van Heumen Céleste C M, van Dijken Jan W V, Tanner Johanna, Pikaar Ronald, Lassila Lippo V J, Creugers Nico H J, Vallittu Pekka K, Kreulen Cees M
Department of Oral Function and Prosthetic Dentistry, College of Dental Science, University Medical Centre Nijmegen, Netherlands.
Dent Mater. 2009 Jun;25(6):820-7. doi: 10.1016/j.dental.2009.01.103. Epub 2009 Mar 31.
The purpose of this clinical study was to evaluate the long-term outcome of 3-unit anterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate.
52 patients (26 females, 26 males) received 60 indirectly made FRC FPDs, using pre-impregnated unidirectional glass fibers, requiring manual wetting, as framework material. FPDs were surface (n=48) or hybrid (n=12) retained and mainly located in the upper jaw. Hybrid FPDs had a combination of retainers; i.e. crown at one and surface retention at the other abutment tooth. Surface FPDs were either purely adhesively retained (n=29) or with additional mechanical retention (n=19). Follow-up period was at minimum 5 years, with check-ups every 1-2 years. Six operators were involved, in three centers in the Netherlands, Finland and Sweden. Survival rates, including repairable defects of FPDs, and success rates were determined.
Kaplan-Meier survival rate at 5 years was 64% (SE 7%). For the level of success, values were 45% (SE 7%) and the estimated median survival time 58 (SE 10.1) months. For surface FPDs, additional mechanical retention did not improve survival significantly. There was a trend towards better survival of surface FPDs over hybrid FPDs, but differences were not significant. Main failure modes were fracture of the FPD and delamination of veneering composite.
A success rate of 45% and a survival rate of 64% after 5 years was found. Fracture of the framework and delamination are the most prevalent failure modes, especially for surface FPDs.
本临床研究旨在评估由纤维增强树脂复合材料（FRC）制成的3单位前牙固定局部义齿（FPD）的长期效果，并确定影响其生存率的设计因素。
52例患者（26名女性，26名男性）接受了60颗间接制作的FRC FPD，使用预浸渍单向玻璃纤维作为框架材料，需手动湿润。FPD为表面固位（n = 48）或混合固位（n = 12），主要位于上颌。混合FPD有多种固位体组合，即一颗基牙为冠内固位体，另一颗基牙为表面固位。表面FPD要么是单纯粘结固位（n = 29），要么是附加机械固位（n = 19）。随访期至少5年，每1 - 2年进行检查。荷兰、芬兰和瑞典的三个中心共有6名操作人员参与。确定了FPD的生存率（包括可修复的缺陷）和成功率。
5年时的Kaplan - Meier生存率为64%（标准误7%）。成功率为45%（标准误7%），估计中位生存时间为58（标准误10.1）个月。对于表面FPD，附加机械固位并不能显著提高生存率。表面FPD的生存率有高于混合FPD的趋势，但差异不显著。主要失败模式为FPD折断和贴面复合材料分层。
5年后发现成功率为45%，生存率为64%。框架折断和分层是最常见的失败模式，尤其是对于表面FPD。
