Stéfani Becker Rodrigues1, Patrícia Franken1, Roger Keller Celeste2, Vicente Castelo Branco Leitune1, Fabrício Mezzomo Collares3. 1. Department of Conservative Dentistry, Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. 2. Department of Preventive and Social Dentistry, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. 3. Department of Conservative Dentistry, Dental Materials Laboratory, School of Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil. Electronic address: fabricio.collares@ufrgs.br.
Abstract
PURPOSE: This systematic review and meta-analysis aimed to evaluate the difference in longevity of tooth-supported ceramic prostheses designed by conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. STUDY SELECTION: Two reviewers searched the Web of Science, PubMed, SCOPUS and LILACS databases between 1966 and October 2017. Clinical studies that compared the survival rate of CAD/CAM against conventional restorations were included. RESULTS: Eleven randomized controlled trials and three prospective studies were included, n=14. Three types of tooth-supported restorations were searched in the included studies: single crown, multiple-unit and partial ceramic crown. The follow-up of patients in the studies ranged from 24 to 84 months. A total of 1209 restorations had been placed in 957 patients in the included trials, and failures were analyzed by type and material restoration. From a total of 72 restoration failures, the CAD/CAM system resulted in a 1.84 (IC95%: 1.28-2.63) higher risk than conventional manufacturing of ceramic restoration. Nevertheless, when drop-outs were included as a failure risk, the CAD/CAM system resulted in a risk of 1.32 (IC95%: 1.10-1.58). Multilevel analysis of tooth-supported ceramic restorations, considering drop-outs as successes, resulted in rates of 1.48 and 2.62 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively. Considering drop-outs as failures, we found rates of 4.23 and 5.88 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively. CONCLUSIONS: The meta-analysis results suggest that the longevity of a tooth-supported ceramic prostheses made by CAD/CAM manufacturing is lower than that of crowns mad by the conventional technique.
PURPOSE: This systematic review and meta-analysis aimed to evaluate the difference in longevity of tooth-supported ceramic prostheses designed by conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. STUDY SELECTION: Two reviewers searched the Web of Science, PubMed, SCOPUS and LILACS databases between 1966 and October 2017. Clinical studies that compared the survival rate of CAD/CAM against conventional restorations were included. RESULTS: Eleven randomized controlled trials and three prospective studies were included, n=14. Three types of tooth-supported restorations were searched in the included studies: single crown, multiple-unit and partial ceramic crown. The follow-up of patients in the studies ranged from 24 to 84 months. A total of 1209 restorations had been placed in 957 patients in the included trials, and failures were analyzed by type and material restoration. From a total of 72 restoration failures, the CAD/CAM system resulted in a 1.84 (IC95%: 1.28-2.63) higher risk than conventional manufacturing of ceramic restoration. Nevertheless, when drop-outs were included as a failure risk, the CAD/CAM system resulted in a risk of 1.32 (IC95%: 1.10-1.58). Multilevel analysis of tooth-supported ceramic restorations, considering drop-outs as successes, resulted in rates of 1.48 and 2.62 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively. Considering drop-outs as failures, we found rates of 4.23 and 5.88 failures per 100 restoration-years for the controls and CAD/CAM groups, respectively. CONCLUSIONS: The meta-analysis results suggest that the longevity of a tooth-supported ceramic prostheses made by CAD/CAM manufacturing is lower than that of crowns mad by the conventional technique.