Microleakage after thermocycling of cemented crowns--a meta-analysis. 2011

Martina Schmid-Schwap, and Alexandra Graf, and Angela Preinerstorfer, and David C Watts, and Eva Piehslinger, and Andreas Schedle
Department of Prosthodontics, Bernhard Gottlieb University Clinic of Dentistry, Medical University of Vienna, Austria.

OBJECTIVE Microleakage testing of dental materials is a commonly accepted evaluation technique of margin integrity. Thermocycling has been utilized by many researchers to study the influence of temperature extremes on the marginal gap of cemented restorations. The aim of this investigation was to analyze microleakage data on cemented crowns, published in the dental literature until Dec 2009, to identify methodological factors that might potentially affect the results of in vitro microleakage tests and to compare the results. METHODS The following databases were included: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) 1950 to Present, Ovid-MEDLINE(R) 1950 to Present with Daily Update, EMBASE, EBM Reviews - Cochrane Database of Systematic Reviews and Pub Med. The search was limited to articles in English, French, Italian and German published until the end of 2009. Classical reviews, comments, animal studies, in vivo articles and studies investigating restorative materials or milk teeth were excluded. 33 different studies were finally selected. The studies were entered in a database and compared using selected literature criteria: sample, restoration procedures, thermocycling and mechanical cycling, evaluation method. For statistical analysis only 16 studies could be applied. RESULTS It was not possible to make a quantitative synthesis of most of the data, due to the heterogeneity of the studies concerning methods, treatment and outcome variables. Comparing the main groups of materials (ceramics, gold alloys and base metal alloys), no significant difference in the proportion of teeth without microleakage was found. Furthermore no significant difference in the proportion of teeth showing microleakage less than two third of the wall or teeth showing microleakage including the entire wall was found. Using the mean values in the meta-analysis instead of the proportions does not change the results. Confidence intervals could only be calculated for two materials (gold alloy, metal alloy). No difference between materials was found. CONCLUSIONS Comparison of the results from different studies is critical, since there are no generally accepted standards for experimental parameters, such as type and concentration of the storage solution, time of storage, temperature during storage, type and duration of thermal cycling and/or mechanical cycling, and the scoring criteria. There is lack of standardization of experimental conditions, which would ensure confidence in the studies and would further allow better comparability of various results.

UI MeSH Term Description Entries
D002484 Cementation The joining of objects by means of a cement (e.g., in fracture fixation, such as in hip arthroplasty for joining of the acetabular component to the femoral component). In dentistry, it is used for the process of attaching parts of a tooth or restorative material to a natural tooth or for the attaching of orthodontic bands to teeth by means of an adhesive. Cementations
D003442 Crowns A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. Dental Crowns,Crown, Dental,Crowns, Dental,Dental Crown,Crown
D003722 Dental Alloys A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions for use in restorative or prosthetic dentistry. Alloy, Dental,Alloys, Dental,Dental Alloy
D003763 Dental Leakage The seepage of fluids, debris, and micro-organisms between the walls of a prepared dental cavity and the restoration. Dental Leakages,Leakage, Dental,Leakages, Dental
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003799 Dental Stress Analysis The description and measurement of the various factors that produce physical stress upon dental restorations, prostheses, or appliances, materials associated with them, or the natural oral structures. Analyses, Dental Stress,Analysis, Dental Stress,Stress Analyses, Dental,Stress Analysis, Dental,Dental Stress Analyses
D006358 Hot Temperature Presence of warmth or heat or a temperature notably higher than an accustomed norm. Heat,Hot Temperatures,Temperature, Hot,Temperatures, Hot
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D018772 Dental Marginal Adaptation The degree of approximation or fit of filling material or dental prosthetic to the tooth surface. A close marginal adaptation and seal at the interface is important for successful dental restorations. Adaptation, Marginal, Dental,Marginal Adaptation, Dental,Dental Internal Adaptation,Dental Internal Fit,Adaptation, Dental Internal,Adaptation, Dental Marginal,Adaptations, Dental Internal,Adaptations, Dental Marginal,Dental Internal Adaptations,Dental Internal Fits,Dental Marginal Adaptations,Fit, Dental Internal,Fits, Dental Internal,Internal Adaptation, Dental,Internal Adaptations, Dental,Internal Fit, Dental,Internal Fits, Dental,Marginal Adaptations, Dental

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