Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] | 2021
Enamel wear against monolithic zirconia restorations: A meta-analysis and systematic review of in vitro studies.
Abstract
OBJECTIVE\nAn assessment was performed to identify and evaluate dental enamel wear caused by monolithic zirconia restoration. Literature searches were conducted in PubMed, Science Direct, Cochrane Evidence, and the Cochrane Library up to May 2020.\n\n\nMATERIAL AND METHODS\nStudies were selected for systematic review according to the inclusion (articles conducted on the wear of enamel samples opposing monolithic zirconia) and exclusion (case reports, non-English articles, and monolithic zirconia samples facing other materials rather than human enamel) criteria. Of those, articles on polished and glazed monolithic zirconia subjected to a 50\u2009N vertical load with a range of 240,000-250,000\u2009cycles, equivalent to 1\xa0year of in vivo mastication, were included in the meta-analysis.\n\n\nRESULTS\nIn total, 3968 articles were pooled. Twenty-five articles met the inclusion criteria for the systematic review. Three studies were included in the meta-analysis. The results showed that the enamel wear against monolithic zirconia was within the statistically accepted level. Moreover, the polished monolithic zirconia surface caused less enamel wear than the glazed surface.\n\n\nCONCLUSION\nThis review indicates that monolithic zirconia restorations cause acceptable antagonist enamel wear. Moreover, the meta-analysis results agreed that the final restoration s surface texture plays an essential role in the wear process.\n\n\nCLINICAL SIGNIFICANCE\nMonolithic zirconia restorations have been widely used in dental practice because they eliminate the chipping problems resulting from using veneered restorations. With recent technology development, monolithic zirconia has obtained more esthetic features and a more natural look. However, due to the high strength and surface roughness of monolithic zirconia, wear on the antagonist s teeth was detected. The results showed that this wear amount was statistically acceptable and lower than other ceramics such as feldspathic porcelain and enamel. Furthermore, surface treatment methods must be applied to minimize tooth wear, as polished or glazed surfaces interfere with enamel loss.