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金属烤瓷树脂粘结固定义齿常规固位体设计与混合固位体设计的临床比较

Clinical comparison of metal ceramic resin-bonded fixed dental prostheses with a conventional and a mixed retainer design.

作者信息

Boemicke Wolfgang, Kappel Stefanie, Stober Thomas, Rammelsberg Peter

机构信息

Assistant Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.

Assistant Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.

出版信息

J Prosthet Dent. 2014 Sep;112(3):472-80. doi: 10.1016/j.prosdent.2014.04.025. Epub 2014 Jun 7.

Abstract

STATEMENT OF PROBLEM

Little is known about the clinical performance of fixed dental prostheses that rigidly connect adhesive retainers and crowns.

PURPOSE

The purpose of this retrospective analysis was to assess and compare the clinical performance of resin-bonded fixed dental prostheses with a conventional and a mixed retainer design.

MATERIAL AND METHODS

Included as participants were all patients of the hospital since 2004 with regular clinical follow-up who were treated with 3-unit or 4-unit metal ceramic resin-bonded fixed dental prostheses with a conventional 2-adhesive retainer design (conventional group) or with a mixed type combining an adhesive retainer with a crown or a partial crown retainer (mixed group). The analysis included 84 participants with a total of 57 (64%) prostheses in the conventional group and 32 (36%) prostheses in the mixed group. Treatment and data collection were standardized. Cumulative survival without failure (defined as a restoration in need of replacement), chipping, and debonding were estimated by the Kaplan-Meier method and compared for the groups (log-rank test) (α=.05).

RESULTS

During a mean observation period of 4.1 years (SD, 2.5 years; minimum, 0.4 years; maximum, 9.4 years), 12 complications occurred in 10 restorations. Defects of the ceramic veneer (n=6) were observed most frequently. The estimated 5-year failure-free survival rate was 97.4% (standard error, .025) in the conventional group and 95% (standard error, .049) in the mixed group (log-rank, P=.32). The 5-year cumulative survival rate without chipping was 90.7% (standard error, .064) for the conventional group and 93.8% (standard error, .061) for the mixed group (log-rank, P=.44). The 5-year cumulative survival rate without debonding was 95.1% (standard error, .034) for the conventional group and 91.5% (standard error, .058) for the mixed group (log-rank, P=.54).

CONCLUSIONS

Limited by a small sample size and a short follow-up period, the findings of this retrospective analysis indicate that the clinical performance, in terms of survival and the incidence of complications, is comparable for conventional resin-bonded fixed dental prostheses and those that rigidly connect an adhesive wing and a partial or complete crown. Acceptable 5-year survival and complication rates imply that the medium-term prognosis for resin-bonded restorations with a retentive preparation design is comparable with that for conventional fixed dental prostheses.

摘要

问题陈述

对于刚性连接粘结固位体和牙冠的固定义齿的临床性能了解甚少。

目的

本回顾性分析的目的是评估和比较采用传统固位体设计和混合固位体设计的树脂粘结固定义齿的临床性能。

材料与方法

纳入自2004年起在该医院接受定期临床随访的所有患者,这些患者接受了3单位或4单位金属烤瓷树脂粘结固定义齿修复,采用传统的双粘结固位体设计(传统组)或采用粘结固位体与全冠或部分冠固位体相结合的混合型设计(混合组)。分析包括84名参与者,传统组共有57个(64%)义齿,混合组有32个(36%)义齿。治疗和数据收集均标准化。采用Kaplan-Meier法估计无失败(定义为需要更换的修复体)、崩瓷和脱粘的累积生存率,并对两组进行比较(对数秩检验)(α = 0.05)。

结果

在平均4.1年(标准差2.5年;最小值0.4年;最大值9.4年)的观察期内,10个修复体出现了12例并发症。最常见的是陶瓷贴面缺损(n = 6)。传统组估计的5年无失败生存率为97.4%(标准误0.025),混合组为95%(标准误0.049)(对数秩,P = 0.32)。传统组5年无崩瓷累积生存率为90.7%(标准误0.064),混合组为93.8%(标准误0.061)(对数秩,P = 0.44)。传统组5年无脱粘累积生存率为95.1%(标准误0.034),混合组为91.5%(标准误0.058)(对数秩,P = 0.54)。

结论

受样本量小和随访期短的限制,本回顾性分析结果表明,就生存率和并发症发生率而言,传统树脂粘结固定义齿与刚性连接粘结翼和部分或全冠的固定义齿的临床性能相当。可接受的5年生存率和并发症发生率意味着具有固位预备设计的树脂粘结修复体的中期预后与传统固定义齿相当。

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