Desempenho biomecânicode materiais cerâmicos e resinosos para confecção de restaurações endocrown: revisão sistemática e meta-análise

Abstract

This systematic review was conducted to evaluate which material, ceramic or composite, has better biomechanical performance for endocrown restorations. The search for the studies was performed and updated in March 2018in five databases: PubMed, Web of Science, Cochrane Library, Clinical Trials and Scopus. Only studies that compared different materials for endocrown restorations were included. 436 articles were selected by 2 independent reviewers, in which 11 in vitro studies were included in thereview. The meta-analysis was performed for the fracture strength values of 8 studies. A overall comparison was performed between ceramic and composite endocrowns, with random-effects models at a significance level of p < 0.05. Subgroupanalyses were performed to analyze the fracture strength of ceramic endocrowns compared with those of compositeconsidering the position of teeth (anterior/posterior) and the depth of endocrown preparations in the pulp chamber (short/long). The ceramic endocrowns had higher fracture strength than composite types (p<0.0001) in the overall analysis and in the subgroup analysis for anterior teeth (p=0.0007). There was no significant difference in the fracture strength between ceramic and composite endocrowns, irrespective of the preparation depth (short: p=0.37/long: p=0.05). The use of ceramic materials may provide better performance than composites relative tothe fracture strength of endocrowns, however, the failure mode of restorations should be considered wheninterpreting the results. The composite materials provided better internal fit and marginal adaptation compared to with ceramics. The biomechanical performance of ceramic and composite endocrowns was dependent on material composition and both showed adequate fracture strength, internal fit and marginal adaptation. However, clinical trials should be conducted to select which material would be more suitable for endocrown restorations.