Schmitz Johannes H, Cortellini Davide, Granata Stefano, Valenti Marco
Quintessence Int. 2017 Jul 20:601-608. doi: 10.3290/j.qi.a38678.
This retrospective study evaluated the clinical success and survival of monolithic lithium disilicate single crowns in the posterior region fabricated with feather-edge margins and cemented with resin-based self-etching cement.
In total, 627 pressed monolithic lithium disilicate restorations on posterior teeth (110 first premolars, 151 second premolars, 240 first molars, 121 second molars, 5 third molars) were placed in 335 patients. All teeth were prepared with feather-edge margins and restored with single crowns. The modified California Dental Association criteria were used to clinically evaluate subjects during regular maintenance recalls.
The mean follow-up time was 48.17 months (SD, 27.7; range, 6 to 144). Nine crowns were replaced during the follow-up period due to bulk fracture of the material (overall 97.93% survival rate), and four teeth were extracted. No other technical or biologic failure was observed.
In this retrospective evaluation, monolithic lithium disilicate crowns with feather-edge margins yielded clinical outcomes similar to those reported with other margin designs and materials. Following the same clinical protocol, crowns on second molars showed lower survival rates when compared to restorations on other teeth in the posterior region. Careful evaluation is mandatory in high-risk patients and terminal teeth. Alternative restorative materials, such as full-contour zirconia crowns, should be considered for the restoration of second molars.
本回顾性研究评估了采用羽状边缘制作并用树脂基自酸蚀粘结剂粘结的后牙整体式二硅酸锂单冠的临床成功率和存留率。
总共为335例患者的后牙放置了627个压制的整体式二硅酸锂修复体（110颗第一前磨牙、151颗第二前磨牙、240颗第一磨牙、121颗第二磨牙、5颗第三磨牙）。所有牙齿均制备成羽状边缘并用单冠修复。在定期维护复诊时，采用改良的加利福尼亚牙科协会标准对受试者进行临床评估。
平均随访时间为48.17个月（标准差，27.7；范围，6至144个月）。随访期间，因材料大块断裂更换了9个牙冠（总体存留率97.93%），拔除了4颗牙齿。未观察到其他技术或生物学失败情况。
在本回顾性评估中，具有羽状边缘的整体式二硅酸锂牙冠产生的临床结果与其他边缘设计和材料所报告的结果相似。按照相同的临床方案，与后牙区其他牙齿的修复体相比，第二磨牙上的牙冠显示出较低的存留率。对高危患者和末端牙齿必须进行仔细评估。对于第二磨牙的修复，应考虑使用全轮廓氧化锆牙冠等替代修复材料。
