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VOLUME 24 , ISSUE 2 ( February, 2023 ) > List of Articles

REVIEW ARTICLE

Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis

Stephan lampl, Jogikalmat Krithikadatta, Deepak Mehta, Desigar Moodley

Keywords : Biological complications, Computer-aided design/computer-aided manufacture materials, Computer-aided design/computer-aided manufacture failure rates, Computer-aided design/computer-aided manufacture success rates, Computer-aided design/computer-aided manufacture survival rates, Technical complications

Citation Information : lampl S, Krithikadatta J, Mehta D, Moodley D. Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis. J Contemp Dent Pract 2023; 24 (2):129-136.

DOI: 10.5005/jp-journals-10024-3472

License: CC BY-NC 4.0

Published Online: 23-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD–CAM fabrications. Materials and methods: Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD–CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models. Results: The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55–100 and 71–100, respectively. The estimated 5-year and 10-year success rates were 74.2–92.75 and 33.3–85.5, respectively. Conclusion: Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term. Clinical significance: The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.


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  1. Oral Health [cited March 24, 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health.
  2. Pandey P, Nandkeoliar T, Tikku AP, et al. Prevalence of dental caries in the Indian population: A systematic review and meta-analysis. J Int Soc Prev Community Dent 2021;11(3):256–265.
  3. Grewal H, Verma M, Kumar A. Prevalence of dental caries and treatment needs amongst the school children of three educational zones of urban Delhi, India. Indian J Dent Res 2011;22(4):517–519.
  4. The Latest State of the Cosmetic Dentistry Industry Survey Results | AACD [cited March 24, 2023]. Available from: https://aacd.com/the-latest-state-of-the-industry-survey-results.
  5. Jorquera G, Mahn E, Sanchez JP, et al. Hybrid ceramics in dentistry: A literature review. J Clin Res Dent 2018;1(2). Available from: https://asclepiusopen.com/articles/95
  6. Srinivasan M, Kamnoedboon P, McKenna G, et al. CAD-CAM removable complete dentures: A systematic review and meta-analysis of trueness of fit, biocompatibility, mechanical properties, surface characteristics, color stability, time-cost analysis, clinical and patient-reported outcomes. J Dent 2021;113:103777. DOI: 10.1016/j.jdent.2021.103777.
  7. Janeva NM, Kovacevska G, Elencevski S, et al. Advantages of CAD/CAM versus conventional complete dentures – A review. Open Access Maced J Med Sci 2018;6(8):1498–1502. DOI: 10.3889/oamjms.2018.308.
  8. Jung S, Moser MM, Kleinheinz J, et al. Biocompatibility of lithium disilicate and zirconium oxide ceramics with different surface topographies for dental implant abutments. Int J Mol Sci 2021;22(14):7700. DOI: 10.3390/ijms22147700.
  9. Zarone F, Di Mauro MI, Ausiello P, et al. Current status on lithium disilicate and zirconia: A narrative review. BMC Oral Health 2019;19(1):134. DOI: 10.1186/s12903-019-0838-x.
  10. Saravi B, Vollmer A, Hartmann M, et al. Clinical performance of CAD/CAM all-ceramic tooth-supported fixed dental prostheses: A systematic review and meta-analysis. Materials (Basel) 2021;14(10):2672. DOI: 10.3390/ma14102672.
  11. Marchesi G, Camurri Piloni A, Nicolin V, et al. Chairside CAD/CAM materials: Current trends of clinical uses. Biology 2021;10(11):1170. DOI: 10.3390/biology10111170.
  12. Ketabi AR, Ketabi R, Brenner M, et al. Retrospective analysis of biological and technical complications using individual CAD/CAM abutments. Dentistry 7(9):1–9. DOI: 10.4172/2161-1122.1000449.
  13. Lechte C, Hausdörfer T, Kanzow P, et al. Clinical performance of CAD-CAM partial-coverage restorations: Experienced versus less-experienced operators. J Prosthet Dent 2022;128(6):1245–1251. DOI: 10.1016/j.prosdent.2022.09.011.
  14. Guncu MB, Aktas G, Turkyilmaz I, et al. Performance of high-translucent zirconia CAD/CAM fixed dental prostheses using a digital workflow: A clinical study up to 6 years. J Dent Sci 2023;18(1):44–49. DOI: 10.1016/j.jds.2022.07.023.
  15. Konstantinidis I, Trikka D, Gasparatos S, et al. Clinical outcomes of monolithic zirconia crowns with CAD/CAM technology. A 1-year follow-up prospective clinical study of 65 patients. Int J Environ Res Public Health 2018;15(11):2523. DOI: 10.3390/ijerph15112523.
  16. Schestatsky R, Zucuni CP, Venturini AB, et al. CAD-CAM milled versus pressed lithium-disilicate monolithic crowns adhesively cemented after distinct surface treatments: Fatigue performance and ceramic surface characteristics. J Mech Behav Biomed Mater 2019;94:144–154. DOI: 10.1016/j.jmbbm.2019.03.005.
  17. Miglani S. Burden of dental caries in India: Current scenario and future strategies. Int J Clin Pediatr Dent 2020;13(2):155–159. DOI: 10.5005/jp-journals-10005-1733.
