Abstract
Statement of problem
Selective laser melting (SLM) additive manufacturing (AM) technologies provide an
alternative to conventional casting and milling procedures in fabricating metal-ceramic
dental prostheses. However, the quality of porcelain bond strength to the SLM AM cobalt-chromium
(Co-Cr) metal framework of a dental restoration is unclear.
Purpose
The purpose of this systematic review and meta-analysis was to identify in vitro studies
that reported the porcelain bond strength to SLM AM Co-Cr dental metal alloys and
compare the porcelain bond strength values to cast, milled, and additively manufactured
Co-Cr dental alloys.
Material and methods
An electronic systematic review was performed in different databases: MEDLINE/PubMed,
EMBASE, World of Science, Cochrane, and Scopus. A manual search was also conducted.
Studies that reported the porcelain bond strength to SLM Co-Cr metal alloys and in
the English language were included. Two investigators evaluated the quality assessment
of the studies by applying the JBI critical appraisal checklist for quasi-experimental
studies (nonrandomized experimental studies). A third investigator was consulted to
resolve lack of consensus. Two subgroups were created based on the test used, 3-point
bend and shear bond strength tests. The porcelain bond strength of cast, milled, and
AM Co-Cr dental alloys were compared. The I2 statistic and its associated P value were used to assess the heterogeneity between studies. The Eger test was used
for determining significance of the funnel pots.
Results
A total of 216 studies were collected from the electronic and manual searches. After
independently evaluating the titles and abstracts by the reviewers, 26 articles were
identified. Three of these were excluded after full-text revision. The porcelain bond
strength comparison between the cast and AM alloys for the 3-point bend subgroup revealed
a significant result for overall effect (P<.001) favoring the SLM method with considerable heterogeneity (I2=83%, P<.001). Furthermore, the porcelain bond strength comparison between cast and milled
alloys for the shear bond strength subgroup revealed a significant test for overall
effect (P=.04) favoring milled procedures with a nonsignificant unimportant heterogeneity (I2=
0%, P<.47) and for the 3-point bend subgroup (P<.001) favoring milled specimens with a significant considerable heterogeneity (I2=79%,
P<.001).
Conclusions
The metal manufacturing method had no effect on the porcelain bond strength to Co-Cr
dental metal alloys.
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Article info
Publication history
Published online: July 19, 2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
