Selz Christian F, Bogler Jan, Vach Kirstin, Strub Joerg R, Guess Petra C
Department of Prosthodontics, School of Dentistry, Albert-Ludwigs-University, Freiburg, Germany.
Department of Prosthodontics, School of Dentistry, Albert-Ludwigs-University, Freiburg, Germany.
J Dent. 2015 Dec;43(12):1428-35. doi: 10.1016/j.jdent.2015.10.017. Epub 2015 Oct 30.
The aim of this prospective clinical study was to evaluate the clinical performance of veneered anatomically designed zirconia fixed dental prostheses (FDPs) resulting from intraoral digital impressions.
24 patients requiring treatment were provided with all-ceramic FDPs. Intraoral scans (iTero) were performed and veneered anatomically designed CAD/CAM-zirconia FDPs (Zerion/VitaVM9) were fabricated. A feldspar veneering ceramic following a slow cooling firing protocol was applied. A self-curing resin based luting material was used for adhesive cementation. Clinical evaluations were performed at baseline and 6, 12, and 18 months recalls according to the modified USPHS-criteria. Intraoral digital surface scans (iTero) were performed at each recall examination and were digitally superimposed (Geomagic) to evaluate potential veneer cohesive fractures. Kaplan-Meier survival analysis comprised secondary caries, clinically unacceptable fractures, root canal treatment and debonding. Kaplan-Meier success rate included restorations with minimal crevices, tolerable color deviations and clinically acceptable fractures. Data were statistically analyzed.
The Kaplan-Meier survival rate and success rate of the FDPs were 100% and 91.7%, respectively. Clinically acceptable veneer cohesive fractures and crevices at the restoration margin were observed in two patients. These shallow veneer fractures were only detected by overlapping baseline and recall scans. Ceramic surface roughness increased significantly over time (p<0.0001).
Veneered zirconia FDPs fabricated from digital intraoral scans showed a favorable clinical performance over an observation period of 18 months. Anatomical zirconia core design and slow cooling firing protocol of the veneering ceramic reduced the incidence of chip fractures to a level that could not be detected clinically.
The digital workflow on the basis of intraoral digital impressions resulted in clinically satisfying outcomes for veneered zirconia FDPs.
本前瞻性临床研究的目的是评估由口内数字印模制作的贴面解剖设计氧化锆固定义齿（FDPs）的临床性能。
为24例需要治疗的患者提供全瓷FDPs。进行口内扫描（iTero），并制作贴面解剖设计的CAD/CAM氧化锆FDPs（Zerion/VitaVM9）。采用慢冷烧制工艺的长石贴面陶瓷。使用自固化树脂基粘结材料进行粘结固位。根据改良的美国公共卫生服务标准，在基线以及6、12和18个月复诊时进行临床评估。每次复诊检查时进行口内数字表面扫描（iTero），并进行数字叠加（Geomagic）以评估潜在的贴面粘结性骨折。Kaplan-Meier生存分析包括继发龋、临床不可接受的骨折、根管治疗和脱粘。Kaplan-Meier成功率包括具有最小缝隙、可耐受颜色偏差和临床可接受骨折的修复体。对数据进行统计学分析。
FDPs的Kaplan-Meier生存率和成功率分别为100%和91.7%。在两名患者中观察到临床可接受的贴面粘结性骨折和修复边缘的缝隙。这些浅表的贴面骨折仅通过重叠基线和复诊扫描才能检测到。陶瓷表面粗糙度随时间显著增加（p<0.0001）。
由口内数字扫描制作的贴面氧化锆FDPs在18个月的观察期内显示出良好的临床性能。解剖氧化锆核设计和贴面陶瓷的慢冷烧制工艺将碎片骨折的发生率降低到临床无法检测到的水平。
基于口内数字印模的数字化工作流程为贴面氧化锆FDPs带来了临床满意的结果。
