Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, D-24105, Kiel, Germany.
Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Arnold-Heller-Str. 16, D-24105, Kiel, Germany.
J Dent. 2019 Oct;89:103178. doi: 10.1016/j.jdent.2019.08.001. Epub 2019 Aug 5.
The purpose of this prospective study was to evaluate the clinical long-term outcome over 15 or more years of crown-retained fixed dental prostheses (FDPs) made from a lithium disilicate ceramic (IPS e.max Press, Ivoclar Vivadent AG).
Thirty-six three-unit FDPs replacing anterior (16%) and posterior (84%) teeth were inserted in 28 patients. Abutment teeth were prepared following a standardized protocol. The size of the proximal connector of the FDPs was 12 mm² (anterior) or 16 mm² (posterior). FDPs were cemented either conventionally with glass-ionomer cement (n = 19) or adhesively with composite resin (n = 17). The following parameters were evaluated at baseline, 6 months after cementation and then annually (at abutment and contralateral teeth): probing pocket depth, plaque index, bleeding on probing, and tooth vitality.
Three FDPs were defined as drop-outs. The mean observation period of the remaining 33 FDPs was 167 months (range: 79-225 months). The survival rate (survival being defined as FDPs remaining in place either with or without complications) according to Kaplan-Meier was 48.6% after 15 years. The success rate (success being defined as free of complications and remaining unchanged) was 30.9% after 15 years.
Fatigue and crack propagation caused by clinical aging in monolithic lithium disilicate ceramics seem to take considerable time, as shown by the presented survival and success rates after 15 years. Further long-term studies are necessary to evaluate the reliability of FDPs made from other all-ceramic materials over a period of 15 or more years.
本前瞻性研究旨在评估经过 15 年或以上临床使用后，使用锂硅二酸盐陶瓷（义获嘉维他公司的 IPS e.max Press）制作的全瓷冠桥的长期临床效果。
28 名患者共植入 36 个三单位的全瓷冠桥，包括 16%的前牙和 84%的后牙。基牙按照标准化的方案进行预备。全瓷冠桥的近中连接体的尺寸为 12 mm²（前牙）或 16 mm²（后牙）。全瓷冠桥通过玻璃离子水门汀（n=19）或复合树脂（n=17）进行常规或粘结固位。在粘结后 6 个月及之后每年（基牙和对侧同名牙）评估以下参数：探诊深度、菌斑指数、探诊出血和牙活力。
3 个全瓷冠桥被定义为脱落。33 个剩余全瓷冠桥的平均观察期为 167 个月（范围：79-225 个月）。根据 Kaplan-Meier 生存分析，15 年后的生存率（定义为全瓷冠桥仍然存在，无论是否存在并发症）为 48.6%。15 年后的成功率（定义为无并发症且保持不变）为 30.9%。
在临床使用中，由于老化引起的疲劳和裂纹扩展似乎需要相当长的时间，正如经过 15 年后呈现的生存和成功率所显示的那样。需要进一步的长期研究来评估其他全瓷材料制作的全瓷冠桥在 15 年或更长时间内的可靠性。
