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      Clinical performance of resin-matrix ceramic partial coverage restorations: a systematic review

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          Abstract

          Objective

          To evaluate clinical performance of the new CAD/CAM resin-matrix ceramics and compare it with ceramic partial coverage restorations.

          Materials and methods

          An electronic search of 3 databases (The National Library of Medicine (MEDLINE/PubMed), Scopus, and the Cochrane Central Register of Controlled Trials) was conducted. English clinical studies published between 2005 and September 2020 that evaluated the clinical performance of CAD/CAM resin-matrix ceramics inlays, onlays, or overlays were selected. The primary clinical question was applied according to PICOS strategy (Population, Intervention, Comparison, Outcome, Study design). The included studies were individually evaluated for risk of bias according to the modified Cochrane Collaboration tool criteria.

          Results

          A total of 7 studies were included according to the established inclusion and exclusion criteria. From the included studies, 6 were randomized clinical trials while one study was longitudinal observational study without control group. According to the results of the included studies, the success rate of CAD/CAM resin-based composite ranged from 85.7 to 100% whereas the success rate reported for ceramic partial coverage restorations ranged from 93.3 to 100%. Fractures and debondings are found to be the most common cause of restorations failure.

          Conclusion

          CAD/CAM resin-based composite can be considered a reliable material for partial coverage restorations with clinical performance similar to glass ceramic restorations. However, this result needs to be confirmed in long-term evaluations.

          Clinical relevance

          CAD/CAM resin-based composites provide a potential alternative to ceramic indirect restorations. However, clinicians must be aware of the lake of knowledge regarding long-term outcome.

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          Most cited references80

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

          David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
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            Mechanical properties of polymer-infiltrated-ceramic-network materials.

            To determine and identify correlations between flexural strength, strain at failure, elastic modulus and hardness versus ceramic network densities of a range of novel polymer-infiltrated-ceramic-network (PICN) materials. Four ceramic network densities ranging from 59% to 72% of theoretical density, resin infiltrated PICN as well as pure polymer and dense ceramic cross-sections were subjected to Vickers Indentations (HV 5) for hardness evaluation. The flexural strength and elastic modulus were measured using three-point-bending. The fracture response of PICNs was determined for cracks induced by Vickers-indentation. Optical and scanning electron microscopy (SEM) was employed to observe the indented areas. Depending on the density of the porous ceramic the flexural strength of PICNs ranged from 131 to 160MPa, the hardness values ranged between 1.05 and 2.10GPa and the elastic modulus between 16.4 and 28.1GPa. SEM observations of the indentation induced cracks indicate that the polymer network causes greater crack deflection than the dense ceramic material. The results were compared with simple analytical expressions for property variation of two phase composite materials. This study points out the correlation between ceramic network density, elastic modulus and hardness of PICNs. These materials are considered to more closely imitate natural tooth properties compared with existing dental restorative materials. Copyright © 2013 Academy of Dental Materials. All rights reserved.
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              Key concepts of clinical trials: a narrative review.

              The recent focus of federal funding on comparative effectiveness research underscores the importance of clinical trials in the practice of evidence-based medicine and health care reform. The impact of clinical trials not only extends to the individual patient by establishing a broader selection of effective therapies, but also to society as a whole by enhancing the value of health care provided. However, clinical trials also have the potential to pose unknown risks to their participants, and biased knowledge extracted from flawed clinical trials may lead to the inadvertent harm of patients. Although conducting a well-designed clinical trial may appear straightforward, it is founded on rigorous methodology and oversight governed by key ethical principles. In this review, we provide an overview of the ethical foundations of trial design, trial oversight, and the process of obtaining approval of a therapeutic, from its pre-clinical phase to post-marketing surveillance. This narrative review is based on a course in clinical trials developed by one of the authors (DJM), and is supplemented by a PubMed search predating January 2011 using the keywords "randomized controlled trial," "patient/clinical research," "ethics," "phase IV," "data and safety monitoring board," and "surrogate endpoint." With an understanding of the key principles in designing and implementing clinical trials, health care providers can partner with the pharmaceutical industry and regulatory bodies to effectively compare medical therapies and thereby meet one of the essential goals of health care reform.
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                Author and article information

                Contributors
                hamdy@connect.hku.hk
                Journal
                Clin Oral Investig
                Clin Oral Investig
                Clinical Oral Investigations
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1432-6981
                1436-3771
                23 March 2022
                23 March 2022
                2022
                : 26
                : 5
                : 3807-3822
                Affiliations
                [1 ]GRID grid.10251.37, ISNI 0000000103426662, Operative Dentistry Department, Faculty of Dentistry, , Mansoura University, ; Algomhoria St, Mansoura City, 35516 Egypt
                [2 ]GRID grid.10251.37, ISNI 0000000103426662, Dental Biomaterials Science Dept, Faculty of Dentistry, , Mansoura University, ; Mansoura, Egypt
                Author information
                http://orcid.org/0000-0003-3205-345X
                Article
                4449
                10.1007/s00784-022-04449-2
                9072524
                35320383
                2c4bf3fe-e1df-4e4f-9290-c52c6a823735
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 1 November 2021
                : 12 March 2022
                Funding
                Funded by: Mansoura University
                Categories
                Review
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2022

                Dentistry
                resin-matrix ceramics,hybrid ceramics,ceramics,cad/cam,indirect restorations
                Dentistry
                resin-matrix ceramics, hybrid ceramics, ceramics, cad/cam, indirect restorations

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