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Impact of finish line designs on the adaptation of ceramic fixed dental prostheses: a systematic review and network meta-analysis #MMPMID40611068
Pal A; Papocsi P; Kelemen K; Golzio Navarro Cavalcante B; Hegyi P; Keremi B; Gede N; Hermann P; Geczi Z; Roth I
BMC Oral Health 2025[Jul]; 25 (1): 1085 PMID40611068show ga
BACKGROUND: Insufficient marginal and internal adaptation can lead to secondary caries, pulp infection, periodontal disease, and tooth loss. This network meta-analysis (NMA) assessed the impact of various finish line designs on the marginal and internal adaptation of ceramic fixed dental prostheses. METHODS: In vitro studies were conducted comparing the adaptation of full-ceramic fixed dental prostheses with various preparation designs (chamfer, shoulder, rounded shoulder, and vertical). An electronic search of four major databases (Cochrane Library, EMBASE, PubMed, Web of Science) on April 1, 2025, identified 4,714 studies. After screening, review authors found 50 studies eligible for qualitative analysis and 34 for quantitative analysis. NMA and pairwise comparisons assessed marginal gap (MG), internal gap (IG), and absolute marginal discrepancy (AMD). The subset analysis considered the presence of cementation, manufacturing techniques, restoration types and evaluation techniques. The QUIN tool evaluated the risk of bias, while GRADE PRO and CINEMA assessed certainty of result. RESULTS: This NMA identified the chamfer preparation as the most favorable for smaller internal gap, the vertical preparation as the most effective for smaller marginal gap, and the rounded shoulder as the top performer for smaller absolute marginal discrepancy (AMD). Although no statistically significant differences in marginal fit (MG and AMD) were found among the tested designs (vertical, chamfer, rounded shoulder, and shoulder), the significantly superior internal adaptation (MD: 26.65 mum) associated with the chamfer finish line supports its recommendation for clinical use. CONCLUSIONS: The findings suggest that although marginal fit differences (MG, AMD) among finish line designs may not be statistically significant, the internal adaptation advantage of the chamfer finish line supports its clinical recommendation. The discrepancies observed between internal and marginal fit emphasize the critical role of cement space optimization to achieve balanced adaptation, which is key to enhancing the longevity and clinical success of ceramic restorations.