School of Dental Medicine, Southern Illinois University, Alton, IL 62002, USA.
J Evid Based Dent Pract. 2010 Mar;10(1):37-8. doi: 10.1016/j.jebdp.2009.11.013.
Approximately 50 articles were included in this review based on a MEDLINE and PubMed search of English-language peer-reviewed literature focused on research published between 1993 and 2008. The authors also hand searched relevant dental journals. Randomized controlled trials, nonrandomized controlled trials, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were all eligible for inclusion in this review.
Treatment of teeth with an all-ceramic restoration in the form of a veneer, inlay, onlay, crown, or fixed dental prosthesis, and the subsequent clinical success or failure of these restorations.
Restoration survival rate (in percent) as a function of observation period and fabrication method, reported by restoration type. Specific fabrication methods for single-tooth restorations included InCeram Alumina, InCeram Spinell, Procera, IPS Empress, IPS Empress 2, and Dicor crowns. Fabrication methods for fixed partial dentures included InCeram, InCeram Zr, IPS Empress 2, and Cercon Zr, respectively. The reported Kaplan-Meier survival rates were grouped by restoration type rather than by ceramic system.
For porcelain veneers, less than 5% failure was reported at 5 years and less than 10% failure rate at 10 years (n ranging from 83 to 3047). For ceramic inlay and onlay restorations, 10-year failure rates were found to be less than 10% (n ranging from 200 to 1588). Greater success rates were reported for anterior crowns. Kaplan-Meier survival rates were calculated for end points ranging in duration from 1 to 4 years (6 studies), 5 to 6 years (12 studies), 7 to 8 years (5 studies), and 10 years or more (2 studies). The results for multiunit prostheses included 11 studies, fewer prostheses, and generally higher failure rates. As with single crowns, failure rates for multiunit prostheses were reported to be consistently higher in the posterior region than anteriorly. Kaplan-Meier survival rates were reported for 3-unit fixed partial dentures for end points ranging from 1 to 10 years, with a mean end point of approximately 5.6 years.
The authors suggest that many all-ceramic restorations were found to demonstrate acceptable longevity compared with conventional restorations (eg, metal-ceramic crowns). For single-rooted anterior teeth, broad support was found for the premise that clinicians may select from any all-ceramic system for laminate veneers, intracoronal restorations such as inlays and onlays, and for full-coverage restorations. For restoration of molar teeth, the review suggests that relatively few all-ceramic systems will provide predictable long-term success. The number of clinical complications with all-ceramic fixed dental prostheses (multiunit) remains high, even with increased connector size. Although zirconium systems offer the advantage of favorable material characteristics for substructures, the clinical problem of chipping of the weaker esthetic veneer persists.
根据 MEDLINE 和 PubMed 对 1993 年至 2008 年期间发表的英文同行评议文献的搜索，大约有 50 篇文章被纳入本综述。作者还对手头相关的牙科期刊进行了检索。本综述纳入了随机对照试验、非随机对照试验、纵向实验临床研究、前瞻性纵向研究和回顾性纵向研究。
全瓷修复体形式为贴面、嵌体、高嵌体、冠或固定义齿的牙齿治疗，以及这些修复体随后的临床成功或失败。
按修复类型报告的观察期和制作方法的修复体存活率（%）。单颗牙修复体的具体制作方法包括 InCeram Alumina、InCeram Spinell、Procera、IPS Empress、IPS Empress 2 和 Dicor 牙冠。固定局部义齿的制作方法分别为 InCeram、InCeram Zr、IPS Empress 2 和 Cercon Zr。报告的 Kaplan-Meier 存活率按修复类型而不是陶瓷系统进行分组。
对于瓷贴面，5 年时的失败率低于 5%，10 年时的失败率低于 10%（n 范围为 83 至 3047）。对于陶瓷嵌体和高嵌体修复体，10 年的失败率发现低于 10%（n 范围为 200 至 1588）。前牙的成功率更高。Kaplan-Meier 存活率的计算终点范围为 1 至 4 年（6 项研究）、5 至 6 年（12 项研究）、7 至 8 年（5 项研究）和 10 年或更长时间（2 项研究）。多单位修复体的结果包括 11 项研究，修复体数量较少，一般失败率较高。与单冠一样，多单位修复体的失败率在后牙区始终高于前牙区。3 单位固定局部义齿的 Kaplan-Meier 存活率报告的终点范围为 1 至 10 年，平均终点约为 5.6 年。
作者认为，与传统修复体（如金属-陶瓷冠）相比，许多全瓷修复体的寿命被认为是可以接受的。对于单根前牙，对于临床医生可以从任何全瓷系统中选择层压贴面、嵌体和高嵌体等牙内修复体以及全冠修复体的前提，有广泛的支持。对于磨牙的修复，本综述表明，相对较少的全瓷系统将提供可预测的长期成功。全瓷固定义齿（多单位）的临床并发症数量仍然很高，即使连接器尺寸增大。尽管氧化锆系统为亚结构提供了有利的材料特性优势，但较弱的美观贴面出现碎裂的临床问题仍然存在。
