Effects of low-temperature degradation on the surface roughness of yttria-stabilized tetragonal zirconia polycrystal ceramics: A systematic review and meta-analysis

Statement of problem: A wide range of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics have been applied for dental restorations. However, whether hydrothermal aging affects the surface roughness of Y-TZP is unknown. Purpose: The purpose of this systematic review and meta-analysis was to evaluate the effects of low-temperature degradation (LTD) on the surface roughness of Y-TZP ceramics. Material and methods: This report follows the Preferred Reporting Items for Systematic Reviews and Qualitative Analyses statement. The literature search was conducted with Medline through the PubMed, Web of Science, and Cochrane Library with no publication year limits. The screening and quality assessment were performed by 2 independent reviewers. The studies comparing the surface roughness of Y-TZP ceramics after LTD by using steam autoclave aging were included in the meta-analysis. Meta-analyses were conducted with a random-effects model (α=.05) by using Review Manager Software (Cochrane Collaboration). Results: Of the 203 potentially relevant studies, 32 full texts were assessed for eligibility. A total of 17 articles were included in the systematic review, and 15 were included in the qualitative analyses. The results showed no significant difference in the arithmetic average height (R_a) values between the nonaged and aged Y-TZP (P=.670; mean difference=0.01; 95% confidence interval=-0.03 to 0.05). Subgroup analyses revealed that the aging duration (P=.003) and specimen preparation (P=.010) contributed significantly to the changes in the surface roughness of the Y-TZP ceramics. Conclusions: Although LTD was found to have no significant effects on the surface roughness of Y-TZP ceramics, the effects of LTD depended on the duration of the steam autoclave process and the specimen preparation.