Tuesday, July 16, 2024

Impact of Different Ceramic Restorations on Enamel Wear: A Systematic Review

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In the world of dentistry, understanding the wear and tear on enamel caused by various restoration materials is crucial. As fixed restorations and natural dental enamel exhibit distinct structural characteristics, they impart different levels of wear on opposing teeth. This study aims to pinpoint the type of ceramic restoration that inflicts minimal enamel wear on naturally opposing teeth, providing vital insights and recommendations for dental practitioners.

Study Selection and Design

The research included randomized clinical trials (RTCs), non-randomized clinical trials (non-RTCs), and observational studies (OS). For inclusion, studies needed to address the research question directly, be available in full text, be written in either English or Spanish, and have a follow-up period of at least six months. The review process began with 499 records, from which 20 RTCs were selected for data extraction. Ultimately, 10 studies were included in the systematic review and 5 in the network meta-analysis, as detailed in protocol number CRD42023397759.

Results and Findings

The risk of bias assessment revealed a moderate to high risk across the selected studies. The quality and certainty of the evidence were deemed moderate. The network meta-analysis indicated that natural dental enamel experiences greater wear when opposed by metal-ceramic restorations. This finding underscores the importance of considering the antagonistic material in dental restorations to mitigate enamel wear.

Practical Implications for Dental Practice

  • Natural enamel exhibits higher wear against metal-ceramic restorations compared to other materials.
  • Glazed and polished zirconia crowns also contribute to significant enamel wear.
  • Long-term clinical trials with larger sample sizes are necessary to solidify these findings.

Conclusion

The study concludes that enamel wear is inevitable regardless of the opposing material. However, surfaces facing ceramic crowns, particularly metal-ceramic, glazed zirconia, and polished zirconia, exhibit increased wear. Future research with extended follow-up periods and larger cohorts is essential to refine these conclusions and guide dental restoration practices more effectively.

Original Article: J Prosthodont Res. 2024 Jun 26. doi: 10.2186/jpr.JPR_D_23_00263. Online ahead of print.

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