氧化锆陶瓷与金属陶瓷后牙固定修复体的随机对照临床试验：3 年随访结果
Randomized controlled clinical trial of zirconia-ceramic and metal-ceramic posterior fixed dental prostheses: a 3-year follow-up.
机构信息
Clinic for Fised and Removable Prosthodontics and Dental Material Science, Center for Dental and Oral Medicina, University of Zürich, Zürich, Switzerland.
出版信息
Int J Prosthodont. 2009 Nov-Dec;22(6):553-60.
PURPOSE
The aim of this study was to test whether posterior fixed dental prostheses (FDPs) with zirconia frameworks exhibit similar survival rates and technical and biologic outcomes as those with metal frameworks.
MATERIALS AND METHODS
Fifty-nine patients in need of 76 FDPs replacing one to three posterior teeth (molars and premolars) were included in the study. The three- to five-unit FDPs were randomly assigned to 38 zirconia-ceramic and 38 metal-ceramic FDPs. At baseline, 6 months, and 1 to 3 years after cementation, the technical outcome of the reconstructions was examined using the United States Public Health Service (USPHS) criteria. The biologic outcome was analyzed at test (abutment) and control (contralateral) teeth by assessing: probing pocket depth (PPD), probing attachment level (PAL), plaque control record (PCR), bleeding on probing (BOP), and tooth vitality. Radiographs of the FDPs were made. Statistical analysis was performed by applying Kaplan-Meier, Pearson chi-square, Fisher exact, and Mann-Whitney U tests.
RESULTS
Fifty-three patients with 67 FDPs (36 zirconia-ceramic, 31 metal-ceramic) were examined after a mean observation period of 40.3 +/- 2.8 months. Six patients with 9 FDPs were lost to follow-up. The survival of both kinds of FDPs was 100%. No significant differences regarding the technical and biologic outcomes were found. Minor chipping of the veneering ceramic was found in 25% of the zirconia-ceramic and 19.4% of the metal-ceramic FDPs. Extended fracturing of the veneering ceramic occurred solely in zirconia-ceramic FDPs (C: 8.6%, D: 2.8% [USPHS criteria]). Few biologic complications were found. Both types of FDPs rendered the same mean values for the biologic parameters (mean PPD, PCR, and BOP for zirconia-ceramic FDPs = 2.4 +/- 0.3, 0.1 +/- 0.1, and 0.3 +/- 0.2, respectively; mean PPD, PCR, and BOP for metal-ceramic FDPs = 2.4 +/- 0.3, 0.1 +/- 0.1, and 0.3 +/- 0.2, respectively).
CONCLUSION
Zirconia-ceramic FDPs exhibited a similar survival rate to metal-ceramic FDPs at 3 years of function.
目的
本研究旨在检验氧化锆基台的后固定义齿（FDP）与金属基台的 FDP 是否具有相似的存活率、技术和生物学结果。
材料与方法
本研究纳入 59 名需用 76 个 FDP 修复 1 至 3 个后牙（磨牙和前磨牙）的患者。三至五单位 FDP 随机分配到 38 个氧化锆陶瓷基台和 38 个金属陶瓷基台。在粘结后 6 个月和 1 至 3 年，使用美国公共卫生服务（USPHS）标准检查修复体的技术结果。通过评估探诊袋深度（PPD）、探诊附着水平（PAL）、菌斑控制记录（PCR）、探诊出血（BOP）和牙齿活力，分析基牙（基台）和对照牙（对侧同名牙）的生物学结果。拍摄 FDP 的射线照片。通过应用 Kaplan-Meier、Pearson chi-square、Fisher exact 和 Mann-Whitney U 检验进行统计分析。
结果
53 名患者（36 个氧化锆陶瓷基台，31 个金属陶瓷基台）在平均 40.3 ± 2.8 个月的观察期后接受了检查。有 6 名患者的 9 个 FDP 失访。两种 FDP 的存活率均为 100%。未发现技术和生物学结果有显著差异。氧化锆陶瓷基台的饰面陶瓷有 25%出现轻微碎裂，金属陶瓷基台的饰面陶瓷有 19.4%出现轻微碎裂。仅在氧化锆陶瓷基台（C：8.6%，D：2.8%[USPHS 标准]）中出现饰面陶瓷的扩展碎裂。发现的生物学并发症较少。两种类型的 FDP 对生物学参数的平均值相同（氧化锆陶瓷基台 FDP 的平均 PPD、PCR 和 BOP 值分别为 2.4 ± 0.3、0.1 ± 0.1 和 0.3 ± 0.2；金属陶瓷基台 FDP 的平均 PPD、PCR 和 BOP 值分别为 2.4 ± 0.3、0.1 ± 0.1 和 0.3 ± 0.2）。
结论
氧化锆陶瓷基台在 3 年的功能中表现出与金属陶瓷基台相似的存活率。
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