Clinical Performance of Partial and Full-Coverage Fixed Dental Restorations Fabricated from Hybrid Polymer and Ceramic CAD/CAM Materials: A Systematic Review and Meta-Analysis

Abstract

<jats:p>The aim of this systematic review and meta-analysis was to evaluate the clinical performance of tooth-borne partial and full-coverage fixed dental prosthesis fabricated using hybrid polymer and ceramic CAD/CAM materials regarding their biologic, technical and esthetical outcomes. PICOS search strategy was applied using MEDLINE and were searched for RCTs and case control studies by two reviewers using MeSH Terms. Bias risk was evaluated using the Cochrane collaboration tool and Newcastle–Ottawa assessment scale. A meta-analysis was conducted to calculate the mean long-term survival difference of both materials at two different periods (≤24, ≥36 months(m)). Mean differences in biologic, technical and esthetical complications of partial vs. full crown reconstructions were analyzed using software package R (p &lt; 0.05). 28 studies included in the systematic review and 25 studies in the meta-analysis. The overall survival rate was 99% (0.95–1.00, ≤24 m) and dropped to 95% (0.87–0.98, ≥36 m), while the overall success ratio was 88% (0.54–0.98; ≤24 m) vs. 77% (0.62–0.88; ≥36 m). No significance, neither for the follow-up time points, nor for biologic, technical and esthetical (88% vs. 77%; 90% vs. 74%; 96% vs. 95%) outcomes was overserved. A significance was found for the technical/clinical performance between full 93% (0.88–0.96) and partial 64% (0.34–0.86) crowns. The biologic success rate of partial crowns with 69% (0.42–0.87) was lower, but not significant compared to 91% (0.79–0.97) of full crowns. The esthetical success rate of partial crowns with 90% (0.65–0.98) was lower, but not significant compared to 99% (0.92–1.00) of full crowns.</jats:p>

Longevity of Polymer-Infiltrated Ceramic Network and Zirconia-Reinforced Lithium Silicate Restorations: A Systematic Review and Meta-Analysis

“…The differences in performance seem to be consistent with the results of in vitro studies performed on PICN, L.D., F.C., and zirconia [ 7 , 9 , 11 , 12 , 13 ]. In regard to how resin matrix ceramics in general fare against other CAD/CAM materials, a review investigating the clinical performance of CAD/CAM restorations reports an estimated failure rate of 3.85% per 100 in resin-matrix ceramics compared to 1.79% in glass-matrix ceramics and 4.07% in polycrystalline ceramics [ 46 ], which is consistent with Al-Haj Husain et al [ 47 ]. The results of the present study also agree with the systematic review by Al-Haj Husain et al [ 47 ] which reported that a similar overall survival rate of partial and full restorations made of hybrid polymer ceramics as 99% in 24 months.…”

“…A retrospective study by Beier et al [ 51 ] involving 1335 silicate glass-ceramic crowns, inlays, onlays and veneers placed between 1987 and 2009 demonstrated that there was a 2.3 times greater risk of failure in patients presenting parafunctional habits. A systematic review on the clinical performance of partial and full coverage CAD/CAM restoration by Al-Haj Husain et al [ 47 ] also reported ceramic chipping as the most common technical complication with no statistical difference amongst hybrid polymer and ceramic materials, which also aligns with results from Vagropoulou et al [ 52 ]. Biological complications were less common than technical failures in both types of ceramics.…”

“…To the best of the authors’ knowledge, this is the first systematic review investigating the clinical survival and success of PICN and ZLS CAD/CAM materials. Previous reviews investigating the performance of indirect restorations were not able to discern the performance of individual CAD/CAM indirect restorations due to the heterogeneity of included studies assessing different materials with varying compositions, and instead reported overall survival rates with no meta-analysis specific to each material [ 46 , 47 ].…”

“…One incidence of secondary caries and one incidence of crack propagation in the abutment tooth were associated with PICN [ 37 ] and one incidence of loss of vitality was reported in ZLS [ 42 ]. Likewise, the most reported biological failure was caries and loss of pulp vitality in the review by Al-Haj Husain et al [ 47 ] From the included studies, there were no reported statistical differences in survival between RMGIC and dual cure self-adhesive resin cement in PICN [ 38 ] and dual cure resin cement and self-adhesive resin cement in ZLS [ 42 ].…”

Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis

“…Reasons for this may be a growing awareness of biocompatibility and aesthetics [2]. Systematic reviews could already show promising results for the long-term survival of CAD/CAM fabricated lithium disilicate ceramic restorations [3,4]. Studies with a 10-year follow-up period were able to provide survival rates of 96.5% for monolithic as well as for two-layer disilicate ceramics [5].…”