Non-Cochrane · intervention · PM41578458
Survival rates of CAD/CAM ceramic dental restorations: A meta-analysis.
Ling Xin, Huang Lei · Medicine · 2026 · PubMed · doi:10.1097/md.0000000000047221
Findings
29 findings
| Population | ||||
|---|---|---|---|---|
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Caries-free (absence of recurrent caries) Clinical follow-up studies · Overall (random-effects) | Proportion 0.98 [0.96, 0.99] GRADE not reported 3 studies · 473 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Follow-up >32 months | Proportion 0.95 [0.91, 0.97] GRADE not reported 8 studies · 1180 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Restoration material: lithium disilicate | Proportion 0.95 [0.93, 0.96] GRADE not reported 5 studies · 796 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Follow-up <32 months | Proportion 0.96 [0.92, 0.98] GRADE not reported 6 studies · 263 participants |
| Patients with at least one CAD/CAM ceramic dental restoration (veneers, crowns, inlays/onlays, partial dentures, abutments) | CAD/CAM ceramic dental restoration (single-arm survival) | None (pooled single-arm proportion) | Survival rate of restorations Mean follow-up 24 to 67 months · Clinical follow-up studies · Common (fixed) effect model | Proportion (survival rate) 0.95 [0.94, 0.96] GRADE not reported 12 studies · 1372 participants |
| Patients with at least one CAD/CAM ceramic dental restoration (veneers, crowns, inlays/onlays, partial dentures, abutments) | CAD/CAM ceramic dental restoration (single-arm survival) | None (pooled single-arm proportion) | Survival rate of restorations Mean follow-up 12 to 64 months · Clinical follow-up studies · Common (fixed) effect model | Proportion (survival rate) 0.96 [0.94, 0.98] GRADE not reported 13 studies · 524 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Mean age >50 years | Proportion 0.96 [0.94, 0.98] GRADE not reported 6 studies · 846 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Mean age >50 years | Proportion 0.97 [0.91, 1.00] GRADE not reported 3 studies · 189 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Edge integrity Clinical follow-up studies · Sensitivity: common-effect model | Proportion 0.95 [0.92, 0.97] GRADE not reported 7 studies · 299 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration type: partial dentures | Proportion 0.96 [0.90, 1.00] GRADE not reported 2 studies · 150 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Overall (random-effects) | Proportion 0.96 [0.94, 0.98] Moderate Downgraded: risk of bias 13 studies · 524 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration type: veneer | Proportion 1.00 [0.96, 1.00] GRADE not reported 2 studies · 58 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration material: lithium disilicate | Proportion 0.98 [0.93, 1.00] GRADE not reported 5 studies · 95 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Restoration material: resin | Proportion 0.92 [0.71, 1.00] GRADE not reported 2 studies · 76 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Restoration material: zirconia | Proportion 0.99 [0.95, 1.00] GRADE not reported 5 studies · 366 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Follow-up >32 months | Proportion 0.97 [0.93, 0.99] GRADE not reported 7 studies · 261 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Restoration material: other (mixed or other materials) | Proportion 0.93 [0.82, 1.00] GRADE not reported 2 studies · 134 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Mean age <50 years | Proportion 0.96 [0.93, 0.99] GRADE not reported 3 studies · 384 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Overall (random-effects) | Proportion 0.96 [0.93, 0.98] Moderate Downgraded: inconsistency 12 studies · 1372 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration type: crown | Proportion 0.96 [0.92, 0.99] GRADE not reported 7 studies · 206 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration material: resin | Proportion 0.92 [0.86, 0.97] GRADE not reported 2 studies · 90 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Edge integrity Clinical follow-up studies · Overall (random-effects) | Proportion 0.94 [0.87, 0.98] GRADE not reported 7 studies · 299 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Restoration type: crown | Proportion 0.95 [0.93, 0.97] GRADE not reported 8 studies · 1162 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration material: zirconia | Proportion 0.95 [0.91, 0.98] GRADE not reported 8 studies · 255 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Mean age <50 years | Proportion 0.95 [0.88, 1.00] GRADE not reported 2 studies · 92 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Color retention Clinical follow-up studies · Overall (random-effects) | Proportion 0.98 [0.96, 1.00] GRADE not reported 7 studies · 342 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 24 to 67 months · Clinical follow-up studies · Follow-up <32 months | Proportion 0.99 [0.97, 1.00] GRADE not reported 4 studies · 192 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration material: other (mixed or other materials) | Proportion 0.99 [0.94, 1.00] GRADE not reported 3 studies · 84 participants |
| Patients with at least one CAD/CAM ceramic dental restoration | CAD/CAM ceramic restorations (veneers, crowns, inlays/onlays, fixed partial dentures, abutments) | None (pooled single-arm proportion) | Survival of restoration (absence of absolute failure) mean follow-up 12 to 64 months · Clinical follow-up studies · Restoration type: inlay/onlay restorations | Proportion 0.92 [0.86, 0.97] GRADE not reported 2 studies · 110 participants |
Included primary studies 25
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Aziz 2022 Clinical performance of CAD-CAM crowns provided by predoctoral students at the University of Toronto DOI:10.1016/j.prosdent.2020.09.048 | 2022 | 1 other review | Survival of restoration (absence of absolute failure) | not extracted yet |
| Montaser 2023 The role of plastidic cytochrome c in algal electron transport and photophosphorylation. PMID:202317 | 1978 | 1 other review | Survival of restoration (absence of absolute failure) | not extracted yet |
