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后牙全瓷嵌体固位固定修复体的 15 年疗效。

Fifteen-year outcome of posterior all-ceramic inlay-retained fixed dental prostheses.

机构信息

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.

出版信息

J Dent. 2019 Oct;89:103174. doi: 10.1016/j.jdent.2019.07.012. Epub 2019 Jul 27.

Abstract

OBJECTIVES

To evaluate the long-term clinical outcome of inlay-retained fixed dental prostheses (IRFDPs) made from lithium-disilicate glass-ceramic.

MATERIAL AND METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

材料与方法

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。

结果

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%。

结论

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。

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