Non-Cochrane · intervention · PM42345916
Mechanical Performance of Milled CAD/CAM Versus 3D-Printed Dental Prostheses: A Systematic Review and Meta-Analysis of Flexural Strength and Fracture Resistance.
Chauca-Bajaña Luis, Zambrano Manzaba Gabriela Guadalupe, Ordoñez-Balladares Andrea, et al. · Dentistry journal · 2026 · PubMed · doi:10.3390/dj14060325
Findings
Population Dental prostheses and specimens for provisional or definitive restorations tested in vitro
6 findings
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Fracture resistance (N) Not applicable (single test) · Laboratory (in vitro) | SMD -1.54 [-3.63, 0.55] GRADE not reported 4 studies · 154 participants |
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Fracture resistance (N) Not applicable (single test) · Laboratory (in vitro) · Leave-one-out sensitivity analysis: omitting Henderson 2022 | SMD -1.57 [-4.55, 1.41] GRADE not reported 3 studies · 94 participants |
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Fracture resistance (N) Not applicable (single test) · Laboratory (in vitro) · Leave-one-out sensitivity analysis: omitting Corbani 2020 | SMD -1.16 [-3.92, 1.59] GRADE not reported 3 studies · 114 participants |
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Fracture resistance (N) Not applicable (single test) · Laboratory (in vitro) · Sensitivity analysis: excluding Handermann 2024 | SMD -2.46 [-3.60, -1.31] GRADE not reported 3 studies · 124 participants |
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Fracture resistance (N) Not applicable (single test) · Laboratory (in vitro) · Leave-one-out sensitivity analysis: omitting Park 2024 | SMD -0.93 [-3.30, 1.44] GRADE not reported 3 studies · 130 participants |
| Milled CAD/CAM resin-based prostheses (subtractive manufacturing) | 3D-printed resin prostheses (additive manufacturing) | Flexural strength (MPa) Not applicable (single test) · Laboratory (in vitro) | SMD 3.70 [0.80, 6.59] GRADE not reported 5 studies · 110 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Park 2020 matched by author and year (probable) | NR | 1 other review | Flexural strength (MPa) | not extracted yet |
| Corbani 2020 matched by author and year (probable) | NR | this review only | Fracture resistance (N) | not extracted yet |
| Corbani 2020 Effect of material thickness on the fracture resistance and failure pattern of 3D-printed composite crowns. PMID:32789310 | 2020 | this review only | Fracture resistance (N) | not extracted yet |
| Gad 2024 A comparative study of strength and surface properties of permanent 3D-printed resins with CAD-CAM milled fixed dental prostheses. PMID:39568135 | 2024 | this review only | Flexural strength (MPa) | not extracted yet |
| Handermann 2024 matched by author and year (probable) | NR | this review only | Fracture resistance (N) | not extracted yet |
| Handermann 2024 Load-bearing capacity of 3D-printed incisor partial-coverage crowns made from zirconia and composite. PMID:38684407 | 2024 | this review only | Fracture resistance (N) | not extracted yet |
| Henderson 2022 matched by author and year (probable) | NR | this review only | Fracture resistance (N) | not extracted yet |
| Henderson 2022 Failure load of milled, 3D-printed, and conventional chairside-dispensed interim 3-unit fixed dental prostheses. PMID:34895902 | 2022 | this review only | Fracture resistance (N) | not extracted yet |
| Mahran 2025 matched by author and year (probable) | NR | this review only | Flexural strength (MPa) | not extracted yet |
| Mahran 2025 Evaluation of a 3D-printed nanohybrid resin composite versus a milled resin composite for flexural strength, wear and color stability. PMID:40234948 | 2025 | this review only | Flexural strength (MPa) | not extracted yet |
| Park 2020 Flexural Strength of 3D-Printing Resin Materials for Provisional Fixed Dental Prostheses. PMID:32911702 | 2020 | this review only | Flexural strength (MPa) | not extracted yet |
| Park 2024 matched by author and year (probable) | NR | this review only | Fracture resistance (N) | not extracted yet |
| Park 2024 Comparison of Fracture Strength of Milled and 3D-Printed Crown Materials According to Occlusal Thickness. PMID:39336386 | 2024 | this review only | Fracture resistance (N) | not extracted yet |
| Sahin 2023 matched by author and year (probable) | NR | this review only | Flexural strength (MPa) | not extracted yet |
| Turkaslan 2022 matched by author and year (probable) | NR | this review only | Flexural strength (MPa) | not extracted yet |
| Turkaslan 2022 Effect of printing orientation on the fracture strength of additively manufactured 3-unit interim fixed dental prostheses after aging. PMID:35526752 | 2022 | this review only | Flexural strength (MPa) | 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 | Shared studies | Jaccard |
|---|---|---|
| Multimorbidity patterns of dental caries and obesity/overweight among adults: a systematic review and meta-analysis. (2025) | 1 | 0.03 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Dental prostheses and specimens for provisional or definitive restorations (in vitro) | Dental prostheses and specimens tested in vitro (flexural strength n=5 studies; fracture resistance n=4 studies) |
| Intervention | CAD/CAM milled resin prostheses (subtractive manufacturing) | CAD/CAM milled resin composite, PMMA, provisional resin, hybrid ceramic and zirconia |
| Comparison | 3D-printed resin prostheses (additive manufacturing) | 3D-printed resin composite, PMMA, provisional and permanent resins, bis-acryl, zirconia |
| Outcomes | Primary: flexural strength (MPa), fracture resistance (N); secondary: elastic modulus, Weibull modulus, failure mode | Flexural strength (n=5); fracture resistance (n=4) |
| Study designs | In vitro experimental studies; controlled laboratory studies; randomized in vitro comparisons; clinical studies if fracture resistance evaluated mechanically | In vitro experimental or comparative studies (n=9) |
| Timing | Not specified | Not specified |
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 | Partial Yes | No | no |
| 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: Partial Yes · NRSI: N/A | NRSI: Partial Yes · RCT: N/A | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |