陶瓷嵌体由牙科学员修复的回顾性临床评估。

Retrospective clinical evaluation of ceramic onlays placed by dental students.

机构信息

Predoctoral student, Schulich Medicine and Dentistry, Western University, London, Ont, Canada.

Associate Professor, Department of Restorative Dentistry, Schulich Medicine and Dentistry, Western University, London, Ont, Canada.

出版信息

J Prosthet Dent. 2018 May;119(5):743-748.e1. doi: 10.1016/j.prosdent.2017.07.004. Epub 2017 Sep 18.

DOI:10.1016/j.prosdent.2017.07.004

PMID:28927922

Abstract

STATEMENT OF PROBLEM

Indirect restorations with partial or complete occlusal surface coverage have been recommended to restore teeth with weakened walls in order to prevent cusp fracture. The success of these restorations when performed by dental students is unknown.

PURPOSE

The purpose of this retrospective study was to evaluate the clinical performance of adhesively bonded ceramic onlay restorations placed by third- and fourth-year dental students.

MATERIAL AND METHODS

Sixty-five ceramic onlays were placed in patients between 2009 and 2015. The onlays were laboratory or chairside fabricated with a computer-aided design and computer-aided manufacturing (CAD-CAM) system, using either IPS e.max Press or IPS e.max CAD. An adhesive technique and luting composite resin agent were used to cement the restorations. Thirty-seven onlays were evaluated clinically using the modified United States Public Health Service (USPHS) criteria. Data were statistically analyzed using the Cox proportional hazards model to compare tooth type and failures and the Fisher exact and McNemar tests to compare the USPHS criteria for significant differences (α=.05). Survival probability was calculated using the Kaplan-Meier algorithm.

RESULTS

Five onlays were considered to be failures and needed replacement. According to the Kaplan-Meier analysis, the estimated survival rate was 96.3% after 2 years and 91.5% at 4 years. All 5 of the failures occurred on molars (13.5%) and none on premolars (P=.025). A statistically significant difference was found for marginal discoloration between onlays placed within 0 to 3 years and 3 to 6 years (P<.05) but no differences between any other criteria.

CONCLUSIONS

Ceramic onlays placed by dental students demonstrated acceptable long-term clinical performance.

摘要

问题陈述

为了防止牙尖折裂，已经建议使用部分或完全覆盖咬合面的间接修复体来修复牙体壁薄弱的牙齿。然而，对于由牙科学员完成的这些修复体的成功率，目前尚不清楚。

目的

本回顾性研究旨在评估由三、四年级牙科学员制作的黏结性陶瓷嵌体修复体的临床性能。

材料与方法

2009 年至 2015 年间，共有 65 例陶瓷嵌体被放置在患者口腔中。嵌体由计算机辅助设计和计算机辅助制造（CAD-CAM）系统的实验室或椅旁制作，使用 IPS e.max Press 或 IPS e.max CAD。采用黏结技术和黏结复合树脂剂黏固修复体。37 个嵌体根据改良后的美国公共卫生服务（USPHS）标准进行临床评估。使用 Cox 比例风险模型对数据进行统计学分析，以比较牙位类型和失败情况，并使用 Fisher 确切检验和 McNemar 检验比较 USPHS 标准的显著性差异（α=.05）。使用 Kaplan-Meier 算法计算生存概率。

结果

有 5 个嵌体被认为是失败的，需要更换。根据 Kaplan-Meier 分析，2 年后的估计生存率为 96.3%，4 年后为 91.5%。所有 5 个失败均发生在磨牙（13.5%），而在前磨牙中则没有（P=.025）。在 0 至 3 年和 3 至 6 年内，在边缘变色方面发现有统计学显著差异（P<.05），但在其他任何标准方面均无差异。