Effects of manufacturing methods on the survival rate of ceramic and indirect composite restorations: A systematic review and meta‐analysis

Abstract

Objectives To evaluate the survival rate of ceramic and indirect composite inlays, onlays, and overlays manufactured according to different methods (CAD/CAM, pressable, and stratified). MEDLINE, EMBASE, and Cochrane Library databases were searched for published articles. Risk of bias, data extraction, subgroup analysis, meta‐analysis, and GRADE was performed. Materials and methods Prospective, retrospective, or RCT studies, without restriction of language, from 1983 to 2019, with follow‐up ≥5 years, reporting survival rates were screened independently by two reviewers in accordance with eligibility criteria. Results A total of 13 articles (12 for ceramic, one for indirect composite) met the inclusion criteria. No articles were included regarding crystalline ceramic. The estimated cumulative survival rate for CAD/CAM was 97% after 5 years and 89% after 10 years; for pressable was 95% after 5 years, and for stratified was 88% after 5 years and 93% after 10 years. Conclusions Regardless of the manufacturing method, vitreous ceramic inlays, onlays, and overlays showed high survival, providing evidence that these restorations are a safe treatment. Clinical relevance Vitreous ceramic inlays, onlays, and overlays showed high survival, regardless of the manufacturing method, providing evidence that these restorations are a safe treatment.

Clinical Performance of Partial and Full-Coverage Fixed Dental Restorations Fabricated from Hybrid Polymer and Ceramic CAD/CAM Materials: A Systematic Review and Meta-Analysis

“…Similar data were found for survival rates of full crowns, estimated 5-year survival rate for leucite or lithium-disilicate reinforced glass ceramic (96.6%) and sintered alumina and zirconia (96%) were similar [16]. For partial restorations, our results are also in agreement with the literature, Sampaio FBWR et al found estimated survival rates for CAD/CAM of 97% after five years [49].…”

“…Previous reviews on resins were inconclusive whether longevity and survival rates of resins are higher compared to ceramics [55]. However, a recent review on CAD/CAM materials for full and partial crowns that included resin-matrix ceramic showed an estimated survival rate after five years of 82.5% [47,49].…”

Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis

“…Likewise, similar data were obtained in different investigations in which ceramic restorations yielded an 88.7% success rate at 10 years, while composite resins presented a success rate of 84.78% at five years of follow-up [ 30 , 70 ]. Although some articles have concluded that there is little evidence regarding the superior performance of ceramic materials versus composites as onlay restoration materials over the short term, it should be noted that the review was limited to the comparison of only two studies [ 1 , 42 ].…”

“…On analyzing the reasons for restoration failure, fracture (4%) was seen to be the most important cause of failure. Previous studies already identified fracture as the most common cause of failure [ 21 , 42 ]. This could be due to the fact that most of the analyzed studies used ceramic materials, which are known to be particularly prone to fracture.…”

“…In this regard, ceramic materials comprise ceramics with a vitreous or vitroceramic matrix, including conventional feldspathic ceramic, synthetic ceramics (leucite-reinforced and/or lithium disilicate ceramic) and hybrid materials or ceramics with a resin matrix [ 37 , 38 ]. In turn, composites are used for the preparation of indirect restorations [ 21 , 37 , 38 , 42 ].…”