目的:这篇综述的目的是分析与消减或添加剂技术一起用于口腔矫治器制造的树脂材料的机械和生物性能,并将其与常规制造的树脂材料进行比较。
方法:该方案在开放科学框架(OSF)注册中心(https://osf.io/h5es3)在线注册,该研究基于系统评价和荟萃分析方案(PRISMA-P)的首选报告项目。在MEDLINE上进行了电子搜索(通过PubMed),Scopus,和WebofScience从2022年2月1日至2022年5月1日。
方法:最近10年发表的体外和体内研究,与CAD-CAM或3D打印树脂咬合夹板。使用Stata17统计软件对被认为是同质的数据进行荟萃分析(95%置信区间[CI];α=0.05)。由于所有变量都是连续的,计算了对冲g度量。固定效应模型用于I2=0%,使用I2>0%的随机效应模型进行统计分析。
结果:全文阅读后纳入了13项研究。研究最多的机械性能是磨损,抗弯强度,表面硬度和表面粗糙度,虽然只有一项研究调查了生物学特性,进行XTT活力测定。对于荟萃分析,只有表面粗糙度,体积损失,选择了抗弯强度。考虑到表面粗糙度,与传统样本相比,减法样本的平均值较低(95%CI=-1.25[-1.84,-0.66]的Hedge\sg)。两组之间在体积损失方面没有检测到显著差异(P>0.05)(Hedge'sg,95%CI=-0.01[-2.71,-2.68])。而对照组的抗弯强度更高(Hedge'sg,95%CI=2.32[0.10-4.53])。
结论:3D打印材料显示出与常规树脂相当的性能,而研磨的夹板材料与传统的热固化丙烯酸树脂相比没有表现出更好的机械性能。聚醚醚酮(PEEK)具有巨大的潜力,需要进一步研究。需要对口腔细胞群进行生物测试,以确认这些材料的长期生物相容性。
结论:结合不同材料的\“混合夹板\”的使用需要在未来的研究中进行改进和评估,以充分利用不同的特性和性能。
OBJECTIVE: The aim of this
review was to analyze mechanical and biological properties of resin materials used with subtractive or additive techniques for oral appliances fabrication and compare them to those conventionally manufactured.
METHODS: The protocol was registered online at Open Science Framework (OSF) registries ( https://osf.io/h5es3 ) and the study was based on the preferred reporting items for systematic
review and meta-analysis protocols (PRISMA-P). An electronic search was conducted on MEDLINE (via PubMed), Scopus, and Web of Science from 1 February 2022 to 1 May 2022.
METHODS: in vitro and in vivo studies published in the last 10 years, with CAD-CAM or 3D printed resins for occlusal splints. Data considered homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05) with Stata17 statistical software. Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I2 = 0%, while statistical analysis was conducted using a random-effects model with I2 > 0%.
RESULTS: 13 studies were included after full-text reading. The mechanical properties most studied were wear, flexural strength, surface hardness and surface roughness, while only 1 study investigated biological properties, performing the XTT viability assay. For the meta-analysis, only surface roughness, volume loss, and flexural strength were selected. Considering surface roughness, the subtractive specimen had a lower average value compared to traditional ones (Hedge\'s g with 95% CI = -1.25[ -1.84, - 0.66]). No significant difference was detected in terms of volume loss (P > 0.05) between the groups (Hedge\'s g with 95% CI = -0.01 [-2.71, - 2.68]). While flexural strength was higher in the control group (Hedge\'s g with 95% CI = 2.32 [0.10-4.53]).
CONCLUSIONS: 3D printed materials showed properties comparable to conventional resins, while milled splint materials have not shown better mechanical performance compared with conventional heat-cured acrylic resin. Polyetheretherketone (PEEK) have great potential and needs to be further investigated. Biological tests on oral cell populations are needed to confirm the long-term biocompatibility of these materials.
CONCLUSIONS: The use of \"mixed splints\" combining different materials needs to be improved and evaluated in future research to take full advantage of different characteristics and properties.