Background: The aim of this systematic review and meta-analysis was to determine the fracture resistance and survival rate of partial indirect restorations inlays, onlays, and overlays fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology from ceramics, composite resin, resin nanoceramic, or hybrid ceramic and to analyze the influence of proximal box elevation on fracture resistance. Materials and methods: This systematic review was based on guidelines proposed by the preferred reporting items for systematic reviews and meta-analyses (PRISMA). An electronic search was conducted in databases US National Library of Medicine National Institutes of Health (PubMed), Scopus, Web of Science (WOS), and Embase. In vitro trials published during the last 10 years were included in the review. Results: Applying inclusion criteria based on the review’s population, intervention, comparison, outcome (PICO) question, 13 articles were selected. Meta-analysis by restoration type estimated the fracture resistance of inlays to be 1923.45 Newtons (N); of onlays 1644 N and of overlays 1383.6 N. Meta-analysis by restoration material obtained an estimated fracture resistance for ceramic of 1529.5 N, for composite resin of 1600 Ne, for resin nanoceramic 2478.7 N, and hybrid ceramic 2108 N. Conclusions: Resin nanoceramic inlays present significantly higher fracture resistance values. Proximal box elevation does not exert any influence on the fracture resistance of indirect restorations.
Background: The objective of this study was to digitally evaluate the effect of the cervical emergence of restorations in terms of gingival tissue volume. Materials and methods: In this study, 31 upper front teeth (from canine to canine) were selected and prepared using the biologically oriented preparation technique (BOPT). Each tooth had undergone a change in its provisional process with different emergence profile angles: 30° and 60°. Each sample was digitalised (STL file) using an intraoral scanner. By using various pieces of manipulation software for STL files, a volumetric analysis protocol was carried out. Changes in gingival thickness and position were measured at the buccal and the lingual positions. Results: By increasing the angulation of the emergence profile to 60°, the gingival thickness increased by 0.255 ± 0.381 mm (p = 0.001; t-test) at buccal and by 0.038 ± 0.381 mm at lingual (p = 0.600; t-test). In relation to the gingival height, at buccal, there is an apical displacement of 0.262 ± 0.246 mm (p = 0.001; t-test), and at lingual, there is an apical displacement of 0.390 ± 0.279 mm (p = 0.001; t-test). It was shown that an increase in the provisional emergence profile angle significantly diminishes the gingival height while significantly increasing gingival thickness. The Pearson’s correlation coefficient, r = 0.636, was moderately high and significant (p = 0.001; Pearson). Conclusions: The soft tissue surrounding the BOPT restored tooth evolved according to the prosthetic emergence angle of the provisional restoration, enabling us to plan for an apico-coronal and bucco-lingual displacement of the gingival tissue prior to the definitive restoration.
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