目的:报告关于(i)全瓷种植体支持牙冠(iSC)临床结果的四个系统评价(SRs)的评估,(ii)生产时间,有效性,和计算机辅助制造(CAM)的成本,(iii)计算机辅助植入计划和手术(CAIPS)的时间和成本,和(iv)患者报告的结果测量(PROMS)。
方法:由经验丰富的临床医生和内容专家组成的作者小组讨论和评估了SR,并就主要发现达成了共识,声明,临床建议,并需要未来的研究。
结果:所有四个SR均根据PRISMA和至少三个文献计量数据库中的详细综合搜索策略进行并报告。搜索策略被认为是可重复的。在语言限制和包括灰色文献方面注意到差异,但是搜索的全面性似乎很有说服力。SR包括对主要研究的偏倚风险评估,他们的研究方法影响了对提取数据的解释。
结论:(i)有限的证据(49NRCT)表明,贴面和整体式全瓷iSC具有长达3年的优异结果。(ii)没有证据评估生产时间和有效性,比较植入物模型的减法和加法CAM,基台和牙冠。(iii)有限的证据(4RCT)表明,在考虑整个工作流程和诊断时,CAIPS涉及更多的时间和成本,制造,和插入恢复。时间似乎是成本上涨的决定性因素。(iv)与传统印模相比,光学用于制造iSC和短跨度FPD时,患者的舒适度增加(2个RCT,5NRCT)。
OBJECTIVE: To report assessments of four systematic reviews (SRs) on (i) clinical outcomes of all-ceramic implant-supported crowns (iSCs), (ii) production time, effectiveness, and costs of computer-assisted manufacturing (CAM), (iii) computer-assisted implant planning and surgery (CAIPS) time and costs, and (iv) patient-reported outcome measures (PROMS).
METHODS: An author group consisting of experienced clinicians and content experts discussed and evaluated the SRs and formulated
consensus on the main findings, statements, clinical recommendations, and need for future research.
RESULTS: All four SRs were conducted and reported according to PRISMA and detailed comprehensive search strategies in at least three bibliometric databases and hand searching. The search strategies were deemed reproducible. Variation was noted regarding language restrictions and inclusion of grey literature, but the search comprehensiveness appeared persuasive. The SRs included bias risk assessments of the primary studies, and their study methodology impacted the interpretations of the extracted data.
CONCLUSIONS: (i) There is limited evidence (49 NRCT) showing that veneered and monolithic all-ceramic iSCs have excellent outcomes observed up to 3 years. (ii) There is no evidence evaluating production time and effectiveness comparing subtractive and additive CAM of implant models, abutments and crowns. (iii) There is limited evidence (4 RCT) that CAIPS involves more time and costs when considering the entire workflow and for diagnostics, manufacturing, and insertion of the restoration. Time seems to be the decisive factor for higher costs. (iv) Patients\' comfort increases when optical compared to conventional impressions are used for fabricating iSCs and short-span FPDs (2 RCT, 5 NRCT).