| Purpose:The purpose of this systematic review and meta-analysis was to compare the marginal adaptation and internal adaptation of ceramic inlays made from digital workflow or conventional workflow,the digital workflow including digital impression and digital fabrication.Summarizes the influence of different impression and manufacturing methods on the adaptation of ceramic inlays,provide evidence-based medicine reference for the clinical selection of prosthetic production methods.Methods:Search databases such as Pub Med,EMBASE,Cochrane Central Register of controlled trials（CENTRAL）,CNKI and Wanfang database.All databases were searched by December 2021.The search strategy was based on the combination of Mesh words and free words.Search published studies about marginal adaptation or internal adaptation of ceramic inlays made from digital workflow or conventional workflow.In the literature,the outcome measures are mean and standard deviation of marginal and internal gaps.Two researchers screened and extracted the literature independently,evaluated the methodological quality of the included articles.The metaanalysis was performed by Rev Man 5.2 software.Result:A total of 902 published literatures were retrieved from databases.After removing duplicates,browsing titles and abstracts,and reading the full text,18 studies were included in this meta analysis.Comparison between complete digital and complete conventional workflows.A total of 9 studies were included in this group.There wasn’t enough evidence to determine whether there is a difference between two workflows（SMD =-0.18,95%CI[-1.01,0.66],P = 0.68）.Four studies compared internal adaptation of these two groups.The internal adaptation of conventional workflow was better than digital workflow（SMD=0.69,95%CI [0.28,1.10],P=0.0009）.Comparison between digital and conventional manufacturing techniques.Gypsum die were cast after conventional impression,the digital manufacturing group scanned the gypsum die and made ceramic inlays with milling machines,while the conventional group made the ceramic inlays from conventional manufacturing techniques.6 studies were included in this group.The result showed that digital manufacturing techniques had better marginal adaptation than conventional manufacturing techniques（SMD =-1.01,95% CI [-1.31,-0.71],P < 0.00001）.Three studies compared the internal adaptation of these two groups.The internal adaptation of conventional manufacturing techniques was similar to digital manufacturing techniques（SMD = 0.46,95%CI [0.06,0.98],P = 0.08）.Comparison between direct digital impression and indirect digital impression.The direct digital impression group scanned preparations,while the indirect impression group scanned gypsum die,after digital impressions,ceramic inlays were made by digital manufacturing techniques.4 studies were included in this group.The two groups provided similar marginal adaptation（SMD=-0.17,95%CI [-0.59,0.24],P =0.41）.Two studies compared the internal adaptation of these two groups,they provided similar internal adaptation（SMD=0.17,95%CI [-0.49,0.82],P=0.62）.Comparison between digital and conventional manufacturing techniques of wax patterns.The wax patterns were made from digital or conventional manufacturing techniques.Two studies were included in this group.The marginal adaptation of the digital manufacturing techniques group was better than that of the conventional manufacturing techniques group（SMD =-2.56,95% CI [-4.84,-0.27],P = 0.03）.Conclusion:1.Compare to ceramic inlays made from complete conventional workflow,ceramic inlays made from partial or complete digital workflows had similar or better marginal adaptation.2.The internal adaptation of ceramic inlays made from complete conventional workflow were better than ceramic inlays made from complete digital workflow.3.Direct digital impression and indirect digital impression provided similar marginal and internal adaptation,when the inlays made from digital manufacturing techniques. |
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