State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
J Dent. 2017 Apr;59:2-10. doi: 10.1016/j.jdent.2017.02.006. Epub 2017 Feb 24.
The aim of this systematic review was to investigate the survival and complication rates of inlay-retainer fixed dental prostheses (IRFDPs).
DATA/SOURCES: A systematic search was conducted in the PubMed, EMBASE, and Cochrane Library databases in English and time filters (articles published from 1960) were used.
Randomized controlled trails (RCTs), controlled clinical trials (CCTs) and prospective cohort studies on IRFDPs with a mean follow-up period of at least 2 years were included. Among 501 screened articles, one RCT and ten prospective cohort studies were included in this study. Of the included studies, information on failure and complications was independently extracted by two reviewers in duplicate. The failure and complication rates of IRFDPs were pooled with a random effect model and Poisson regression was applied to further investigate the influence of framework materials. The estimated 3- and 5-year survival rates of IRFDPs were 92.6% (95% CI: 85.8-97.6%) and 87.9% (95% CI: 77.4-96.1%), respectively. Debonding, fracture, dentine hypersensitivity and secondary caries were primary complications. The estimated 5-year rates of debonding, veneer fracture and secondary caries were 5.3%, 15.2% and 2.7%, respectively. Additionally, fiber-reinforced composite IRFDPs exhibited a lower incidence of debonding and caries with a higher rate of veneer fracture compared with metal-based and all-ceramic IRFDPs (p<0.05).
Compared with conventional fixed dental prostheses (FDPs) and implant-supported single crowns (ISCs), IRFDPs exhibited an acceptable 3-year survival rate but higher complication rates of debonding and veneer fracture.
IRFDPs can be recommended as viable short- or middle-term minimally invasive alternatives to short-span conventional FDPs and ISCs, while the clinical outcome of IRFDPs as long-term definitive restorations still calls for further research. The indications of IRFDPs should be strictly controlled and monitored.
本系统评价旨在调查嵌体固位体固定修复体（IRFDPs）的生存率和并发症发生率。
以英文在 PubMed、EMBASE 和 Cochrane 图书馆数据库中进行系统检索，并使用时间过滤器（1960 年以来发表的文章）。
纳入 IRFDP 的随机对照试验（RCTs）、对照临床试验（CCTs）和前瞻性队列研究，平均随访期至少 2 年。在筛选出的 501 篇文章中，本研究纳入了一项 RCT 和 10 项前瞻性队列研究。在纳入的研究中，两位评审员独立重复提取失败和并发症信息。采用随机效应模型对 IRFDP 的失败和并发症发生率进行汇总，并应用泊松回归进一步研究框架材料的影响。IRFDP 的估计 3 年和 5 年生存率分别为 92.6%（95%CI：85.8-97.6%）和 87.9%（95%CI：77.4-96.1%）。离解、骨折、牙本质过敏和继发龋是主要并发症。估计 5 年离解、贴面骨折和继发龋的发生率分别为 5.3%、15.2%和 2.7%。此外，与金属基和全陶瓷 IRFDPs 相比，纤维增强复合材料 IRFDPs 的离解和龋病发生率较低，贴面骨折发生率较高（p<0.05）。
与传统固定修复体（FDPs）和种植体支持的单冠（ISCs）相比，IRFDPs 的 3 年生存率可接受，但离解和贴面骨折的并发症发生率较高。
IRFDPs 可作为短期或中期微创替代短跨度传统 FDPs 和 ISCs 的可行选择，而作为长期确定性修复体的 IRFDPs 的临床效果仍需要进一步研究。IRFDPs 的适应证应严格控制和监测。
