Resistance of CAD/CAM composite resin and ceramic occlusal veneers to fatigue and fracture in worn posterior teeth: a systematic review

Abstract

The aim of this systematic review is to summarize and analyze the scientific evidence evaluating the mechanical performance of Computer Aided Design, Computer Aided Manufacturing (CAD/CAM) composite resin and CAD/CAM lithium disilicate ceramic occlusal veneers, in terms of fatigue and fracture resistance, on severely worn posterior teeth. Currently, occlusal veneers are an alternative for treating worn posterior teeth. Even though there is scientific evidence demonstrating the good performance of lithium disilicate occlusal veneers, there are now more materials that are less brittle and have a modulus of elasticity more similar to dentin than ceramics, such as resin CAD/CAM blocks. Therefore, it is important to identify which type of material is best for restoring teeth with occlusal wear defects that can provide better clinical performance. This review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. We performed a search in the Pubmed, Embase, Web of Science, Scopus, Cochrane, Open Gray, Redalyc, Dspace, and Grey Literature Report databases, supplemented by a manual search, without time or language limitation, until January 2022, for studies evaluating the fatigue and fracture resistance of CAD/CAM composite resin Karelys del Cisne, Maldonado Torres Juan Andrés, Espinoza Cárdenas

4 and ceramic occlusal veneers. The quality of the full-text articles was analyzed according to the modified CONSORT criteria for in vitro studies, and 400 articles were initially identified. After removing duplicate studies and applying the selection criteria, the systematic review finally included 6 studies. The CAD/CAM composite resin occlusal veneers have similar mechanical performance in terms of fatigue and fracture resistance as CAD/CAM lithium disilicate occlusal veneers.