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Journal of Clinical and Experimental... Sep 2022Evaluation of the different causes listed in literature for the rate of success of Zirconia based restorations. (Review)
Review
BACKGROUND
Evaluation of the different causes listed in literature for the rate of success of Zirconia based restorations.
MATERIAL AND METHODS
With the help of PRISMA guidelines , this Systematic review was carried out. For a time span of 18 years that is from 2003 to 2020, articles were searched using three electronic data bases which are PubMed , Cochrane Library and Sciencedirect. The selected 27 articles which included the in vivo as well as the in vitro studies presented the performance of zirconia-based prosthetic restorations. The studies also stated the commonest reason for failure which ultimately depicted the rate of success of the fixed dental prosthesis. Due to heterogeneity of gathered information , meta analysis could not be carried out.
RESULTS
Failure of bond between veneer material and zirconia sub-structure could be related to the cause of fracture of veneering porcelain hypothetically.
CONCLUSIONS
Mechanical connection and building up of compressive strength due to thermal contraction at the time of cooling after sintering process is the reason for the bond developed amongst the two materials. Zirconia based restorations, zirconia failure cause.
PubMed: 36158774
DOI: 10.4317/jced.59711 -
Clinical and Experimental Dental... Dec 2022This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers. (Review)
Review
OBJECTIVES
This systematic review aims to investigate the effect of different preparation designs on the marginal fit and fracture strength of ceramic occlusal veneers.
MATERIALS AND METHODS
Based on the PICO question and the search terms, an electronic search was performed in Google Scholar, PubMed (MEDLINE), Scopus, Cochrane Library, Web of Science, Science Direct, Wiley, Ovid, and SAGE for articles published up to July 2022. After including English in vitro studies that evaluated posterior ceramic occlusal overlays at the posterior with ceramic restorations by following the PRISMA statement, the extracted data was tabulated. The methodological quality of the included studies was evaluated. Risk of bias assessment was done independently by two authors using the modified MINORS scale.
RESULTS
About 3138 search results were screened, of which 22 were selected due to their titles. Twenty-one full-text articles were assessed for eligibility. Seventeen in-vitro studies were finalized for the extraction of quantitative data. All 17 articles had a low risk of bias and were retained. The influencing items for evaluating the research were different in most studies; therefore, qualitative synthesis of the results was feasible. They generally included preparation design, material thickness, depth of preparation in the tooth, internal divergence angle, and finish line. Meta-analysis was not done due to heterogeneity of preparation types and evaluation methods. Results revealed that fracture resistance of occlusal veneers is higher than normal mastication force, and it is sufficient to prepare the occlusal surface, use a self-etching primer for bonding, and an acceptable minimum ceramic thickness. The marginal discrepancy of occlusal veneers is clinically acceptable. However, this systematic review faces some limitations due to the lack of in vivo studies, different preparation designs in included studies, different follow-ups, and lack of comprehensive explanations in articles.
CONCLUSIONS
The preparation design of occlusal veneers influences both marginal adaptation and fracture resistance. Various preparation designs are proven to have clinically acceptable fracture strength and marginal adaptation.
Topics: Dental Porcelain; Dental Veneers; Flexural Strength; Dental Stress Analysis; Materials Testing; Ceramics
PubMed: 36062841
DOI: 10.1002/cre2.653 -
Journal of Prosthodontics : Official... Oct 2022The purpose of this systematic review and meta-analysis was to evaluate the effect of using additive manufacturing (AM) for dental ceramic fabrication in comparison with... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the effect of using additive manufacturing (AM) for dental ceramic fabrication in comparison with subtractive manufacturing (SM), and to evaluate the effect of the type of AM technology on dental ceramic fabrication.
MATERIALS AND METHODS
A search was conducted electronically in MEDLINE (via PubMed), EBSCOhost, Scopus, and Cochran Library databases, and also by other methods (table of contents screening, backward and forward citations, and grey literature search) up to February 12, 2022, to identify records evaluating additive manufacturing of ceramics for dental purposes in comparison with subtractive manufacturing. A minimum of 2 review authors conducted tstudy selection, quality assessment, and data extraction. Quality assessment was performed with Joanna Briggs Institute tool, and the quantitative synthesis was performed with the Comprehensive Meta-Analysis program (CMA, Biostat Inc). Hedges's g for effect size was calculated, with 0.2 as small, 0.5 as medium, and 0.8 as large. Heterogeneity was assessed with I and prediction interval (PI) statistics. Publication bias was investigated with funnel plots and grey literature search. Certainty of evidence was assessed with the Grading of Recommendations: Assessment, Development, and Evaluation (GRADE) tool.
