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Comparison of the fracture strengths of single-unit metal-ceramic and monolithic zirconium restorations in the molar region: a systematic review and meta-analysis

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Abstract

Despite the success of monolithic zirconia restorations (MZ), metal-ceramic restorations (MC) are still considered the gold standard for fixed prosthetics in the posterior region. This systematic review and meta-analysis aimed to compare the fracture strengths of single-unit MC and MZ in the molar region. This review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, 2020) statement. All articles were searched from the PubMed and Web of Science databases until November 18, 2022. All in vitro studies evaluating the fracture strengths of MC and MZ were also included. Statistical analysis was performed with the Comprehensive Meta-Analysis program, with a significance level of 0.05. Out of 753 studies, five were selected. The fracture strengths of MZ and MC did not show any statistically significant difference for both tooth (95% CI − 1.589: 2.118, p = 0.779, z = 0.280) and implant (95% CI − 2.215: 2.191, p = 0.992 z = − 0.010) supported restorations. However, different abutment materials (p < 0.001) and aging treatments (p < 0.001) in tooth-supported restorations displayed a significant statistical difference. Additionally, a significant difference was also observed in subgroup analysis considering different cements (p = 0.001) and load speeds (p = 0.001) in implant-supported restorations. Fracture strengths of MZ and MC did not show a significant statistical difference in implant or tooth-supported single-unit posterior restorations. MZ may be a suitable alternative to MC in single-unit posterior restorations. The results should be interpreted with caution, as the included studies were in vitro.

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Data availability

The data for this research can be found in Table 1, and the same data can be found in the available articles from references [34,35,36,37,38].

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  1. Department of Prosthodontics, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Inonu Boulevard No: 4, Afyonkarahisar, Turkey

    Özer Işisağ & Nur Pektaş

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All authors made substantial contribution to the conception and design of the manuscript. All authors drafted the work and revised it critically for important intellectual content. All authors agree to be accountable for all aspects of the study design and its content. All authors approved the final submitted version.

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Işisağ, Ö., Pektaş, N. Comparison of the fracture strengths of single-unit metal-ceramic and monolithic zirconium restorations in the molar region: a systematic review and meta-analysis. Odontology (2023). https://doi.org/10.1007/s10266-023-00878-x

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