Hosseini Mandana, Worsaae Nils, Schiødt Morten, Gotfredsen Klaus
Department of Oral Rehabilitation, School of Dentistry, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.
Clin Oral Implants Res. 2013 Oct;24(10):1078-87. doi: 10.1111/j.1600-0501.2012.02514.x. Epub 2012 Jun 18.
The purpose of this clinical study was to describe outcome variables of all-ceramic and metal-ceramic implant-supported, single-tooth restorations.
A total of 59 patients (mean age: 27.9 years) with tooth agenesis and treated with 98 implant-supported single-tooth restorations were included in this study. Two patients did not attend baseline examination, but all patients were followed for 3 years. The implants supported 52 zirconia, 21 titanium and 25 gold alloy abutments, which retained 64 all-ceramic and 34 metal-ceramic crowns. At baseline and 3-year follow-up examinations, the biological outcome variables such as survival rate of implants, marginal bone level, modified Plaque Index (mPlI), modified Sulcus Bleeding Index (mBI) and biological complications were registered. The technical outcome variables included abutment and crown survival rate, marginal adaptation of crowns, cement excess and technical complications. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. The statistical analyses were mainly performed by using mixed model of ANOVA for quantitative data and PROC NLMIXED for ordinal categorical data.
The 3-year survival rate was 100% for implants and 97% for abutments and crowns. Significantly more marginal bone loss was registered at gold-alloy compared to zirconia abutments (P = 0.040). The mPlI and mBI were not significantly different at three abutment materials. The frequency of biological complications was higher at restorations with all-ceramic restorations than metal-ceramic crowns. Loss of retention, which was only observed at metal-ceramic crowns, was the most frequent technical complication, and the marginal adaptations of all-ceramic crowns were significantly less optimal than metal-ceramic crowns (P = 0.020). The professional-reported aesthetic outcome demonstrated significantly superior colour match of all-ceramic over metal-ceramic crowns (P = 0.015). However, no significant differences in the other aesthetic parameters at various restoration materials were registered. After 3 years, the patient-reported outcome variables at different restoration materials were not significantly different.
The biological outcomes at the zirconia and metal abutments were comparable. All-ceramic crowns demonstrated better colour match, but higher frequency of marginal discrepancy compared to metal-ceramic crowns. Generally, the patients noticed no difference in aesthetic outcome of all-ceramic and metal-ceramic restorations.
本临床研究旨在描述全瓷和金属烤瓷种植体支持的单颗牙修复体的结果变量。
本研究纳入了59例（平均年龄：27.9岁）牙缺失患者，共98颗种植体支持的单颗牙修复体。2例患者未参加基线检查，但所有患者均随访3年。种植体支持52颗氧化锆、21颗钛和25颗金合金基台，这些基台上保留了64颗全瓷冠和34颗金属烤瓷冠。在基线和3年随访检查时，记录生物学结果变量，如种植体存活率、边缘骨水平、改良菌斑指数（mPlI）、改良龈沟出血指数（mBI）和生物学并发症。技术结果变量包括基台和冠的存活率、冠的边缘适合性、粘固剂过量和技术并发症。美学结果采用哥本哈根指数评分进行评估，患者报告的结果使用OHIP - 49问卷进行记录。统计分析主要采用方差分析的混合模型处理定量数据，采用PROC NLMIXED处理有序分类数据。
种植体的3年存活率为100%，基台和冠的3年存活率为97%。与氧化锆基台相比，金合金基台的边缘骨吸收明显更多（P = 0.040）。三种基台材料的mPlI和mBI无显著差异。全瓷修复体的生物学并发症发生率高于金属烤瓷冠。固位丧失是最常见的技术并发症，仅在金属烤瓷冠中观察到，全瓷冠的边缘适合性明显不如金属烤瓷冠（P = 0.020）。专业人员报告的美学结果显示，全瓷冠的颜色匹配明显优于金属烤瓷冠（P = 0.015）。然而，不同修复材料在其他美学参数上无显著差异。3年后，不同修复材料患者报告的结果变量无显著差异。
氧化锆和金属基台的生物学结果相当。与金属烤瓷冠相比，全瓷冠颜色匹配更好，但边缘差异频率更高。总体而言，患者未注意到全瓷和金属烤瓷修复体在美学结果上的差异。
