SynthesisJournal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.]2026
Is Additive Manufacturing of Dental Zirconia Comparable to Subtractive Methods When Considering Printing Orientation and Layer Thickness? A Systematic Review and Meta-Analysis.
Synthesis in Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is Additive Manufacturing of Dental Zirconia Comparable to Subtractive Methods When Considering Printing Orientation and Layer Thickness? A Systematic Review and Meta-Analysis.Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] · 2026Pooled it
- Effect of Manufacturing Technique and Cementation Protocol on the Load-Bearing Capacity of 3D-Printed Zirconia Molar Crowns.Bioengineering (Basel, Switzerland) · 2026Article
- Stainability of Polished and Glazed Printed Monolithic Zirconia After Coffee Thermocycling.Clinical and experimental dental research · 2025Article
- Bonding Strategies for Zirconia Fixed Restorations: A Scoping Review of Surface Treatments, Cementation Protocols, and Long-Term Durability.Biomimetics (Basel, Switzerland) · 2025Review
- Fracture Resistance of 3-Unit Zirconia Fixed Dental Prostheses Differing in Wall Thickness Fabricated by Either 3D-Printing or Milling.Journal of functional biomaterials · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveThe aim of this systematic review and meta-analysis was to determine whether the production of monolithic dental zirconia using additive manufacturing (AM), with consideration of different printing directions and layer thicknesses, enhances its mechanical and physical properties relative to subtractive manufacturing (SM). METHODOLOGY: This systematic review followed PRISMA guidelines and was registered on the Open Science Framework. The PICO strategy was used, focusing on monolithic dental zirconia, comparing AM (stereolithography [SLA] and digital light processing [DLP]) with SM (i.e., CIPing/presintering/milling). In vitro studies were included. Electronic searches were conducted across multiple databases and gray literature, followed by data selection and extraction. Methodological quality was assessed using the QUIN tool for in vitro risk of bias. Mean and standard deviation of flexural strength, density, roughness, and specimen count per group were used to calculate the mean difference (MD) with a 95% confidence interval (CI) in the meta-analysis.
resultsA total of 31 studies were included in the qualitative synthesis and 21 in the quantitative analysis. Most were classified as having a medium risk of bias. The meta-analysis indicated that AM zirconia exhibited lower flexural strength than SM zirconia. However, subgroup analyses revealed no significant difference in the flexural strength of samples fabricated using SLA technology or printed at the 0° orientation relative to SM zirconia. Individually, AM zirconia fabricated with 25 or 50 μm layer thicknesses possessed lower flexural strength than SM zirconia, regardless of print direction. No differences were observed between the manufacturing methods regarding surface roughness, although SM demonstrated significantly higher density than AM zirconia.
conclusionsAM dental zirconia demonstrated lower flexural strength when pooled across printing technologies, build orientations, and layer thicknesses. However, it exhibited comparable strength to SM zirconia at 0° or fabricated using SLA technology. Both AM and SM methods yielded similar surface roughness, with SM producing higher density. Most studies had a medium risk of bias, suggesting the need for further research and methodological rigor, particularly regarding translucency. CLINICAL SIGNIFICANCE: Based on current in vitro evidence, AM zirconia may show potential for posterior crowns; however, further clinical validation is needed, especially for the anterior region due to insufficient translucency to meet esthetic demands.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.