Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany.
Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Medical Center - University of Freiburg, Faculty of Medicine - University of Freiburg, Freiburg, Germany.
Clin Oral Implants Res. 2018 Jan;29(1):91-99. doi: 10.1111/clr.13072. Epub 2017 Sep 21.
To evaluate the clinical and patient-reported outcome of all-ceramic zirconia implant supported fixed dental prostheses (FDPs) 5 years after implant installation.
Thirteen patients were treated with two terminally placed one-piece zirconia implants for a three-unit FDP each. The FDPs consisted of a CAD/CAM-fabricated zirconia framework over-pressed with a fluor-apatite veneering ceramic and were adhesively cemented. Survival and success were assessed by applying modified US Public Health Service (USPHS) criteria and preparation of Kaplan-Meier (KM) plots. Alpha and Bravo ratings were accepted for success (among others including small area veneer chippings and occlusal roughness), whereas Charlie ratings allowing for intra-oral correction (e.g., polishing) were accepted for survival. Furthermore, patient-reported outcome measures (PROMs) were analyzed with the help of visual analogue scales (VAS). Wilcoxon matched-pairs signed-rank test (USPHS criteria) and linear mixed models (PROMs) were used to evaluate time effects on response variables.
All patients were available 61.8 ± 1.1 months after implant installation (53.6 ± 3.1 months after final prosthesis insertion). FDP survival was 100%. Significant incidence of veneer chipping (p = .0096) and occlusal roughness (p = .0019) was observed. Charlie rated extent of both phenomena resulted in a KM success estimate of 38.5% (95% CI: 14.1%-62.8%; seven FDPs with obvious roughness, three of them with extended veneer chipping). Compared with the pre-treatment assessments (30%-81% of satisfaction), all surveys at prosthetic delivery showed significantly improved VAS scores (66%-93%; p ≤ .038), except for speech (p = .341). Concerning function, esthetics and self-esteem, no decrease in satisfaction could be observed until the end of follow-up (90%-96%; p ≥ .057), whereas perception of sense (92%) and speech (95%) increased over time (p ≤ .030). Occurrence of technical complications did not correlate with patient satisfaction.
Bi-layered FDPs made from zirconia/fluor-apatite highly satisfied patients but showed significant incidence of technical complications.
评估种植体支持的全陶瓷氧化锆固定修复体（FDP）在种植体植入后 5 年的临床和患者报告的结果。
13 名患者接受了两个末端放置的一体式氧化锆种植体治疗，每个种植体各有一个三单位 FDP。FDP 由 CAD/CAM 制造的氧化锆支架上覆盖一层氟磷灰石饰瓷，并通过胶接固定。通过应用改良的美国公共卫生服务（USPHS）标准和绘制 Kaplan-Meier（KM）图来评估生存和成功。接受 Alpha 和 Bravo 评分作为成功标准（还包括小面积饰瓷崩裂和咬合粗糙度等），而接受 Charlie 评分以允许进行口腔内矫正（例如抛光）作为生存标准。此外，借助视觉模拟量表（VAS）分析了患者报告的结果测量（PROM）。采用 Wilcoxon 配对符号秩检验（USPHS 标准）和线性混合模型（PROM）来评估时间对反应变量的影响。
所有患者在种植体植入后 61.8±1.1 个月（最终修复体插入后 53.6±3.1 个月）时均可进行评估。FDP 存活率为 100%。观察到明显的饰瓷崩裂（p=.0096）和咬合粗糙度（p=.0019）发生率。Charlie 评分评估了这两种现象的严重程度，得出 KM 成功率估计值为 38.5%（95%CI：14.1%-62.8%；七例 FDP 存在明显的粗糙度，其中三例存在延伸的饰瓷崩裂）。与治疗前评估（满意度为 30%-81%）相比，所有在修复体交付时的调查均显示 VAS 评分显著提高（66%-93%；p≤.038），除了言语功能（p=.341）。在功能、美观和自尊心方面，直到随访结束时，满意度均未下降（90%-96%；p≥.057），而感知（92%）和言语功能（95%）则随着时间的推移而增加（p≤.030）。技术并发症的发生与患者满意度无关。
由氧化锆/氟磷灰石制成的双层 FDP 极大地满足了患者的需求，但显示出明显的技术并发症发生率。
