目的:本系统评价旨在比较临床结果,内部间隙,真实,精度,与研磨(SM)氧化锆修复体相比,3D打印(AM)的生物相容性。
方法:对互联网数据库进行了彻底搜索,直到2023年9月。搜索检索到的研究比较了AM氧化锆与SM氧化锆修复体的临床结果,fit,真实,精度,和生物相容性。
方法:在1736条记录中,只有59人被筛选为合格,和22条记录纳入本审查.使用修订后的Cochrane偏差风险工具(ROB2)评估研究质量,纽卡斯尔渥太华量表(NOS),和ModifiedConsort语句。一项临床研究显示偏倚风险中等,而偏倚风险较低。所有实验室研究都显示出一些偏见。短期观察显示100%生存率,没有牙周并发症的迹象。3D打印的氧化锆牙冠显示出统计学上显着的较低的ΔE和与相邻牙齿的更好匹配(p≤0.5)。适合,真实,和精度随印刷技术和牙齿表面而变化。
结论:与铣削牙冠相比,3D打印的氧化锆牙冠与相邻的天然牙齿提供了更好的美学颜色和轮廓匹配。3D打印和铣削都导致在临床上可接受的内部和边缘配合内的牙冠。除了纳米粒子喷射,SM冠的边缘间隙小于AM冠,然而,两者在临床上都是可以接受的.层压单板可能更准确地通过3D打印生产。3D打印的轴向表面精度优于铣削的轴向表面。建议进行长期RCT以确认3D打印修复体的临床适用性。
结论:内部配合和间隙,精度,和真实性是成功的牙科修复的基本要求。两种技术都可以产生具有临床上可接受的边缘和内部配合的修复体。轴向表面和狭窄或收缩区域比传统研磨氧化锆更有利于3D打印。
This systematic review aimed to compare the clinical outcome, internal gap, trueness, precision, and biocompatibility of 3D-printed (AM) compared to milled (SM) zirconia restorations.
A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies compared AM zirconia to SM zirconia restorations regarding clinical outcome, fit, trueness, precision, and biocompatibility.
Of 1736 records, only 59 were screened for eligibility, and 22 records were included in this review. The quality of studies was assessed using the revised Cochrane risk-of-bias tool (ROB2), and the Modified Consort Statement. One clinical study exhibited a low risk of bias. All laboratory studies revealed some bias concerns. Short-term observation showed 100 % survival with no signs of periodontal complications. 3D-printed zirconia crowns showed statistically significant lower ΔE and a better match to adjacent teeth (p ≤ 0.5). The fit, trueness, and precision vary with the printing technique and the tooth surface.
3D-printed zirconia crowns provide better aesthetic color and contour match to adjacent natural teeth than milled crowns. Both 3D printing and milling result in crowns within the clinically acceptable internal and marginal fit. Except for nanoparticle jetting, the marginal gap of SM crowns was smaller than AM crowns, however, both were clinically acceptable. Laminate veneers might be more accurately produced by 3D printing. 3D-printed axial surface trueness was better than milled axial surfaces. Long-term RCTs are recommended to confirm the clinical applicability of 3D-printed restorations.
Internal fit and gap, precision, and trueness are fundamental requirements for successful dental restorations. Both techniques produce restorations with clinically acceptable marginal and internal fit. Axial surfaces and narrow or constricted areas favored 3D-printed than conventionally milled zirconia.