目的:比较和报告使用添加剂(AM)或减法(SM)制造的植入物支持的固定假牙(iFDP)的性能。
方法:进行了电子搜索(Medline,Embase,CochraneCentral,认识论,clinicaltrialsregistries)withafocusedPICOquestion:Inparticularedoridouspatientswithmissingsingle(ormultiple)talesunderstanding(P),与SMiFDP(C)相比,AMiFDP(I)是否导致改善的临床表现(O)?包括将AM与SMiFDP进行比较的研究(随机临床试验,前瞻性/回顾性临床研究,案例系列,体外研究)。
结果:在2\'184个引文中,没有符合纳入标准的临床研究,而六项体外研究被证明是合格的。由于缺乏临床研究和研究中相当大的异质性,无法进行荟萃分析.AMiFDP由氧化锆和聚合物制成。对于SMiFDP,氧化锆,二硅酸锂,使用了树脂改性陶瓷和不同类型的聚合物基材料。通过评估边际和内部差异以及机械性能(断裂载荷,弯矩)。纳入的三项研究检查了临时或确定的iFDP的边际和内部差异,而四个检查机械性能。基于边际和内部差异以及AM和SMiFDP的机械性能,研究揭示了不确定的结果。
结论:尽管AM的发展和全面的搜索,关于AMiFDP的性能及其与SM技术的比较的数据非常有限。因此,由AM引起的iFDP的临床表现仍有待阐明。
OBJECTIVE: To compare and report on the performance of implant-supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing.
METHODS: An electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies).
RESULTS: Of 2\'184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta-analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin-modified ceramics and different types of polymer-based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results.
CONCLUSIONS: Despite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated.