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Abstract：
Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.
摘要：
尽管CAD/CAM陶瓷是金属陶瓷固定假牙的有希望的替代品，对他们的中长期临床表现知之甚少。本系统综述旨在评估生存率和成功率，并描述CAD/CAM牙齿支持的氧化锆和基于二硅酸锂的固定假牙（FDP）的潜在并发症特征。我们系统地搜索了MEDLINE和WebofScience，以寻找相关的前瞻性研究，并进行了至少一年的随访。我们估计汇集了1-，5-,和10年生存率和成功率通过结合收集的数据在泊松回归模型。进行描述性统计以评估纳入研究中失败和并发症的分布。纳入研究的偏倚风险通过单臂试验的适应清单进行评估。汇总估计1-，5-,10年生存率从93.80%到94.66%，89.67%到91.1%，和79.33%至82.20%，分别。不包括失败的相应成功率，但包括任何其他类型的干预措施为94.53%至96.77%，90.89%至94.62%，和81.78%至89.25%。继发性龋齿是最常见的失败原因，接着是贴面的碎裂。除故障外，最常见的并发症原因是贴面破裂，但需要干预。纳入研究的偏倚风险通常是可以接受的，七项研究与低偏倚风险相关，八项研究有中等偏倚风险，和三项具有严重偏倚风险的研究。当前对CAD/CAM支持的FDP的荟萃分析显示，在长达10年的暴露中，生存率和成功率令人满意。需要更多关注长期绩效的前瞻性研究，以加强文献中目前可用的证据。
