Restorative Section, Melbourne Dental School, Melbourne University, 720 Swanston Street, Melbourne, Victoria, 3010, Australia.
Department of Prosthodontics, Royal Dental Hospital of Melbourne, Melbourne, Victoria 3010, Australia.
J Esthet Restor Dent. 2018 May;30(3):193-215. doi: 10.1111/jerd.12384. Epub 2018 Apr 20.
This systematic review aimed to evaluate the longevity of ceramic onlays and identify the factors that influence their survival.
An electronic search was conducted through PubMed (MEDLINE), Google Scholar and Cochrane Library, up to August 2017. The literature search aimed to retrieve all the clinical studies on the longevity of ceramic onlays. Ceramic onlay was defined as any partial ceramic restoration that covers at least one cusp.
A total of 21 studies met the selection criteria and were deemed suitable for this review. The medium-term studies (2-5 years) indicated a survival rate of 91-100%, and the long term studies (more than 5 years) showed a survival rate of 71-98.5%. The most common reason of failure was fracture, followed by debonding and caries. The most common patterns of deterioration were loss of margin integrity and discoloration. Onlay longevity can be enhanced if the preparation allows for at least 2 mm occlusal ceramic thickness and incorporates additional retentive features. Restoring teeth that are nonvital, teeth in a more posterior region, or teeth for patients with parafunctional habits appears to be associated with greater ceramic failure. Fabrication materials and methods, and adhesive bonding system did not seem to influence onlay longevity.
The clinical performance of the ceramic onlay appears acceptable regardless of the follow-up duration. Fracture of the ceramic onlay is the predominant cause of failure, and the most observed form of deterioration was associated with the restoration margin.
Ceramic onlay appears to be a reliable option to restore posterior teeth. The most common pattern of failure is fracture of the ceramic material. The risk of ceramic onlay failure seems to increase if the restored tooth is nonvital and the patient demonstrates parafunctional habits.
本系统评价旨在评估陶瓷嵌体的寿命，并确定影响其存活率的因素。
通过电子检索 PubMed（MEDLINE）、Google Scholar 和 Cochrane Library，检索时间截至 2017 年 8 月，以获取关于陶瓷嵌体寿命的所有临床研究。陶瓷嵌体定义为覆盖至少一个牙尖的任何部分陶瓷修复体。
共有 21 项研究符合入选标准，适合进行本综述。中期研究（2-5 年）显示的存活率为 91-100%，长期研究（5 年以上）显示的存活率为 71-98.5%。最常见的失败原因是折裂，其次是脱落和龋齿。最常见的恶化模式是边缘完整性丧失和变色。如果预备体允许至少 2mm 的咬合面陶瓷厚度，并包含额外的固位特征，则可以提高嵌体的寿命。对于非活髓牙、后牙区的牙齿或有咀嚼习惯的患者，修复牙似乎与更高的陶瓷失败率相关。制作材料和方法以及粘接系统似乎不会影响嵌体的寿命。
陶瓷嵌体的临床性能在随访时间内似乎是可以接受的。陶瓷嵌体的折裂是主要的失败原因，最常见的恶化形式与修复体边缘有关。
陶瓷嵌体似乎是一种可靠的修复后牙的选择。最常见的失败模式是陶瓷材料的折裂。如果修复牙是无活力的，患者有咀嚼习惯，那么陶瓷嵌体失败的风险似乎会增加。
