De Backer Hein, Van Maele Georges, De Moor Nathalie, Van den Berghe Linda, De Boever Jan
Centre for Special Care, PaeCaMed Research, Unit of Gnathology and Temporomandibular Disorders, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
Int J Prosthodont. 2006 Mar-Apr;19(2):143-53.
This study of fixed partial dentures (FPDs) evaluated the long-term efficacy and determined frequencies and causes of failures.
A total of 322 FPDs in 193 patients, fabricated at an undergraduate university clinic, were evaluated over a 20-year period. All patients were invited to participate in a supportive maintenance program. Failures of the FPDs were divided into irreversible complications (loss of FPD/abutment) and reversible complications (FPD intact after conservative treatment) and into biologic and technical/patient-related failures.
The Kaplan-Meier survival rate after 20 years was 66.2%. Statistically significant differences in survival rates were found between FPDs without post-and-core abutment teeth as compared to FPDs with at least one post-and-core abutment tooth (P = .002) and for vital abutments versus post-and-core abutments (P = .001), but significant differences were not found between restorations in the maxilla and mandible (P = .27). Caries and loss of retention were the main reasons for failure and accounted for 61% of the failures.
The survival of FPDs by undergraduate students at a university clinic during a 20-year period was comparable to the results published by university departments or general practitioners. Occurrence of a previously reversible complication is a predictive factor for an irreversible complication later on. A reversible complication within the first 2 years will probably lead to an early irreversible complication.
本研究对固定局部义齿(FPD)进行评估,以确定其长期疗效、失败频率及原因。
在一所大学本科诊所制作的193例患者的322颗固定局部义齿,在20年期间进行评估。所有患者均受邀参加支持性维护计划。固定局部义齿的失败分为不可逆并发症(固定局部义齿/基牙缺失)和可逆并发症(保守治疗后固定局部义齿完好),以及生物性和技术/患者相关失败。
20年后的Kaplan-Meier生存率为66.2%。与至少有一颗桩核基牙的固定局部义齿相比,无桩核基牙的固定局部义齿在生存率上存在统计学显著差异(P = 0.002),活髓基牙与桩核基牙之间也存在显著差异(P = 0.001),但在上颌和下颌修复体之间未发现显著差异(P = 0.27)。龋齿和固位丧失是失败的主要原因,占失败病例的61%。
一所大学诊所的本科生制作的固定局部义齿在20年期间的生存率与大学科室或全科医生发表的结果相当。先前可逆并发症的发生是后期不可逆并发症的预测因素。前两年内出现的可逆并发症可能会导致早期不可逆并发症。