RESULTS
A total of 28 studies were included for the qualitative and quantitative synthesis; 11 in vitro studies on accuracy, 1 in vivo study on color, and 16 in vitro studies on physical and mechanical properties. Meta-analysis showed overall higher accuracy for SM compared with AM, with medium effect size (0.679, CI: 0.173 to 1.185, p = 0.009) and also for marginal (g = 1.05, CI: 0.344 to 1.760, p = 0.004), occlusal (g = 2.24, CI: 0.718 to 3.766, p = 0.004), and total (g = 4.544, CI: -0.234 to 9.323, p = 0.062) with large effect size; whereas AM had higher accuracy than SM with small effect size for the external (g = -0.238, CI: -1.215 to 0.739), p = 0.633), and internal (g = -0.403, CI: -1.273 to 0.467, p = 0.364) surfaces. For technology, self-glazed zirconia protocol had the smallest effect size (g = -0.049, CI: -0.878 to 0.78, p = 0.907), followed by stereolithography (g = 0.305, CI: -0.289 to 0.9, p = 0.314), and digital light processing (g = 1.819, CI: 0.662 to 2.976, p = 0.002) technologies. Flexural strength was higher for ceramics made by SM in comparison to AM with large effect size (g = -2.868, CI: -4.371 to -1.365, p < 0.001). Only 1 study reported on color, favoring ceramics made through combined AM and SM.
CONCLUSIONS
Subtractive manufacturing had better overall accuracy, particularly for the marginal and occlusal areas, higher flexural strength, and more favorable hardness, fracture toughness, porosity, fatigue, and volumetric shrinkage; whereas AM had more favorable elastic modulus and wettability. Both methods had favorable biocompatibility. All studies on accuracy and mechanical properties were in vitro, with high heterogeneity and low to very low certainty of evidence. There is a lack of studies on color match and esthetics.
Topics: Computer-Aided Design; Esthetics, Dental; Zirconium; Ceramics; Flexural Strength; Stereolithography; Materials Testing; Dental Porcelain; Surface Properties
PubMed: 35675133
DOI: 10.1111/jopr.13553 -
Clinical Oral Investigations Aug 2022This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
This systematic review was performed to determine the main cause of technical failure of tooth-supported zirconia crowns and fixed partial dentures (FPDs), categorizing them as fracture/chipping or loss of retention/decementation.
MATERIALS AND METHODS
Electronic and manual searches were performed for randomized clinical trials, prospective clinical trials, and prospective cohort studies that reported the technical failure rates of zirconia restorations. The Cochrane Collaboration risk-of-bias tool and Newcastle-Ottawa scale were used to assess the quality of the studies.
RESULTS
Fifty-two studies were included and most of them had unclear risk of bias. Considering all reported fractures/chipping, for veneered crowns with 1 to 3 years of follow-up, the relative risk (RR) of fracture in relation to loss or retention was 3.95 (95% CI 1.18-13.23; p = 0.03). For 4 to 6 years of follow-up, the RR was 5.44 (95% CI 1.41-20.92; p = 0.01). For veneered FPDs with 1 to 3 years of follow-up, the RR was 5.98 (95% CI 2.31-15.01; p = 0.0002). For 4 to 6 years of follow-up, the RR was 3.70 (95% CI 1.63-8.41; p = 0.002). For 7 years or more of follow-up, the RR was 3.45 (95% CI 1.84-6.46; p = 0.0001). When only framework fractures were considered, there were no significant differences for the RR in all follow-up periods (p > 0.05).
CONCLUSIONS
Higher RR for fracture/chipping in relation to decementation for veneered zirconia crowns and FPDs at all follow-up times. For framework fractures, no difference was observed between the risk of failure of the restoration due to fracture or decementation.
CLINICAL RELEVANCE
Zirconia crowns and FPDs showed relatively high success and survival rates. However, considering the technical failures, there is approximately four times higher chance of fracture/chipping than loss of retention for both single and multi-unit tooth-supported veneered zirconia restorations.
Topics: Crowns; Dental Porcelain; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Prospective Studies; Zirconium
PubMed: 35660957
DOI: 10.1007/s00784-022-04573-z -
Journal of Prosthodontic Research Jan 2023Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review...
PURPOSE
Various oral rehabilitation approaches are available for severely worn dentition. However, evidence-based guidelines for permanent treatment are limited. This review aims to investigate clinical observational findings and compare in-vitro outcomes of thin and ultrathin occlusal veneers using different materials and approaches.
