Técnica CAD/CAM comparado con técnica convencional en pacientes con indicación de restauración indirecta unitaria posterior / CAD/CAM versus conventional techniques for unitary posterior indirect restoration

RESUMEN: Introducción: La confección de restauraciones indirectas ha sido tradicionalmente realizada mediante técnicas convencionales de laboratorio, la cual involucra la realización de una serie de pasos y la necesidad de que el paciente asista a varias sesiones clínicas. En las últimas décadas ha sido incorporada la técnica CAD/CAM, la cual ha simplificado la confección de restauraciones indirectas. Es necesario comparar el desempeño clínico de ambas técnicas. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metaanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos tres revisiones sistemáticas que en conjunto incluyeron ocho estudios primarios, de los cuales, cinco corresponden a ensayos aleatorizados. Concluimos que la técnica CAD/CAM probablemente aumenta la falla de la restauración y la pérdida de retención. Por otra parte, podría disminuir levemente la pérdida de vitalidad y tener nula o poca diferencia en el riesgo de extracción dentaria, riesgo de caries secundaria y cambio de color superficial, pero la certeza de la evidencia es baja.

ABSTRACT: Introduction: Conventional laboratory techniques for indirect restoration involve multiple stages and several clinical sessions for patients. In the last decades, the CAD/CAM technique has been incorporated in clinical practice, simplifying the fabrication process of indirect restorations. A comparative assessment of the clinical performance of both techniques is required. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified three systematic reviews including eight studies overall, of which five were randomized trials. We conclude that CAD/CAM technique probably increase the risk of restoration failure and loss of retention. On the other hand, CAD/CAM technique may slightly reduce the risk of loss of vitality and may make little or no difference to the risk of tooth extraction, risk of secondary caries and superficial color change, but the certainty of the evidence is low.

Aesthetic restoration of full ceramic veneer by slip casting / 实用口腔医学杂志

Full ceramic prosthesis is becoming the main prosthetic development direction. As an important kind of full ceramic prosthesis, full ceramic veneer has not only natural cosmetic appearance and perfect biocompatibility, but also can preserve tooth structure as much as possible, which would be more easily accepted by patients for cosmetic prosthesis. Many methods, such as slip casting, die casting and CAD/CAM technology are available to make full ceramic veneer. All the methods have their own advantages and disadvantages. Slip casting is easy to be developed widely with low cost, so be used in practical work. In this article, the working process of full ceramic veneer, especially manufacture of removable dies, duplication of refractory models, were introduced, which was supposed to be beneficial for the technicians.