Variables affecting the fit of zirconia fixed partial dentures: A systematic review

Maria Bousnaki; Maria Chatziparaskeva; Athina Bakopoulou; Argiris Pissiotis; Petros Koidis

doi:10.1016/j.prosdent.2019.06.019

Variables affecting the fit of zirconia fixed partial dentures: A systematic review

J Prosthet Dent. 2020 May;123(5):686-692.e8. doi: 10.1016/j.prosdent.2019.06.019. Epub 2019 Nov 5.

Authors

Maria Bousnaki¹, Maria Chatziparaskeva², Athina Bakopoulou³, Argiris Pissiotis⁴, Petros Koidis⁵

Affiliations

¹ Doctoral student, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: mpousnak@dent.auth.gr.
² Postgraduate student, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
³ Assistant Professor, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴ Professor, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁵ Professor and Chairman, Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.

PMID: 31703922
DOI: 10.1016/j.prosdent.2019.06.019

Abstract

Statement of problem: Different parameters affect the marginal and internal fit of zirconia fixed partial dentures (FPDs) on natural teeth. Determining a way to optimize these restorations is essential.

Purpose: The purpose of this systematic review was to determine the variables affecting the marginal fit and internal accuracy of zirconia FPDs on natural teeth.

Material and methods: An electronic search was conducted by 2 independent reviewers by using the MEDLINE, Cochrane, Web of Science, and Scopus databases, as well as Google Scholar, for studies published up to July 2018, and a manual search was conducted from the reference lists of related articles. Eligibility criteria included articles in English published in peer-reviewed journals that assessed the marginal and/or internal adaptation of zirconia FPDs on teeth with 3 or more units, with at least 1 of the experimental groups being frameworks or FPDs fabricated from zirconia. Risk of bias was assessed with the aid of the Cochrane Handbook for Systematic Reviews of Interventions.

Results: The search provided 418 records, with 41 fulfilling the inclusion criteria. The selected studies showed considerable heterogeneity regarding materials, state of sintering, manufacturer and computer-aided design and computer-aided manufacturing (CAD-CAM) system, experimental methodology, sample size, and span length. Of the included articles, 36 were in vitro studies and 5 were clinical studies, most of which exhibited high-performance and detection biases. CAD-CAM systems provided more precise marginal and internal fit than CAM systems. An increase of framework span length to 6 or more units decreased both marginal and internal fit. The reported marginal gap tended to increase after the veneering process. The introduction of a conventional impression into an otherwise digital workflow seems to have a negative effect on the marginal fit.

Conclusions: The accuracy of zirconia FPDs or frameworks is considerably influenced by the processing procedure used and the choice of CAD-CAM system.

Publication types

Systematic Review

MeSH terms

Computer-Aided Design*
Dental Marginal Adaptation*
Denture, Partial, Fixed*
Zirconium

Substances

Zirconium
zirconium oxide