Marginal Gap of Pre-Cemented Endocrowns: A Systematic Review of Measurement Methods and the Influence of Fabrication Method and Crown Material

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2025-05-26 DOI:10.1002/cre2.70152

James Dudley, Taseef Hasan Farook

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Abstract

Objective

The aim of this systematic review was to analyze the existing literature on the methods used for in vitro marginal gap measurement of pre-cemented endocrowns and determine whether the fabrication method and material used influenced the marginal gap.

Materials and Methods

Systematic screening was conducted until January 2025 using EBSCO Host, Scopus, PubMed, and Web of Science databases. This systematic review followed PRISMA guidelines, including in vitro studies on marginal gaps in single-unit pre-cemented endodontic crowns while excluding in vivo and virtual assessments, and studies analyzing preformed and implant-supported crown assessments. The quality of the selected studies was evaluated using the Joanna Briggs Critical Appraisal Checklist. Welch's t-test and ANOVA were used to analyze differences in marginal gaps across the included variables.

Results

Twenty-eight studies were included for analysis. The mean marginal gap for endocrowns across all included studies was 82.75 ± 33.10 µm. Endocrowns fabricated on maxillary teeth demonstrated a mean marginal gap of 77.01 ± 25.46 µm compared with 85.05 ± 36.04 µm for mandibular teeth (t = −0.66, p = 0.513). Endocrowns fabricated using computer-aided design/computer-aided manufacturing (CAD/CAM) (86.65 ± 38.14 µm) had significantly smaller marginal gaps compared with those produced using conventional impressions (109.37 ± 30.05 µm) (t = 2.746, p = 0.038). Seven measurement methods were reported, with significant differences observed in marginal gap values across the different methods (F = 4.61, p = 0.013). Impression replica and stereomicroscopy were the most used marginal gap methods, used collectively in 19 (68%) of the included 28 studies. Impression replica (95.49 ± 31.57 µm) and stereomicroscopy (63.69 ± 26.81 µm) methods produced significantly different marginal gap measurements (p = 0.003). There were no significant differences in marginal gap between endocrown materials (p = 0.122), with marginal gaps ranging from 60.93 ± 26.66 µm in the less explored polymer-infiltrated ceramic to 95.21 ± 34.07 µm in the more frequently studied zirconia. Lithium disilicate remained the most heavily researched material with a pooled marginal gap of 84.04 ± 32.91 µm across all included studies.

Conclusion

The choice of measurement technique significantly influenced the reported marginal gap values, with impression replica, stereomicroscopy, and 3D superimposition being the most commonly used methods. While the fabrication method had a notable impact on marginal gaps in vitro, the choice of crown material did not.

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预粘接内冠边缘间隙：测量方法及制作方法和冠材影响的系统综述

目的分析国内外已有的预胶合牙髓内冠体外边缘间隙测量方法，探讨牙髓内冠的制作方法和材料对边缘间隙的影响。材料和方法使用EBSCO主机、Scopus、PubMed和Web of Science数据库进行系统筛选，直至2025年1月。该系统综述遵循PRISMA指南，包括对单单元预胶结牙髓冠边缘间隙的体外研究，但不包括体内和虚拟评估，以及分析预成型和种植体支持的牙冠评估的研究。所选研究的质量使用乔安娜布里格斯关键评估清单进行评估。采用Welch’st检验和方差分析分析各纳入变量间边际差距的差异。结果纳入28项研究进行分析。在所有纳入的研究中，内冠的平均边缘间隙为82.75±33.10µm。上颌牙内冠的平均边缘间隙为77.01±25.46µm，下颌骨为85.05±36.04µm （t =−0.66,p = 0.513）。计算机辅助设计/计算机辅助制造（CAD/CAM）制造的牙冠（86.65±38.14µm）的边缘间隙明显小于传统印模（109.37±30.05µm）（t = 2.746, p = 0.038）。报告了7种测量方法，不同方法的边际间隙值存在显著差异（F = 4.61, p = 0.013）。印模复制和体视显微镜是最常用的边缘间隙方法，在纳入的28项研究中有19项（68%）共同使用。印模复制法（95.49±31.57µm）和立体显微镜法（63.69±26.81µm）的边际间隙测量值差异显著（p = 0.003）。不同内冠材料的边缘间隙无显著差异（p = 0.122），聚合物浸润陶瓷的边缘间隙为60.93±26.66µm，氧化锆的边缘间隙为95.21±34.07µm。二硅酸锂仍然是研究最多的材料，在所有纳入的研究中，汇总的边际差距为84.04±32.91µm。结论测量技术的选择对所报道的边缘间隙值有显著影响，其中印模复制、体视显微镜和三维叠加是最常用的测量方法。制备方法对牙冠边缘间隙有显著影响，而冠材料的选择对牙冠边缘间隙无显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.