Stober T, Bermejo J L, Schwindling F S, Schmitter M
Department of Prosthodontics, University Hospital Heidelberg, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany.
J Oral Rehabil. 2016 Aug;43(8):621-9. doi: 10.1111/joor.12409. Epub 2016 May 20.
The purpose of this study was to measure enamel wear caused by antagonistic monolithic zirconia crowns and to compare this with enamel wear caused by contralateral natural antagonists. Twenty monolithic zirconia full molar crowns were placed in 20 patients. Patients with high activity of the masseter muscle at night (bruxism) were excluded. For analysis of wear, vinylpolysiloxane impressions were prepared after crown incorporation and at 6-, 12-, and 24-month follow-up. Wear of the occlusal contact areas of the crowns, of their natural antagonists, and of two contralateral natural antagonists (control teeth) was measured by use of plaster replicas and a 3D laser-scanning device. Differences of wear between the zirconia crown antagonists and the control teeth were investigated by means of two-sided paired Student's t-tests and linear regression analysis. After 2 years, mean vertical loss was 46 μm for enamel opposed to zirconia, 19-26 μm for contralateral control teeth and 14 μm for zirconia crowns. Maximum vertical loss was 151 μm for enamel opposed to zirconia, 75-115 μm for control teeth and 60 μm for zirconia crowns. Statistical analysis revealed significant differences between wear of enamel by zirconia-opposed teeth and by control teeth. Gender, which significantly affected wear, was identified as a possible confounder. Monolithic zirconia crowns generated more wear of opposed enamel than did natural teeth. Because of the greater wear caused by other dental ceramics, the use of monolithic zirconia crowns may be justified.
本研究的目的是测量由拮抗的整体式氧化锆全冠导致的牙釉质磨损，并将其与对侧天然拮抗牙导致的牙釉质磨损进行比较。在20名患者中放置了20个整体式氧化锆全磨牙冠。排除夜间咬肌活动度高（磨牙症）的患者。为了分析磨损情况，在全冠植入后以及6个月、12个月和24个月随访时制作乙烯基聚硅氧烷印模。通过使用石膏模型和三维激光扫描设备测量全冠的咬合接触区域、其天然拮抗牙以及两个对侧天然拮抗牙（对照牙）的磨损情况。通过双侧配对t检验和线性回归分析研究氧化锆全冠拮抗牙与对照牙之间的磨损差异。2年后，与氧化锆相对的牙釉质平均垂直磨损量为46μm，对侧对照牙为19 - 26μm，氧化锆全冠为14μm。与氧化锆相对的牙釉质最大垂直磨损量为151μm，对照牙为75 - 115μm，氧化锆全冠为60μm。统计分析显示，与氧化锆相对的牙釉质磨损与对照牙的磨损之间存在显著差异。性别被确定为可能影响磨损的一个混杂因素，且对磨损有显著影响。整体式氧化锆全冠导致的相对牙釉质磨损比天然牙更多。由于其他牙科陶瓷导致的磨损更大，使用整体式氧化锆全冠可能是合理的。
