Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Clin Oral Implants Res. 2013 Jul;24(7):758-62. doi: 10.1111/j.1600-0501.2012.02482.x. Epub 2012 May 9.
The objective of this clinical study was to evaluate survival and incidence of complications for metal-ceramic and all-ceramic implant-supported fixed dental prostheses (FDPs) and tooth-implant-supported FDPs.
One-hundred and sixty-six FDPs placed in 132 patients from a prospective study were selected for this retrospective analysis. Included were 91 conventional implant-supported FDPs with implant support on both extremities, 27 implant-supported cantilever FDPs, and 48 tooth-implant-supported FDPs. All restorations were veneered with ceramic. Twenty-six FDPs had a zirconia framework and 140 had a metal framework. Kaplan-Meier analysis was performed to estimate FDP success defined as complication-free survival and the Cox regression model was used to isolate risk factors for the most frequent complications.
Within a median follow-up of 1 year and 2 months, three failures were caused by a failed implant (n = 2) and by extended chipping of the veneer (n = 1). In contrast with this low incidence of failure was a high incidence of complications including chipping (n = 29), loss of retention (n = 35), and abutment fractures (n = 2). Multivariate survival analysis revealed a significantly greater incidence of chipping for males and a tendency to increased incidence of chipping for zirconia-based FDPs. The incidence of loss of retention tended to be less for tooth-implant-supported FDPs, for which semi-permanent cement was the only significant risk factor, with a hazard ratio of almost 5.
As chipping of the ceramic veneer was the most frequent complication leading to substantial aftercare, improvements of ceramic veneers are desirable for zirconia-based and metal-based FDPs.
本临床研究的目的是评估金属-陶瓷和全陶瓷种植体支持的固定义齿（FDP）以及牙-种植体支持的 FDP 的生存率和并发症发生率。
从一项前瞻性研究中选择了 132 名患者的 166 个 FDP 进行这项回顾性分析。纳入了 91 个常规种植体支持的 FDP，这些 FDP 的种植体在两端均有支持，27 个种植体支持的悬臂 FDP 和 48 个牙-种植体支持的 FDP。所有修复体均采用陶瓷贴面。26 个 FDP 采用氧化锆框架，140 个 FDP 采用金属框架。采用 Kaplan-Meier 分析来估计 FDP 的成功率，定义为无并发症的存活率，并用 Cox 回归模型来分离最常见并发症的风险因素。
在中位随访 1 年零 2 个月内，有 3 个失败病例是由种植体失败（n=2）和贴面扩展碎裂（n=1）引起的。与低失败率形成对比的是高并发症发生率，包括碎裂（n=29）、固位丧失（n=35）和基牙折断（n=2）。多变量生存分析显示，男性碎裂的发生率显著更高，而基于氧化锆的 FDP 碎裂的发生率有增加的趋势。对于牙-种植体支持的 FDP，固位丧失的发生率较低，半永久性粘结剂是唯一显著的风险因素，风险比接近 5。
由于陶瓷贴面碎裂是导致大量后续治疗的最常见并发症，因此对于基于氧化锆和金属的 FDP，改进陶瓷贴面是必要的。