| Angelis 2020 Monolithic CAD-CAM lithium disilicate versus monolithic CAD-CAM zirconia for single implant-supported posterior crowns using a digital… DOI:10.1016/j.prosdent.2018.11.016 | 2020 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Aziz 2024 Clinical and radiographical evaluation of CAD-CAM crowns with and without deep margin elevation: 10-year results DOI:10.1016/j.prosdent.2024.04.017 | 2025 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Bompolaki 2022 Clinical Performance of CAD/CAM Monolithic Lithium Disilicate Implant‐Supported Single Crowns Using Solid or Predrilled Blocks in a Fully… DOI:10.1111/jopr.13364 | 2021 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Canatan 2022 A randomized, controlled clinical evaluation of two resin cement systems in the adhesion of CAD/CAM‐fabricated resin nanoceramic… DOI:10.1111/jerd.12910 | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Hassan 2024 Clinical performance comparison between lithium disilicate and hybrid resin nano-ceramic CAD/CAM onlay restorations: a two-year randomized… DOI:10.1007/s10266-023-00841-w | 2023 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Hey 2012 Metal–ceramic-fixed dental prosthesis with CAD/CAM-fabricated substructures: 6-year clinical results DOI:10.1007/s00784-012-0851-9 | 2012 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Lei 2022 A 3-Year Clinical Evaluation of Endodontically Treated Posterior Teeth Restored with Resin Nanoceramic Computer-Aided… DOI:10.12659/msm.937331 | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Maaita 2022 Endocrowns Clinical Performance and Patient Satisfaction: A Randomized Clinical Trial of Three Monolithic Ceramic Restorations DOI:10.1111/jopr.13414 | 2021 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Mijiritsky 2023 Clinical performance of full-arch implant-supported fixed restorations made of monolithic zirconia luted to a titanium bar: A… DOI:10.1016/j.jdent.2023.104675 | 2023 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Muhlemann 2020 Prosthetic outcomes and clinical performance of CAD‐CAM monolithic zirconia versus porcelain‐fused‐to‐metal implant crowns in the molar… DOI:10.1111/clr.13631 | 2020 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Pontevedra 2022 Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital… DOI:10.1007/s00784-022-04396-y | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Pontevedra 2024 Digital workflow for monolithic and veneered zirconia and metal-ceramic posterior fixed partial dentures: A five-year prospective… DOI:10.2186/jpr.jpr_d_22_00237 | 2024 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Salem 2022 Clinical assessment of different <scp>implant‐supported</scp> esthetic crown systems fabricated with <scp>semi‐digital</scp> workflow:… DOI:10.1111/jerd.12961 | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Schlichting 2022 Ultrathin CAD-CAM glass-ceramic and composite resin occlusal veneers for the treatment of severe dental erosion: An up to 3-year… DOI:10.1016/j.prosdent.2022.02.009 | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Schubert 2024 Clinical performance of monolithic lithium disilicate hybrid abutment crowns over at least 3.5 years DOI:10.1111/jopr.13719 | 2023 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Seidel 2020 The occlusal wear of ceramic fixed dental prostheses: 3-Year results in a randomized controlled clinical trial with split-mouth design DOI:10.1016/j.jdent.2020.103500 | 2020 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Spitznagel 2017 Polymer-infiltrated ceramic CAD/CAM inlays and partial coverage restorations: 3-year results of a prospective clinical study over 5 years DOI:10.1007/s00784-017-2293-x | 2017 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Wittneben 2016 Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A… DOI:10.1177/0022034516681767 | 2016 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Wittneben 2020 Clinical and esthetic outcomes of two different prosthetic workflows for implant‐supported all‐ceramic single crowns—3 year results of a… DOI:10.1111/clr.13586 | 2020 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Wittneben 2024 Implant‐supported single all‐ceramic crowns made from prefabricated (stock) or individualized CAD/CAM zirconia abutments: A 5 year… DOI:10.1111/jerd.13188 | 2024 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Ying 2023 Outcome of teeth restored with CAD/CAM zirconium dioxide post-cores: a retrospective study with a follow-up period of 3–6 years DOI:10.1186/s12903-022-02273-4 | 2022 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Yu 2024 Clinical outcomes of self-glazed zirconia veneers produced by 3D gel deposition: a retrospective study DOI:10.1186/s12903-024-04253-2 | 2024 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
| Zhang 2023 Clinical evaluation and quantitative occlusal change analysis of posterior implant‐supported all‐ceramic crowns: A 3‐year randomized… DOI:10.1111/clr.14151 | 2023 | this review only | Survival of restoration (absence of absolute failure) | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients who received at least one CAD/CAM ceramic dental restoration | Patients with CAD/CAM ceramic restorations (n=25 studies) |
| Intervention | Nonmetallic restorations (veneers, crowns, abutments, dentures) designed and machined by CAD/CAM | CAD/CAM zirconia, lithium disilicate, resin and other ceramic veneers, crowns, inlays/onlays, partial dentures |
| Comparison | Conventional or other restorations where available (not required) | Mostly none; some trials compared with conventional or prefabricated restorations |
| Outcomes | Survival rate (absence of absolute failure); complications (color, marginal defects, recurrent caries) | Survival (13 RCTs, 524 restorations; 12 cohort studies, 1372 restorations); color retention (n=7); edge integrity (n=7); caries-free (n=3) |
| Study designs | Controlled clinical trials and cohort studies with minimum follow-up of 1-2 years | 13 RCTs; 12 cohort studies (9 retrospective, 3 prospective) |
| Timing | Follow-up of at least 1 year (abstract) or over 2 years (methods) | Mean follow-up 12 to 120 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Partial Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |