021) were collected using the PubMed and Medline databases.
RESULTS
The search strategy associated with the established inclusion and exclusion criteria resulted in a total of 17 articles. Factors related to failures in the performance of restorations were analyzed together with the clinical performance results of each material over the years of study, according to the methodology of each article.
CONCLUSIONS
Regardless of the restorative material, the successful results over more than 5 years are due much more to the correct application of the technique, the operator's skill/knowledge and factors related to the patient, such as the type of tooth, number of faces involved in the restoration and oral hygiene.
Topics: Humans; Prospective Studies; Retrospective Studies; Composite Resins; Dental Materials
PubMed: 35438266
DOI: 10.1922/EJPRD_2371Maciel09 -
Journal of Prosthodontics : Official... Oct 2020To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant... (Meta-Analysis)
Meta-Analysis
PURPOSE
To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant impressions for partially and completely edentulous patients.
MATERIALS AND METHODS
Electronic and manual searches were conducted to identify in vitro and clinical studies, reporting on the 3D accuracy between digital and conventional implant impressions. Secondary outcomes were the effect of implant angulation, type of conventional impression technique, and type of intraoral scanner on the accuracy of implant impressions.
RESULTS
The inclusion criteria were met by 9 in vitro studies and 1 clinical study reporting on completely edentulous impressions, while 6 in vitro and 2 clinical studies reported on partially edentulous impressions. Quantitative meta-analysis was performed for 5 completely edentulous and 6 partially edentulous studies. The studies exhibited high values for heterogeneity. A random effects model was conducted to estimate the effect size. Based on 5 in vitro studies on completely edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 8.20 µm (95% CI: -53.56, 37.15) and the digital impressions had nominally less deviation (p = 0.72). Based on 1 clinical and 5 in vitro studies on partially edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 52.31 µm (95% CI: 6.30, 98.33) and the conventional impressions had nominally less deviation (p = 0.03). Five in vitro and 2 clinical studies were not included in the quantitative analysis due to heterogeneity in the methodology. Implant angulation affected the accuracy in favor of the partially edentulous conventional impressions whereas the effect of different scanners was not statistically significant on the completely edentulous impressions (p = 0.82).
CONCLUSIONS
Digital scans appear to have comparable 3D accuracy with conventional implant impressions based mainly on in vitro studies. However, clinical trials are recommended to investigate the clinical accuracy of digital scans and digitally fabricated interim or prototype prostheses, before digital implant scans can be recommended for routine clinical use.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Materials; Dental Impression Technique; Humans; Models, Dental; Mouth, Edentulous
PubMed: 32613641
DOI: 10.1111/jopr.13211 -
The Journal of Prosthetic Dentistry Feb 2021The polycrystalline nature of zirconia hinders its ability to bond to tooth structure. Consequently, durable bonding to zirconia has been challenging. In vitro studies... (Review)
Review
STATEMENT OF PROBLEM
The polycrystalline nature of zirconia hinders its ability to bond to tooth structure. Consequently, durable bonding to zirconia has been challenging. In vitro studies have evaluated various methods of bonding to zirconia, but clinical data are sparse.
PURPOSE
The purpose of this systematic review was to critically appraise clinical studies investigating the survival rate of resin-bonded zirconia fixed partial dentures (FPDs), inlay-retained zirconia FPDs, and zirconia veneers.
MATERIAL AND METHODS
Searches were performed in MEDLINE, EMBASE, PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. Clinical studies of over 12 months duration involving bonded zirconia restorations between 1990 and July 2018 were reviewed. All suitable studies were assessed for quality by using a "Questionnaire for selecting articles on Dental Prostheses".
RESULTS
Eight studies were ultimately included. Three studies examined posterior inlay-retained FPDs with estimated survival rates of 12.1% at 10 years, 95.8% at 5 years, and 100% at 20 months. Five studies reviewed anterior, resin-bonded FPDs, all of which had a 3- to 10-year survival rate of 100%. Debonds occurred in all studies, but the prostheses could usually be rebonded.
CONCLUSIONS
With correctly designed buccal and lingual coverage retainers and minimal if any veneering porcelain, zirconia-based, posterior, inlay-retained FPDs seem to have a high clinical survival rate. The role of bonding efficacy in this survival rate is unknown. Anterior, cantilevered, resin-bonded zirconia FPDs seem to have a high clinical survival rate. While these prostheses can debond, fracture of the entire prosthesis is unlikely, so they may be rebonded. To bond zirconia, the use of airborne-particle abrasion with 50-μm alumina (AlO) at 0.1 to 0.25 MPa in combination with a phosphate monomer-containing adhesive resin is recommended until further studies become available. Dental dam isolation is also recommended during zirconia bonding.
Topics: Dental Bonding; Dental Materials; Dental Porcelain; Denture Design; Denture, Partial, Fixed; Treatment Outcome; Zirconium
PubMed: 32115220
DOI: 10.1016/j.prosdent.2019.12.017