Fokkinga Wietske A, Kreulen Cees M, Bronkhorst Ewald M, Creugers Nico H J
Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
J Dent. 2007 Oct;35(10):778-86. doi: 10.1016/j.jdent.2007.07.006. Epub 2007 Aug 22.
The aim of this long-term follow-up was to collect up to 17-year survival data of different metal post-and-core restorations with a covering crown.
At initiation of the study, a controlled clinical trial, single tooth was provided with an artificial covering crown, by 18 operators. Restorations under investigation were the post-and-core restorations: cast post-and-core restorations, prefabricated metal post and resin composite core restorations, and post-free all-composite core restorations. Before treatment allocation, the recipient tooth was categorized according to the expected dentin height after tooth preparation. A tooth was assessed to have "substantial dentin height" (Trial 1) or "minimal dentin height" (Trial 2). The study sample consisted of 257 patients that received 307 core restorations. The performance of the restorations was based on data collected from the files of the current dentists monitoring the oral health of the patients. The survival probability was analyzed at different levels: on the restoration level (S(R)), and on the level of the tooth carrying the restoration (S(T)). Kaplan Meier analyses were used to compare survival probabilities.
"Type of post-and-core restoration" showed no influence on the survival probability (at both levels) in both trials (P-value>0.05). The 17-year survival rates at restoration level varied from 71% to 80%, and at tooth level from 83% to 92%.
The results of this study showed no difference in survival probabilities among different core restorations under a covering crown of endodontically treated teeth. The preservation of substantial remaining coronal tooth structure seems to be critical to the long-term survival of endodontically treated crowned teeth.
这项长期随访的目的是收集不同带覆盖冠的金属桩核修复体长达17年的生存数据。
在该研究开始时,一项对照临床试验中,18名操作者为单颗牙齿制作人工覆盖冠。所研究的修复体为桩核修复体:铸造桩核桩核修复体、预成金属桩与树脂复合核修复体以及无桩全复合核修复体。在进行治疗分配之前,根据备牙后预期的牙本质高度对患牙进行分类。一颗牙齿被评估为具有“足够的牙本质高度”(试验1)或“最小的牙本质高度”(试验2)。研究样本包括257名接受了307个核修复体的患者。修复体的性能基于从监测患者口腔健康的现任牙医档案中收集的数据。在不同层面分析生存概率:修复体层面(S(R))和带修复体的牙齿层面(S(T))。采用Kaplan Meier分析来比较生存概率。
在两项试验中,“桩核修复体类型”对生存概率(在两个层面)均无影响(P值>0.05)。修复体层面的17年生存率在71%至80%之间,牙齿层面的生存率在83%至92%之间。
本研究结果表明,在根管治疗牙齿的覆盖冠下,不同核修复体的生存概率没有差异。保留足够的剩余牙冠结构似乎对根管治疗后带冠牙齿的长期生存至关重要。