Influence of CAD/CAM diamond bur wear on the accuracy and surface roughness of dental ceramic restorations: A systematic review.

Objectives: To systematically review the current literature investigating the computer-aided design/computer-aided manufacturing (CAD/CAM) diamond bur deterioration with repeated use and its effects on the accuracy, marginal and internal fit, and surface roughness of the dental ceramic restorations from the subtractive manufacturing technique.

Materials and methods: Three online databases, Ovid, Scopus, and Web of Science, were screened up to February 2024. In vitro studies investigating bur wear and its influences on subtractively-manufactured (SMed) ceramic restorations, except zirconia, were included. The selected articles were limited to English-language and peer-reviewed publications. Additionally, a manual search was conducted by screening the reference lists of included studies. The risk of bias of included articles was assessed following the modified Consolidated Standards of Reporting Trials (CONSORT) checklist.

Results: Twelve studies satisfied the inclusion criteria and were included. Only one study reported that the influence of bur deterioration on the trueness of SMed restorations depended on the crown areas, but the proximal contacts showed a significant reduction. Five studies assessed the effect on marginal and internal adaptation. To a certain extent, repeated use of the same diamond burs causes a progressive increase in the marginal gap and a slight decrease in the internal luting space. Half of the included studies assessed surface roughness. The influence of bur wear was mainly due to the bur-material combination.

Conclusions: During subtractive manufacturing, bur deterioration is a crucial factor influencing the quality of fabricated ceramic restorations. Diamond burs must be replaced regularly to avoid compromising the accuracy of subtractively manufactured restorations.