Do 3D-printed and milled tooth-supported complete monolithic zirconia crowns differ in accuracy and fit? A systematic review and meta-analysis of in vitro studies
Abstract
Statement of problem
Additive
(3-dimensional printing) and subtractive (milling) methods are digital
approaches to fabricating zirconia restorations. Comparisons of their
resultant fabrication accuracy and restoration fit are lacking.
Purpose
The
purpose of this systematic review and meta-analysis was to evaluate the
accuracy and fit of monolithic zirconia crowns fabricated by
3-dimensional printing and milling.
Material and methods
The
PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and
Google Scholar databases were searched up to August 2023. Eligible
records were included, and the standardized mean difference (SMD)
analyzed 4 outcomes: marginal fit, intaglio fit, trueness, and
precision. Publication bias was analyzed with Trim-and-fill, the Egger
regression test, and Begg funnel plot. Methodological quality was rated
using the QUIN tool.
Results
A
total of 15 publications were found eligible out of the initial 6539
records. The 3-dimensional printing group demonstrated a lower marginal
fit (SMD=1.46, 95% CI=[0.67, 2.26], P<.001; I2=83%, P<.001) and trueness (SMD=0.69, 95% CI=[0.20, 1.18], P=.006; I2=88%, P<.001) and a significantly higher precision (SMD=−2.19, 95% CI=[−2.90, −1.48], P<.001; I2=56%, P=.045). The intaglio fit did not differ significantly across the study groups (SMD=0.77, 95% CI=[−0.22, 1.77], P=.127; I2=87%, P<.001).
Conclusions
Given
the high degree of heterogeneity, it can be cautiously concluded that
while 3-dimensional printing led to greater precision, the outcomes of
the 2 accuracy and adaptation parameters most crucial to the longevity
of the restorations—trueness and marginal fit—showed the superiority of
the milling technique.
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