Clinical Department of Restorative and Prosthetic Dentistry, Innsbruck Medical University, Austria.
Int J Prosthodont. 2012 Jan-Feb;25(1):70-8.
The aim of this clinical retrospective study was to evaluate the clinical quality, estimated survival rate, and failure analysis of different all-ceramic restorations in a long-term analysis of up to 20 years.
Different all-ceramic restorations (crowns [n = 470], veneers [n = 318], onlays [n = 213], and inlays ]n = 334[) were placed in 302 patients (120 men, 182 women) between 1987 and 2009 at Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Number of restoration failures and reasons for failure were recorded. The study population included 106 (35.1%) individuals diagnosed with bruxism. The success rate was determined using Kaplan-Meier survival analysis.
The mean observation time was 102 ± 60 months. Ninety-five failures were recorded. The main reason for failure was fracture of the ceramic (33.68%). The estimated survival rate was 97.3% after 5 years, 93.5% at 10 years, and 78.5% at 20 years. Nonvital teeth showed a significantly higher risk of failure (P < .0001). There was a 2.3-times greater risk of failure associated with existing parafunction (bruxism, P = .0045). Cementation using Variolink showed significantly fewer failures than Optec Cement (P = .0217) and Dual Cement (P = .0099). No significant differences were found for type of restoration and distribution in the mouth.
All-ceramic restorations offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates are associated with bruxism, nonvital teeth, and specific cementation agents.
本临床回顾性研究旨在通过长达 20 年的长期分析，评估不同全瓷修复体的临床质量、估计生存率和失败分析。
1987 年至 2009 年期间，在奥地利因斯布鲁克医科大学，302 名患者（120 名男性，182 名女性）共植入了 470 个牙冠、318 个贴面、213 个嵌体和 334 个高嵌体。通过患者定期的维护预约进行临床检查。根据改良加利福尼亚牙科协会/雷格标准评估美学匹配、瓷面、边缘变色和完整性。记录修复体失败的数量和失败的原因。研究人群包括 106 名（35.1%）被诊断为磨牙症的个体。使用 Kaplan-Meier 生存分析确定成功率。
平均观察时间为 102±60 个月。记录到 95 次失败。失败的主要原因是陶瓷断裂（33.68%）。5 年后估计的生存率为 97.3%，10 年后为 93.5%，20 年后为 78.5%。非活髓牙的失败风险显著更高（P<0.0001）。存在磨牙症等功能异常时，失败风险增加 2.3 倍（P=0.0045）。与使用 Optec 水门汀和 Dual 水门汀相比，使用 Variolink 水门汀的失败率明显更低（P=0.0217，P=0.0099）。修复体类型和在口腔中的分布没有显著差异。
全瓷修复体具有可预测性和成功性，10 年内估计生存率为 93.5%。磨牙症、非活髓牙和特定的粘结剂会显著增加失败率。
