Teichmann Maren, Göckler Fabian, Weber Volker, Yildirim Murat, Wolfart Stefan, Edelhoff Daniel
Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Department of Prosthodontics and Biomaterials, Center of Implantology, Medical Faculty, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
J Dent. 2017 Jan;56:65-77. doi: 10.1016/j.jdent.2016.10.017. Epub 2016 Oct 29.
To prospectively evaluate the clinical long-term outcome of tooth-supported crowns (SCs), implant-supported crowns (ISCs), and fixed dental prostheses (FDPs) made of a lithium-disilicate glass-ceramic framework material (IPS Empress 2).
Between 1997 and 1999, a total of 184 restorations (106 SCs, 32 ISCs, 33 FDPs, and 13 diverse restorations) were placed in 73 patients. Kaplan-Meier estimation was applied for survival and chipping-free rates. Inter-group comparison of both rates was realized by a log rank test and a 2×2 contingency table. Also, SCs and FDPs were compared regarding adhesive vs. conventional cementation, and anterior vs. posterior positioning, for impact on survival.
Due to 14 dropouts (34 restorations) and reasonable exclusion of 19 other restorations, the final dataset included: i) 87 SCs [37 patients, mean observation time 11.4 (±3.8)years]; ii) 17 ISCs [12 patients, mean observation time 13.3 (±2.3)years; and iii) 27 FDPs [19 patients, mean observation time 8.9 (±5.4)years]. The 10-year survival rate/chipping-free rate for SCs were 86.1%/83.4%, for ISCs 93.8%/94.1%, and for FDPs were 51.9%/90.8%. Both ISCs and SCs had a significantly higher survival than FDPs (ISCs vs. FDPs: both tests p=0.001; SCs vs. FDPs: p=0.001 and p=0.005). Differences in the chipping-free rates did not reach significance. Also, neither the cementation mode nor positioning of the restoration had an impact on survival.
SCs had a slightly lower outcome than can generally be expected from single crowns. In contrast, ICSs had a favorable outcome and the FDPs predominantly failed.
The practitioner's choice of dental materials is based (at best) on long-term experience. The present 10-year results are based on comprehensive data analyses and show the high potential of lithium-disilicate as a reliable material, especially for single-unit restoration.
前瞻性评估由二硅酸锂玻璃陶瓷框架材料（IPS Empress 2）制成的牙支持式冠（SCs）、种植体支持式冠（ISCs）和固定义齿（FDPs）的临床长期效果。
1997年至1999年期间，共为73例患者植入了184颗修复体（106颗SCs、32颗ISCs、33颗FDPs和13颗其他修复体）。采用Kaplan-Meier法估计生存率和无崩瓷率。通过对数秩检验和2×2列联表对两组的这两个比率进行组间比较。此外，还比较了SCs和FDPs在粘结式与传统粘结方式以及前牙与后牙位置方面对生存率的影响。
由于14例失访（34颗修复体）以及合理排除另外19颗修复体，最终数据集包括：i）87颗SCs [37例患者，平均观察时间11.4（±3.8）年]；ii）17颗ISCs [12例患者，平均观察时间13.3（±2.3）年]；iii）27颗FDPs [19例患者，平均观察时间8.9（±5.4）年]。SCs的10年生存率/无崩瓷率分别为86.1%/83.4%，ISCs为93.8%/94.1%，FDPs为51.9%/90.8%。ISCs和SCs的生存率均显著高于FDPs（ISCs与FDPs比较：两项检验p = 0.001；SCs与FDPs比较：p = 0.001和p = 0.005）。无崩瓷率的差异未达到显著水平。此外，修复体的粘结方式和位置对生存率均无影响。
SCs的效果略低于单冠通常预期的效果。相比之下，ISCs效果良好，而FDPs主要失败。
从业者对牙科材料的选择（充其量）基于长期经验。目前的10年结果基于全面的数据分析，显示了二硅酸锂作为一种可靠材料的巨大潜力，尤其是用于单单位修复。
