RESUMO
STATEMENT OF PROBLEM: Prefabricated and custom glass fiber posts have been successfully used to reconstruct endodontically treated teeth. However, the performance of computer-aided design and computer-aided manufacture (CAD-CAM) milled glass fiber posts is unclear. PURPOSE: The purpose of this systematic review with meta-analysis was to compare the fracture and bond strength and cement layer thickness of CAD-CAM milled glass fiber posts with prefabricated or custom glass fiber posts. MATERIAL AND METHODS: The protocol was registered in the Open Science Framework (http://osf.io/65jm7). Two reviewers searched the PubMed/MEDLINE, Web of Science, Embase, Scopus, and ProQuest databases for articles up to September 2023. In addition, the reference lists were hand searched. A meta-analysis was performed by using the RevMan 5.4 program. The risk of bias was assessed using the RoBDEMAT tool. RESULTS: After screening, a total of 18 studies were included. The CAD-CAM milled glass fiber posts showed higher fracture strength (P=.02; Standardized Mean Difference [SMD]: 0.57; 95% Confidence Interval [CI]: 0.07 to 1.07), bond strength (P=.010; SMD: 1.07; 95% CI: 0.26 to 1.89), and lower cement layer thickness (P=.009; SMD: -2.94; 95% CI: -5.15 to -0.73) when compared with prefabricated glass fiber posts. However, fracture strength (P=.53; SMD: 0.38; 95% CI: -0.79 to 1.54) and bond strength (P=.90; SMD: -0.05; 95% CI: -0.81 to 0.72) were statistically similar between CAD-CAM milled and custom glass fiber posts. Significant and substantial heterogeneity was observed in all meta-analyzes (P<.01; I>60%). The studies sufficiently reported most domains related to bias, except for randomization of samples, sample size rationale and reporting and operator blinding. CONCLUSIONS: CAD-CAM milled and custom glass fiber posts provide an effective and safe option for restoring endodontically treated teeth, especially for weakened teeth or enlarged root canals. However, further well-designed clinical research is recommended to strengthen these findings.
RESUMO
Las cerámicas dentales son conocidas por su excelencia en reproducir artificialmente los dientes naturales. Casos clínicos más severos en el sector anterior, con acentuada alteración del color, necesidad de substitución de coronas o amplias restauraciones, asociado a una redefinición y largura de los dientes, son solucionadas satisfactoriamente a través de los nuevos sistemas cerámicos como lo sistema IPS e.Max. Este sistema es basado en una cerámica vítrea reforzada con cristales de disilicato de litio (6065%). En este artículo sereporta un caso deunapaciente de 47 años de edadque se realizaron cuatro coronas totales con el sistema cerámico IPS e.Max. El resultado final muestra una estética natural y funcional, con óptimas propiedades ópticas, que son peculiares al sistema cerámico empleado. La conclusión es que el sistema cerámico IPS e.Max es un sistema muy versátil, además de convertirse actualmente en una excelente alternativa como sistema de restauración, tanto estética como funcionalmente, consiguiendo una excelente armonía entre la sonrisa del paciente y la estética de las restauraciones.
Dental ceramics are known for their excellence in the artificial reproduction of natural teeth. Clinical cases with severe marked discoloration in the anterior region, need of crown replacement or extensive restorations associated to a redefinition and length of the teeth, are successfully treated with new ceramic systems such as IPS system e. Max. The system is based on glass-reinforced ceramic lithium disilicate crystals (6065%). This article describes a case of a 47 year old woman with four full crowns made with IPS e.max ceramic system is reported. The final result shows a natural and functional aesthetic with excellent optical properties, which are particular to the ceramic system used. In conclusion the IPS e.max ceramic system is a versatile system in addition to currently becoming an excellent alternative for restoration systems, both aesthetically and functionally, achieving an excellent balance between the patient's smile and aesthetic restorations.