Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany.
Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Arnold-Heller Str. 16, 24105 Kiel, Germany.
J Dent. 2019 Oct;89:103174. doi: 10.1016/j.jdent.2019.07.012. Epub 2019 Jul 27.
To evaluate the long-term clinical outcome of inlay-retained fixed dental prostheses (IRFDPs) made from lithium-disilicate glass-ceramic.
Forty-five IRFDPs were placed in 42 patients (21 women, mean age 36.1 years and 21 men, mean age 42.0 years). The IRFDPs replaced 4 premolars and 19 first molars in the maxilla and 4 premolars and 18 first molars in the mandible. All teeth were prepared following a standardized protocol for ceramic inlay restorations. Five of the 45 FDPs were hybrid-retained restorations, i.e. one abutment tooth with an inlay retainer and one with a full crown retainer. All restorations were fabricated from heat-pressed lithium-disilicate ceramic (IPS e.max Press, Ivoclar Vivadent AG). The minimal size of the proximal connector was 16 mm (4 mm × 4 mm in height and width) with a minimum occlusal ceramic thickness of 1.5 mm. Hydrofluoric acid etching (5%) and silane application was used for conditioning the bonding surfaces. Standard adhesive luting techniques were performed using a dentin adhesive and a resin composite. Standardized follow-up reports were performed annually. The survival rates were performed using the Kaplan-Meier analysis.
The mean observation period was 100 months (minimum 4, maximum 234 months). Thirty-three FDPs (73%) failed during the observation period and had to be replaced by other restorations. The Kaplan-Meier survival rate for IRFDPs was 57% after 5 years, 38% after 8 years and 22% after 15 years, while for hybrid-retained FDPs it was 100% after 5 years, 60% after 8 years and also 60% after 15 years.
With the design used in the current, study lithium-disilicate ceramic IRFDP had a high clinical failure rate and cannot be recommended for regular clinical use.
评估采用锂硅玻璃陶瓷制作嵌体固位式固定修复体（IRFDP）的长期临床效果。
共纳入 42 名患者（21 名女性，平均年龄 36.1 岁；21 名男性，平均年龄 42.0 岁）的 45 个 IRFDP。IRFDP 修复上颌 4 个前磨牙和 19 个第一磨牙，下颌 4 个前磨牙和 18 个第一磨牙。所有牙齿均按照陶瓷嵌体修复的标准化方案进行制备。45 个 FDP 中有 5 个为混合固位修复体，即 1 个基牙用嵌体固位体，1 个用全冠固位体。所有修复体均由热压锂硅玻璃陶瓷（IPS e.max Press，Ivoclar Vivadent AG）制成。近中连接体的最小尺寸为 16mm（高 4mm×宽 4mm），最小的咬合面陶瓷厚度为 1.5mm。使用 5%氢氟酸蚀刻（etching）和硅烷处理（silane application）来处理粘结面。使用牙本质粘结剂和树脂复合材料进行标准粘结技术。每年进行标准化随访报告。采用 Kaplan-Meier 分析评估生存率。
平均观察期为 100 个月（最短 4 个月，最长 234 个月）。在观察期间，33 个 FDP（73%）失败，需要更换其他修复体。IRFDP 的 Kaplan-Meier 生存率为 5 年后 57%，8 年后 38%，15 年后 22%，而混合固位 FDP 的生存率为 5 年后 100%，8 年后 60%，15 年后 60%。
采用本研究中的设计，锂硅玻璃陶瓷 IRFDP 的临床失败率较高，不建议常规临床使用。
