Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany.
Clin Oral Implants Res. 2019 May;30(5):466-475. doi: 10.1111/clr.13433. Epub 2019 Apr 23.
To assess survival/success rates and patient-reported outcome of zirconia-based posterior single crowns (SCs) supported by zirconia implants in a prospective two-center study after five years of observation.
Forty-five patients were restored with 45 zirconia implant-supported posterior SCs composed of zirconia frameworks hand-layered with a leucite-reinforced feldspathic ceramic. Survival rates of SCs were assessed and technical success was evaluated according to modified United States Public Health Care (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models were used to evaluate time effects on response variables.
Forty patients were available after a mean observation period of 61.0 ± 1.4 months. One SC had to be replaced, resulting in a Kaplan-Meier (KM) survival estimate for the SCs of 97.5 ± 2.47%. Since nine reconstructions showed at least in one category a major deviation from the ideal (five major chippings, four with increased occlusal roughness, one significant crevice, and one pronounced over-contouring), the KM success estimate was 79.3 ± 5.8%. Incidence of chipping (n = 19) and occlusal roughness (n = 35) was frequent (p < 0.001). All PROMs at prosthetic delivery except for speech (p = 0.139) showed significantly improved VAS scores (81%-94%; p < 0.001) compared to pre-treatment evaluations. Thereafter, no decrease in satisfaction could be observed until the 5-year follow-up (93%-97%).
Veneered zirconia-based SCs supported by zirconia implants showed high survival rates and highly satisfied patients' needs. However, significant incidence of technical complications is compromising the clinical long-term outcome for this indication.
通过一项为期五年的前瞻性双中心研究，评估氧化锆基后牙单冠（SCs）的存活率/成功率和患者报告的结果，这些单冠由氧化锆种植体支持，并用氧化锆基底冠分层堆积长石增强玻璃陶瓷修复。
45 名患者接受了 45 颗氧化锆种植体支持的后牙单冠修复，这些单冠由氧化锆基底冠组成，基底冠采用手用分层堆积长石增强玻璃陶瓷修复。根据改良的美国公共医疗保健（USPHS）标准评估SCs 的存活率和技术成功率。此外，采用视觉模拟量表（VAS）评估患者报告的结果测量（PROMs）。采用 Wilcoxon 配对符号秩检验、混合效应有序逻辑回归和线性混合模型评估时间对反应变量的影响。
在平均 61.0±1.4 个月的观察期后，40 名患者可供评估。有 1 颗单冠需要更换，因此单冠的 Kaplan-Meier（KM）存活率估计值为 97.5±2.47%。由于 9 个修复体在至少一个类别中存在明显偏离理想状态（5 个主要崩瓷，4 个出现咬合面粗糙度增加，1 个出现明显缝隙，1 个出现明显过度塑形），因此 KM 成功率估计值为 79.3±5.8%。崩瓷发生率（n=19）和咬合面粗糙度发生率（n=35）较高（p<0.001）。除了言语功能（p=0.139），所有 PROM 在修复体交付时的 VAS 评分均显著提高（81%-94%；p<0.001），与治疗前评估相比。此后，直到 5 年随访时，满意度才没有下降（93%-97%）。
氧化锆基底冠分层堆积长石增强玻璃陶瓷修复的氧化锆基后牙单冠具有较高的存活率和较高的患者满意度。然而，大量技术并发症的发生正在影响该适应证的临床长期效果。
