Millen Christopher, Brägger Urs, Wittneben Julia-Gabriela
Int J Oral Maxillofac Implants. 2015 Jan-Feb;30(1):110-24. doi: 10.11607/jomi.3607.
To identify the influence of fixed prosthesis type on biologic and technical complication rates in the context of screw versus cement retention. Furthermore, a multivariate analysis was conducted to determine which factors, when considered together, influence the complication and failure rates of fixed implant-supported prostheses.
Electronic searches of MEDLINE (PubMed), EMBASE, and the Cochrane Library were conducted. Selected inclusion and exclusion criteria were used to limit the search. Data were analyzed statistically with simple and multivariate random-effects Poisson regressions.
Seventy-three articles qualified for inclusion in the study. Screw-retained prostheses showed a tendency toward and significantly more technical complications than cemented prostheses with single crowns and fixed partial prostheses, respectively. Resin chipping and ceramic veneer chipping had high mean event rates, at 10.04 and 8.95 per 100 years, respectively, for full-arch screwed prostheses. For "all fixed prostheses" (prosthesis type not reported or not known), significantly fewer biologic and technical complications were seen with screw retention. Multivariate analysis revealed a significantly greater incidence of technical complications with cemented prostheses. Full-arch prostheses, cantilevered prostheses, and "all fixed prostheses" had significantly higher complication rates than single crowns. A significantly greater incidence of technical and biologic complications was seen with cemented prostheses.
Screw-retained fixed partial prostheses demonstrated a significantly higher rate of technical complications and screw-retained full-arch prostheses demonstrated a notably high rate of veneer chipping. When "all fixed prostheses" were considered, significantly higher rates of technical and biologic complications were seen for cement-retained prostheses. Multivariate Poisson regression analysis failed to show a significant difference between screw- and cement-retained prostheses with respect to the incidence of failure but demonstrated a higher rate of technical and biologic complications for cement-retained prostheses. The incidence of technical complications was more dependent upon prosthesis and retention type than prosthesis or abutment material.
在螺钉固位与粘结固位的背景下，确定固定修复体类型对生物学和技术并发症发生率的影响。此外，进行多因素分析以确定哪些因素综合起来会影响种植体支持的固定修复体的并发症和失败率。
对MEDLINE（PubMed）、EMBASE和Cochrane图书馆进行电子检索。使用选定的纳入和排除标准来限制检索范围。采用简单和多因素随机效应泊松回归对数据进行统计学分析。
73篇文章符合纳入本研究的标准。螺钉固位修复体分别比单冠粘结修复体和固定局部粘结修复体显示出技术并发症增多的趋势且显著更多。对于全牙弓螺钉固位修复体，树脂崩裂和陶瓷贴面崩裂的平均发生率较高，分别为每100年10.04次和8.95次。对于“所有固定修复体”（修复体类型未报告或未知），螺钉固位时生物学和技术并发症明显较少。多因素分析显示粘结修复体的技术并发症发生率显著更高。全牙弓修复体、悬臂修复体和“所有固定修复体”的并发症发生率显著高于单冠修复体。粘结修复体的技术和生物学并发症发生率显著更高。
螺钉固位的固定局部修复体显示出显著更高的技术并发症发生率，螺钉固位的全牙弓修复体显示出明显较高的贴面崩裂率。当考虑“所有固定修复体”时，粘结固位修复体的技术和生物学并发症发生率显著更高。多因素泊松回归分析未能显示螺钉固位和粘结固位修复体在失败发生率方面存在显著差异，但显示粘结固位修复体的技术和生物学并发症发生率更高。技术并发症的发生率更多地取决于修复体和固位类型，而非修复体或基牙材料。
