Monolithic zirconia as a valid alternative to metal-ceramic for implant-supported single crowns in the posterior region: A systematic review and meta-analysis of randomized controlled trials

IF 4.3 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Prosthetic Dentistry Pub Date : 2024-11-01 DOI:10.1016/j.prosdent.2023.05.006

Péter Tajti DMD , Eleonora Solyom DMD , László Márk Czumbel DMD , Bence Szabó MSc , Réka Fazekas DMD, PhD , Orsolya Németh DMD, MDSc, PhD , Péter Hermann DMD, MSc, PhD , Gábor Gerber DMD, PhD , Péter Hegyi MD, PhD , Krisztina Mikulás DMD, PhD

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Abstract

Statement of problem

Technical complication rates of standard metal-ceramic implant-supported posterior restorations are relatively high. Whether monolithic zirconia crowns represent a more successful alternative is unclear.

Purpose

The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of posterior monolithic zirconia and metal-ceramic implant-supported single crowns.

Material and methods

A search was conducted in MEDLINE, Scopus, Embase, Web of Science, and CENTRAL databases for randomized controlled trials up to April 2023 with a follow-up time of at least 1 year. Restoration and implant survival and failure rates, marginal bone loss (MBL), bleeding on probing (BOP), and technical complications were analyzed by 2 reviewers. Statistical analyses were conducted using the R-statistics software program. The risk of bias was assessed by the Cochrane Risk of Bias Tool 2 (RoB 2), and the certainty of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

A total of 11 out of 2030 records were identified by title and abstract, and 4 records were included after full-text analysis. The statistical analysis revealed no significant difference in MBL (MD –0.11, 95% CI: [–0.25; 0.03]), BOP (OR 0.66, 95% CI: [0.25; 1.77]), or implant failure (OR 1.30, 95% CI: [0.24; 7.08]). Monolithic zirconia presented significantly less chipping over 1 year (OR 0.17, 95% CI: [0.03; 0.99]). The chipping rate was 0% for monolithic zirconia and 7.61% for metal-ceramic. Based on a narrative review, the restoration survival rate was 97.5% in the monolithic zirconia group and 99.1% in the metal-ceramic group.

Conclusions

Monolithic zirconia showed favorable short-term survival rates and had significantly less chipping over 1 year. Regarding MBL, BOP, and failure rates, both restoration types presented similar results at the 1-year follow-up.

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单晶氧化锆作为后牙区种植体支持单冠的金属陶瓷有效替代物：随机对照试验的系统回顾和荟萃分析。

问题陈述：标准金属陶瓷种植体支持的后部修复体的技术并发症发生率相对较高。目的：本系统综述和荟萃分析的目的是比较后部整体氧化锆冠和金属陶瓷种植体支持单冠的临床效果：在 MEDLINE、Scopus、Embase、Web of Science 和 CENTRAL 数据库中搜索了截至 2023 年 4 月、随访时间至少 1 年的随机对照试验。修复体和种植体的存活率和失败率、边缘骨损失（MBL）、探诊出血（BOP）和技术并发症由两名审稿人进行分析。统计分析使用 R 统计软件程序进行。采用 Cochrane Risk of Bias Tool 2（RoB 2）评估偏倚风险，并采用建议、评估、发展和评价分级法（GRADE）评估证据的确定性：在 2030 条记录中，共有 11 条记录通过标题和摘要被识别，4 条记录在全文分析后被纳入。统计分析显示，MBL（MD -0.11，95% CI：[-0.25; 0.03]）、BOP（OR 0.66，95% CI：[0.25; 1.77]）或种植体失败（OR 1.30，95% CI：[0.24; 7.08]）无明显差异。整体氧化锆在一年内的崩裂率明显较低（OR 0.17，95% CI：[0.03; 0.99]）。整体氧化锆的崩裂率为 0%，金属陶瓷的崩裂率为 7.61%。根据叙述性回顾，整体氧化锆组的修复体存活率为 97.5%，金属陶瓷组为 99.1%：结论：整体氧化锆显示出良好的短期存活率，1 年内崩瓷现象明显减少。在 MBL、BOP 和失败率方面，两种修复体在 1 年的随访中表现出相似的结果。

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来源期刊

Journal of Prosthetic Dentistry 医学-牙科与口腔外科

CiteScore

7.00

自引率

13.00%

发文量

599

审稿时长

69 days

期刊介绍： The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.