Raedel Michael, Fiedler Cliff, Jacoby Stephan, Boening Klaus W
Staff Dentist and Research Fellow, Department for Prosthetic Dentistry, Medical Faculty Carl Gustav Carus, Technical University Dresden, Germany.
Former student and Research Fellow, Department for Prosthetic Dentistry, Medical Faculty Carl Gustav Carus, Technical University Dresden, Germany.
J Prosthet Dent. 2015 Jul;114(1):40-5. doi: 10.1016/j.prosdent.2014.08.017. Epub 2015 Apr 7.
Scientific data about the long-term survival of teeth treated with cast post and cores are scarce. Retrospective studies often use different target events for their analyses. A comparison is therefore complicated. For associated tooth-, jaw-, and patient-related factors little evidence exists as to their effect on survival.
The purpose of this study was to extend the knowledge on the survival of teeth treated with cast post and cores for observation periods of more than 10 years. A decrease or increase in survival times according to the presence or absence of associated parameters needs to be evaluated.
A retrospective evaluation was conducted of all cast post and cores inserted in 1 university clinic between January 1992 and June 2011. A Kaplan-Meier survival analysis was carried out by using extraction as the target event. The survival curves for different tooth types, the presence or absence of adjacent teeth, and the prosthetic restoration of the respective jaws were compared by using the log-rank test (α=.05). A Cox regression model was calculated for multivariate analyses.
A total of 717 cast post and cores for 343 patients were recorded. The mean survival time was 13.5 years. A statistically significant decrease in survival times was found for canines (11.9 years) and premolars (13.4 years) versus molars (14.1 years), no adjacent teeth (10.6 years) versus at least 1 adjacent tooth (13.8 years), and the restoration with removable dental prostheses (12.5 years) versus fixed dental prostheses and single crowns (13.9 years). The largest reduction in survival time was found for teeth being used as an abutment for a double crown-retained removable partial dental prosthesis (telescopic denture) (9.8 years). Tooth type and adjacent tooth status remained as significant variables within the multivariate Cox regression model.
Cast post and cores have an acceptable long-term survival time. Because different factors may influence survival, considering these factors in treatment planning may increase the long-term success of these restorations.
关于用铸造桩核修复的牙齿长期留存情况的科学数据稀缺。回顾性研究在分析时常常采用不同的目标事件。因此,进行比较很复杂。关于相关的牙齿、颌骨及患者因素对留存情况的影响,几乎没有证据。
本研究的目的是拓展对用铸造桩核修复的牙齿超过10年观察期留存情况的认识。需要评估根据相关参数的有无,留存时间的减少或增加情况。
对1992年1月至2011年6月间在1所大学诊所植入的所有铸造桩核进行回顾性评估。以拔除作为目标事件进行Kaplan-Meier留存分析。采用对数秩检验(α = 0.05)比较不同牙型、有无邻牙以及各颌骨修复体的留存曲线。计算Cox回归模型进行多变量分析。
共记录了343例患者的717个铸造桩核。平均留存时间为13.5年。发现犬齿(11.9年)和前磨牙(13.4年)相对于磨牙(14.1年)、无邻牙(10.6年)相对于至少有1颗邻牙(13.8年)、可摘局部义齿修复(12.5年)相对于固定义齿和单冠修复(13.9年)的留存时间有统计学显著降低。用作双冠固位可摘局部义齿(套筒冠义齿)基牙的牙齿留存时间缩短最多(9.8年)。牙型和邻牙情况在多变量Cox回归模型中仍为显著变量。
铸造桩核有可接受的长期留存时间。由于不同因素可能影响留存情况,在治疗计划中考虑这些因素可能会提高这些修复体的长期成功率。