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ORAL PRESENTATION ABSTRACTS

P002 Name of Presenter: Jonathan Yuen Jun Xian, Klinik Pergigian Trong, Ministry of Health,
Perak, Malaysia
Title of Presentation: The clinical behaviour and survival of computer-aided design and
computer-aided manufacturing (CAD-CAM) hybrid ceramic restorations on endodontically
treated teeth: A systematic review and meta-analysis

Abstract
Yuen JJX 1,*, Saw ZK 2, Chua HS 3, Beh YH 4
1 Klinik Pergigian Trong, Ministry of Health, Perak, Malaysia.
2 Klinik Pergigian Bagan Serai, Ministry of Health, Perak, Malaysia.
3 Klinik Pergigian Marang, Ministry of Health, Terengganu, Malaysia
4 Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur,
Malaysia

Introduction: Hybrid ceramics seek to combine the mechanical and optical properties of ceramics and
composites to mimic natural teeth. Given the novelty of this restorative material, an evaluation of their
clinical performance is warranted.
Objectives: This systematic review was to assess the survival of computer-aided design and computer-aided
manufacturing (CAD-CAM) hybrid ceramic restorations on endodontically treated teeth and to describe the
incidence of complications.
Methodology: The study was registered in PROSPERO and adhered to PRISMA guidelines. A comprehensive
search across six online databases was performed. Clinical studies which involved CAD-CAM hybrid ceramic
restorations on endodontically treated teeth were included. Several investigators independently conducted
the study selection, data extraction, and quality assessment processes. Risk of bias were assessed using
Cochrane RoB 2 tool and Newcastle-Ottawa Scale. Failure rates were analysed using Poisson regression
models to obtain summary estimates of 3- and 5-year survival proportions which were pooled using a
random-effects model. Subgroup analysis was performed between two hybrid ceramic materials, resin
nanoceramic (RNC) and polymer infiltrated ceramic network (PICN).
Results: The search resulted in 250 studies after duplicate removal. Full-text analysis was performed for
24 articles and 11 articles were included in the final analysis. Meta-analysis of 289 restorations revealed an
overall estimated failure rate of 3.44 (95% confidence interval [95% CI]: 2.67–4.21) per 100-restoration years,
translating to a survival rate of 90.2% (95% CI: 88.1-92.3%) after 3 years and 84.2% (95% CI: 81.0-87.5%) after 5
years. A significantly higher (p < 0.05) failure rate was reported for RNC (5.97%, CI: 3.52-8.41%) compared to
PICN restorations (1.61%, CI: 0.87-2.36%). Restoration debonding was the main reason for failure.
Conclusion: Restoring endodontically treated teeth with CAD-CAM hybrid ceramic restorations have
an acceptable survival rate, however debonding was a common complication. PICN restorations have a
statistically significant higher survival rate than RNC restorations

Key words: Hybrid ceramics, CAD-CAM, Endodontically treated teeth, Survival

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