METHODS
An electronic search of online databases, such as PubMed (MEDLINE), BioMed Central (BMC), Cochrane, and Scopus, was performed for the 2009 - Jun 2021 period, following the PRISMA 2020 criteria. The reports sought for retrieval were all the articles evaluating the clinical outcomes of permanent full-mouth rehabilitation, and all in-vitro records that investigated and compared fracture strength, survival rate, and modes of failure of ultrathin (0.3 - 0.6 mm), thin (0.5 - 0.8 mm), and thick (0.8-1.5 mm) occlusal veneer restorations, with regard to the available indirect restorative materials. The Newcastle Ottawa risk of bias criteria was used to judge the clinical studies and a modified consort statement was used for the evaluation of in-vitro studies. The data of the included studies were extracted and grouped based on the similarity of the outcomes and study protocols. Data heterogeneity determined the qualitative and quantitative grouping of the results.
RESULTS
Two clinical and 17 in-vitro studies were included. Data exhibited heterogeneity within the materials, variables, testing protocols and observation periods. Therefore, only qualitative synthesis of the results was feasible. Clinically used 1 mm lithium disilicate overlays and ultrathin one-step no-prep polymer infiltrated ceramic network (PICN) occlusal veneers exhibited very high success and survival rates. The analysis of in-vitro studies exhibited variable survival rates and fracture load values, based on materials, thickness, and restorative approaches used.
CONCLUSIONS
Within the limitations of this systematic review, it can be concluded that the clinical outcomes of thin and ultrathin occlusal veneers/overlays are auspicious. In-vitro experimental results support the usage of the thin and ultrathin occlusal veneers.
Topics: Survival Rate; Materials Testing; Dental Veneers; Dental Porcelain; Ceramics; Dental Materials; Dental Stress Analysis; Computer-Aided Design
PubMed: 35545532
DOI: 10.2186/jpr.JPR_D_21_00270 -
The Journal of Prosthetic Dentistry May 2024The increasing use of computer-aided design and computer-aided manufacturing (CAD-CAM) systems has led to the development of resin-ceramic materials that meet the... (Review)
Review
STATEMENT OF PROBLEM
The increasing use of computer-aided design and computer-aided manufacturing (CAD-CAM) systems has led to the development of resin-ceramic materials that meet the requirements of minimally invasive dentistry, including the resin nanoceramic (RNC) and polymer-infiltrated ceramic network (PICN). The wear characteristics of these materials are unclear.
PURPOSE
The purpose of this systematic review was to compare the wear resistance of resin-ceramic materials when compared with one another or with lithium disilicate glass-ceramics.
MATERIAL AND METHODS
The PubMed, Scopus, and DOSS search engines were used to identify articles published between 2013 and 2021. Two independent researchers conducted the systematic review by following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and by following a combination of keywords.
RESULTS
Of a total of 310 articles, 26 were selected, including only 1 clinical study. Among these, 15 compared resin-ceramic materials with each other, while 11 compared resin-ceramic materials with lithium disilicate ceramics. Two types of wear were used to compare the materials: attrition and abrasion. The most commonly studied materials were 2 RNCs (Lava Ultimate and Cerasmart), 1 PICN (Vita Enamic), and 1 ceramic (IPS e.max CAD). Among the resin-ceramic materials, the PICN (Vita Enamic) showed less wear than the RNCs. Of the RNCs, Cerasmart had less attrition wear and less wear of the opposing teeth.
CONCLUSIONS
Lithium disilicate glass-ceramics have a higher wear resistance than resin-ceramic materials, but they cause more wear of the opposing teeth.
Topics: Computer-Aided Design; Ceramics; Humans; Dental Porcelain; Dental Restoration Wear; Dental Materials; Resins, Synthetic
PubMed: 35459543
DOI: 10.1016/j.prosdent.2022.01.027 -
The Journal of Adhesive Dentistry Apr 2022This systematic review aims to explore and compile the effect of adhesive luting on the mechanical properties of dental ceramics used as restorative materials. (Meta-Analysis)
Meta-Analysis
PURPOSE
This systematic review aims to explore and compile the effect of adhesive luting on the mechanical properties of dental ceramics used as restorative materials.
MATERIALS AND METHODS
The PubMed/MEDLINE, Web of Science and Scopus databases were searched on January 31st, 2021 to select laboratory studies written in English, without publishing-date restrictions, which compared the mechanical properties of commercially available dental ceramics as restorative materials luted using adhesive vs non-adhesive strategies. A total of 20 (out of 2039) studies were eligible and included in the analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (RevMan5.1, random effects model, α = 0.05) were obtained by comparing resistance values of adhesive and non-adhesive conditions (global analysis). Subgroup analyses were performed considering ceramic composition and aging.
