Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, Germany.
Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland.
J Dent. 2017 Dec;67:58-65. doi: 10.1016/j.jdent.2017.09.008. Epub 2017 Sep 20.
To determine the clinical and patient-reported outcomes of bi-layered, all-ceramic posterior single crowns (SCs) supported by zirconia implants in an uncontrolled, prospective, multicenter study.
In two centers, 60 patients received 71 one-piece zirconia oral implants to be restored with either SCs (n=49) or three-unit fixed dental prostheses (n=11). Of these patients, 45 implants were restored with all-ceramic, zirconia-based posterior SCs (one per patient). Survival rates of implants and reconstructions were assessed, and technical success was evaluated according to modified U.S. Public Health Service (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Kaplan-Meier (KM) plots and log-rank tests were used for success/survival analyses. The Wilcoxon matched-pairs signed-rank test was used to evaluate time effects on response variables (PROMs, USPHS criteria).
Forty patients with 40 SCs could be evaluated after 36.7±1.2months. No SC was replaced, resulting in 100% survival. The KM success estimate was 87.5% (two chippings, one restoration margin, and one contour were rated Charlie). In general, the incidence of chipping (p=.0005) and occlusal roughness (p=.0003) was frequent. Compared with the pre-treatment patient surveys (67-93%), all surveys at prosthetic delivery except for speech (p=.139) showed significantly improved VAS scores (81-94%; p<.0001). Thereafter, no decrease in satisfaction could be observed over time until the 3-year follow-up (86-93%; p≥.390).
Veneered, zirconia-based SCs supported by zirconia implants satisfied patients' needs highly. However, significant incidence of chipping and roughness of the veneering ceramic may compromise the clinical long-term outcome for this indication.
Posterior, zirconia-based SCs supported by zirconia oral implants entirely survived the follow-up period of 3 years, but two major chippings, one a significant marginal opening and one pronounced over-contouring, resulted in a reduced KM success estimate of 87.5% after 36 months of observation.
在一项无对照、前瞻性、多中心研究中，确定双层全陶瓷后牙单冠（SCs）在氧化锆种植体支持下的临床和患者报告结果。
在两个中心，60 名患者共植入 71 枚一体式氧化锆口腔种植体，其中 49 名患者接受后牙单冠（SCs）修复，11 名患者接受三单位固定义齿修复。在这些患者中，45 枚种植体用全陶瓷氧化锆基后牙SCs（每个患者一枚）修复。评估种植体和修复体的存活率，并根据改良美国公共卫生服务（USPHS）标准评估技术成功。此外，通过应用视觉模拟量表（VAS）评估患者报告的结果测量（PROMs）。Kaplan-Meier（KM）图和对数秩检验用于成功/存活分析。Wilcoxon 配对符号秩检验用于评估时间对响应变量（PROMs、USPHS 标准）的影响。
40 名患者（40 个SCs）在 36.7±1.2 个月后可进行评估。没有 SC 被替换，存活率为 100%。KM 成功估计值为 87.5%（两个崩瓷，一个修复体边缘，一个轮廓为 Charlie）。总的来说，崩瓷（p=.0005）和咬合面粗糙度（p=.0003）的发生率较高。与治疗前的患者调查（67-93%）相比，除了言语（p=.139）外，所有在修复体交付时的调查显示 VAS 评分显著提高（81-94%；p<.0001）。此后，在 3 年的随访中，没有观察到满意度随时间下降（86-93%；p≥.390）。
氧化锆基 SCS 覆盖氧化锆种植体满足了患者的需求。然而，显著的崩瓷发生率和饰面陶瓷的粗糙度可能会影响该适应证的临床长期结果。
后牙氧化锆基 SCS 覆盖氧化锆种植体在 3 年的随访期间完全存活，但有两个主要的崩瓷，一个是明显的边缘开口，一个是明显的过度塑形，导致 KM 成功估计值在 36 个月的观察后下降至 87.5%。
