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Review
. 2020 Jul 4;9(7):2107.
doi: 10.3390/jcm9072107.

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

Nadin Al-Haj Husain  1 , Mutlu Özcan  2 , Pedro Molinero-Mourelle  1 , Tim Joda  3
Affiliations
Review

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

Nadin Al-Haj Husain et al. J Clin Med. .

Abstract

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 < 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.

Keywords: CAD/CAM; bonding; composite resin cement; dental; hybrid polymer; indirect; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic search results.
Figure 2
Figure 2
Summary of the Cochrane collaboration tool for assessing risk of bias for randomized controlled trials.
Figure 3
Figure 3
Survival ratios of all included specimens. (A) Forest plot ≤24 months; (B) forest plot ≥36 months; (C) funnel plot ≤24 months; (D) funnel plot ≥36 months.
Figure 4
Figure 4
Success ratios of all biologic, technical and esthetical aspects. (A) Forest plot ≤24 months; (B) forest plot ≥36 months; (C) funnel plot ≤24 months; (D) funnel plot ≥36 months.
Figure 5
Figure 5
Success ratios of all biologic aspects. (A) Forest plot for partial and (B) full crowns; (C) funnel plot for partial and (D) full crowns.
Figure 6
Figure 6
Success ratios of all technical aspects. (A) Forest plot for partial and (B) full crowns; (C) funnel plot for partial and (D) full crowns.
Figure 7
Figure 7
Success ratios of all esthetical aspects. (A) Forest plot for partial and (B) full crowns; (C) funnel plot for partial and (D) full crowns.
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