  18. Batra P, Saini P, Yadav V. Oral health concerns in India. J Oral Biol Craniofac Res 2020;10(2):171–174. DOI: 10.1016/j.jobcr.2020.04.011.
  19. Gambhir RS, Nirola A, Gupta T, et al. Oral health knowledge and awareness among pregnant women in India: A systematic review. J Indian Soc Periodontol 2015;19(6):612–617. DOI: 10.4103/0972-124X.162196.
  20. Moga C. Development of a Quality Appraisal Tool for Case Series Studies Using a Modified Delphi Technique: Methodology Paper. Institute of Health Economics: Edmonton, AB, Canada; 2012. ISBN 978-1-926929-04-0. Available online: https://www.semanticscholar.org/paper/Development-of-a-quality-appraisal-tool-for-case-a-Moga-Guo/fd47b9a8e1b91168b3adcb6f300.
  21. El-Ma'aita A, Al-Rabab'ah MA, Abu-Awwad M, et al. Endocrowns clinical performance and patient satisfaction: A randomized clinical trial of three monolithic ceramic restorations. J Prosthodont 2022;31(1):30–37. DOI: 10.1111/jopr.13414.
  22. Schlichting LH, Resende TH, Reis KR, et al. Ultrathin CAD-CAM glass-ceramic and composite resin occlusal veneers for the treatment of severe dental erosion: An up to 3-year randomized clinical trial. J Prosthet Dent 2022;128(2):158.e1–158.e12. DOI: 10.1016/j.prosdent.2022.02.009.
  23. Gardell E, Larsson C, von Steyern PV. Translucent zirconium dioxide and lithium disilicate: A 3-year follow-up of a prospective, practice-based randomized controlled trial on posterior monolithic crowns. Int J Prosthodont 2021;34(2):163–172. DOI: 10.11607/ijp.6795.
  24. Scholz KJ, Tabenski IM, Vogl V, et al. Randomized clinical split-mouth study on the performance of CAD/CAM-partial ceramic crowns luted with a self-adhesive resin cement or a universal adhesive and a conventional resin cement after 39 months. J Dent 2021;115:103837. DOI: 10.1016/j.jdent.2021.103837.
  25. Mühlemann S, Lakha T, Jung RE, et al. Prosthetic outcomes and clinical performance of CAD-CAM monolithic zirconia versus porcelain-fused-to-metal implant crowns in the molar region: 1-year results of a RCT. Clin Oral Implants Res 2020;31(9):856–864. DOI: 10.1111/clr.13631.
  26. Nassar H, Halim CH, Katamish HA. Clinical outcomes of zirconia-reinforced lithium silicate partial coverage crowns compared to lithium disilicate partial coverage crowns. A randomized controlled split-mouth clinical study. F1000 Res 2019;8:305. DOI: 10.12688/f1000research.18274.1.
  27. Monaco C, Llukacej A, Baldissara P, et al. Zirconia-based versus metal-based single crowns veneered with overpressing ceramic for restoration of posterior endodontically treated teeth: 5-year results of a randomized controlled clinical study. J Dent 2017;65:56–63. DOI: 10.1016/j.jdent.2017.07.004.
  28. Naenni N, Bindl A, Sax C, et al. A randomized controlled clinical trial of 3-unit posterior zirconia-ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results. J Dent 2015;43(11):1365–1370. DOI: 10.1016/j.jdent.2015.07.013.
  29. Sailer I, Gottnerb J, Kanelb S, et al. Randomized controlled clinical trial of zirconia-ceramic and metal-ceramic posterior fixed dental prostheses: A 3-year follow-up. Int J Prosthodont 2009;22(6):553–560. PMID: 19918588.
  30. Chaar MS, Passia N, Kern M. Ten-year clinical outcome of three-unit posterior FDPs made from a glass-infiltrated zirconia reinforced alumina ceramic (in-ceram zirconia). J Dent 2015;43(5):512–517. DOI: 10.1016/j.jdent.2015.02.016.
  31. Reich S, Endres L, Weber C, et al. Three-unit CAD/CAM-generated lithium disilicate FDPs after a mean observation time of 46 months. Clin Oral Investig 2014;18(9):2171–2178. DOI: 10.1007/s00784-014-1191-8.
  32. Burke FJT, Crisp RJ, Cowan AJ, et al. Five-year clinical evaluation of zirconia-based bridges in patients in UK general dental practices. J Dent 2013;41(11):992–999. DOI: 10.1016/j.jdent.2013.08.007.
  33. Sorrentino R, De Simone G, Tetè S, et al. Five-year prospective clinical study of posterior three-unit zirconia-based fixed dental prostheses. Clin Oral Investig 2012;16(3):977–985. DOI: 10.1007/s00784-011-0575-2.
  34. Schmitt J, Holst S, Wichmann M, et al. Zirconia posterior fixed partial dentures: A prospective clinical 3-year follow-up. Int J Prosthodont 2009;22(6):597–603. PMID: 19918596.
  35. Beuer F, Edelhoff D, Gernet W, et al. Three-year clinical prospective evaluation of zirconia-based posterior fixed dental prostheses (FDPs). Clin Oral Investig 2009;13(4):445–451. DOI: 10.1007/s00784-009-0249-5.
  36. Rodrigues SB, Franken P, Celeste RK, et al. CAD/CAM or conventional ceramic materials restorations longevity: A systematic review and meta-analysis. J Prosthodont Res 2019;63(4):389–395. DOI: 10.1016/j.jpor.2018.11.006.
  37. Almukhlis S. Clinical Performance of CAD/CAM Versus Conventional Ceramic Restorations on Posterior Teeth: A Retrospective Study. Student Theses, Dissertations and Capstones 2018. Available from: https://nsuworks.nova.edu/hpd_cdm_stuetd/114.
  38. Abdullah AO, Tsitrou EA, Pollington S. Comparative in vitro evaluation of CAD/CAM vs conventional provisional crowns. J Appl Oral Sci 2016;24(3):258–263. DOI: 10.1590/1678-775720150451.
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