RESULTS
In the global analysis, adhesive luting induced higher mechanical resistance values compared to non-adhesive luting (p ≤ 0.01). The same effect was observed for glass and alumina ceramics (p ≤ 0.01), but not for zirconia polycrystals (p = 0.83). Adhesive luting was favorable in both the aged and non-aged subgroup analysis (p ≤ 0.01). High heterogeneity was found in all meta-analyses. All analyzed studies in the systematic review scored negatively for risk of bias in most of the factors considered.
CONCLUSIONS
Adhesive luting reinforces the mechanical properties of dental ceramics used as restorative materials, with the exception of zirconia polycrystals.
Topics: Ceramics; Dental Bonding; Dental Cements; Dental Materials; Dental Porcelain; Materials Testing; Resin Cements; Surface Properties
PubMed: 35416449
DOI: 10.3290/j.jad.b2916469 -
Journal of Prosthodontics : Official... Dec 2022Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Several studies have compared digital intraoral scanners and conventional impressions. The accuracy of these two methods in terms of marginal accuracy of lithium disilicate crowns is not well-established, yet. The purpose of this study was to systematically review available publications on marginal fit of single-unit, full-coverage, tooth-supported lithium disilicate restorations.
METHODS
Pubmed, Web of Science, Cochrane, EMBASE, and Scopus were electronically searched along with a manual search. After critical appraisal, data from selected studies were extracted and mean marginal difference with a 95% confidence interval was calculated. Meta-analysis of the collected data was conducted using STATA software.
RESULTS
The meta-analysis revealed similar marginal gap values in intraoral scanners with conventional groups (p>0.05) and in intraoral scanners with extraoral canners (p>0.05).
CONCLUSION
No significant difference was seen between digital and conventional impressions or intra- and extraoral scanners for marginal accuracy of lithium disilicate crowns.
Topics: Humans; Workflow; Dental Impression Technique; Dental Prosthesis Design; Computer-Aided Design; Dental Marginal Adaptation; Dental Porcelain; Crowns
PubMed: 35344238
DOI: 10.1111/jopr.13515 -
Clinical Oral Investigations May 2022To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations. (Review)
Review
OBJECTIVE
To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations.
MATERIALS AND METHODS
An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria.
RESULTS
A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure.
CONCLUSION
CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations.
CLINICAL RELEVANCE
CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome.
Topics: Ceramics; Composite Resins; Computer-Aided Design; Dental Materials; Dental Porcelain; Inlays; Longitudinal Studies; Observational Studies as Topic
PubMed: 35320383
DOI: 10.1007/s00784-022-04449-2 -
The Journal of Prosthetic Dentistry Jan 2024Marginal integrity and internal adaptation are key to the long-term success of porcelain laminate veneers. Evidence for their marginal and internal fit is unclear, and... (Meta-Analysis)
Meta-Analysis
STATEMENT OF PROBLEM
Marginal integrity and internal adaptation are key to the long-term success of porcelain laminate veneers. Evidence for their marginal and internal fit is unclear, and the factors affecting such fit have not been identified.
PURPOSE
The purpose of this systematic review and meta-analysis was to summarize the scientific literature assessing the effects of various parameters on the marginal and internal fit of porcelain laminate veneers.
MATERIAL AND METHODS
An electronic search was conducted to identify all relevant published articles on the fit accuracy of ceramic veneers between January 2000 and June 2021 in the PubMed-MEDLINE, Scopus, Embase, Google Scholar, and Web of Science databases. Information, including the study outcomes, in terms of the mean marginal gap, internal gap, and absolute marginal discrepancies of porcelain laminate veneers, was extracted from the selected studies. The inverse-variance random effects model was used to analyze the pooled results and estimate the overall effect based on the heterogeneity of studies (α=.05).
RESULTS
Twenty-one studies were selected for analysis, 2 clinical and 19 in vitro. The risk of bias was "medium" for most studies (19 of 21), and only 2 studies were classified as "high risk." A mean difference of -4.53 μm (95% CI: -21.46 to 12.41) was found, with no statistically significant difference in marginal gap between the pressed and milled fabrication modes (P=.600). As for the internal gap, significant differences were found (mean difference=-40.56 μm; 95% CI: -76.54 to -4.58), with pressed veneers performing better (P=.030). Butt joint preparation design produced significantly (P=.002) lower marginal gaps than the palatal chamfer (mean difference=-14.02 μm; 95% CI: -23.07 to -4.98).
CONCLUSIONS
No significant differences were found between the pressed and milled porcelain laminate veneers for marginal gap, but for the internal gap, the differences were significantly in favor of the pressed type. The butt joint veneer preparation design was significantly better than the palatal chamfer design in terms of marginal fit.
Topics: Ceramics; Computer-Aided Design; Dental Marginal Adaptation; Dental Porcelain; Dental Veneers
PubMed: 35260253
DOI: 10.1016/j.prosdent.2022.01.009