17 May 2024

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A Comparative Analysis of 3D-Printed vs Milled Dental Restorations: A Systematic Review and Meta-Analysis

Lorenzo Breschi, Diego D’Urso

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Advancements in manufacturing technologies have revolutionized the fabrication of dental restorations and prostheses, allowing for enhanced material manipulation and improved geometric precision. In their recent review, Alghauli et al. have explored the feasibility of producing 3D-printed intracoronal restorations, thin veneers, and ultrathin veneers. They have scrutinized the mechanical behavior, accuracy, biological properties, and susceptibility to staining of 3-D printed restorations, comparing to those that were conventionally milled.

Materials and Methods: This systematic review has meticulously examined studies focused on indirect partial coverage restorations, including inlays, onlays, laminate, and occlusal veneers. These restorations were fabricated using either 3D printing (additive manufacturing) or milling (subtractive manufacturing) technology. Electronic search results were managed using Endnote X 20.4.1 (Clarivate Analytics, USA), with duplicate records removed. Eligible records were assessed based on inclusion criteria, with 13 items used to evaluate risk of bias. Main outcome measures included marginal and internal fit, trueness, fracture resistance, and aging effects on fracture resistance of 3D-printed compared to milled restorations. Secondary outcomes encompassed biological and esthetic properties, roughness, cost-effectiveness, and production time.

Results: From 1150 initial records, only 17 were deemed suitable after thorough examination. Pooled data revealed the feasibility of producing ultrathin restorations (<0.2 mm thickness) using 3D printing technology. 3D-printed laminate veneers and intracoronal restorations exhibited superior trueness, marginal and internal fit compared to milled counterparts (p < 0.05), though material choice and preparation design influenced the outcomes. Additionally, 3D printing proved more time efficient.

Conclusions: This review underscores the viability of additive manufacturing for producing restorations with thicknesses ranging from 0.1 to 0.2 mm. The high accuracy of these restorations enhances resistance to caries progression, surpassing clinical failure thresholds with reliable adhesion. However, further enhancements are necessary, particularly in reducing susceptibility to staining. Continued development of materials and printing technology will address these challenges and pave the way for widespread clinical adoption of 3D-printed resin restorations.

Keywords: 3D-printing, additive manufacturing, ceramic, inlay and onlay, laminate and occlusal veneers, PEEK, resin 

For more information: M.A. Alghauli, A.Y. Alqutaibi. 3D-printed intracoronal restorations, occlusal and laminate veneers: Clinical relevance, properties, and behavior compared to milled restorations; a systematic review and meta-analysis. JERD 2024 March.

Source: https://doi.org/10.1111/jerd.13228