目的：：通过Meta分析系统评价全瓷修复与烤瓷修复的临床效果。方法：计算机检索PubMed、Cochrane Library、EMbase、SinoMed、中国知网和万方、维普数据库,按标准纳入比较全瓷与烤瓷修复临床效果的随机对照研究,进行资料提取及偏倚评价,采用RevMan 5.3软件进行Meta 分析。结果：最终纳入15篇文献,其中全瓷修复体768例,烤瓷修复体1386例。 Meta分析结果显示：相比于烤瓷修复,全瓷修复能显著降低牙龈炎症(RR=0.30,95%CI=0.10-0.90,P=0.03)的发生风险。还能减少基牙继发龋、改善修复体的龈缘着色及边缘适合性,但无统计学差异。二者颜色匹配及修复体崩瓷状况相当。全瓷修复易导致牙髓炎症及牙髓失活,且固定桥修复时全瓷桥支架断裂(RR=6.24,95%CI=1.20-32.41,P=0.03)的危险性显著增高。结论：现有的有限证据表明,全瓷修复的临床效果要优于烤瓷修复,在临床应用中占有一定优势,但全瓷桥的强度有待提高。%Objective:To evaluate the clinical outcome of all-ceramic and metal-ceramic restorations by means of Meta-analysis. Methods:The relevant randomized controlled trials ( RCTs) were electronically searched from PubMed, the Cochrane Library, EM-base, SinoMed, Weipu databases, CNKI and Wanfang. After data extraction and bias evaluation the Meta-analysis was conducted using RevMan 5. 3 software. Results:Finally 15 RCTs involving 768 all-ceramic restorations and 1386 Metal-ceramic restorations met the eli-gibility criteria. The results showed that, compared with metal-ceramic restorations, all-ceramic restorations could significantly decrease the risk of gingivitis(RR=0. 30,95%CI=0. 10-0. 90, P=0. 03),could decrease secondary caries and improve the satisfaction of cervical discoloration and marginal adaptation but without significant difference. There was no difference in color match and chipping of the veneering ceramics. However, all-ceramic restorations may lead to loss of the abutment tooth vitality. The risk of all-ceramic frame-work fracture while adopting fixed bridges was significantly higher(RR=6. 24, 95%CI=1. 20 -32. 41, P=0. 03). Conclusion:Based on the existing limited evidence,the efficacy of all-ceramic restorations is better than metal-ceramic restorations. But the intensity of all-ceramic bridges needs to be improved.
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