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整体聚合物渗透陶瓷网络 CAD/CAM 单冠:一项前瞻性临床研究的三年中期结果。

Monolithic Polymer-Infiltrated Ceramic Network CAD/CAM Single Crowns: Three-Year Mid-Term Results of a Prospective Clinical Study.

出版信息

Int J Prosthodont. 2020 Mar/Apr;33(2):160-168. doi: 10.11607/ijp.6548.

Abstract

PURPOSE

To evaluate the clinical outcomes of monolithic CAD/CAM-fabricated polymer-infiltrated ceramic network (PICN) single crowns (SC) after 3 years.

MATERIALS AND METHODS

A total of 34 patients who received 76 single crowns were included in this cohort study. Full-coverage crown preparation with reduced thickness (1.0 to 1.5 mm) was applied. All monolithic PICN SCs (VITA Enamic) were manufactured using a CAD/CAM system and adhesively seated. Clinical follow-up evaluations were performed at 6, 12, 24, and 36 months after insertion using modified United States Public Health Service (USPHS) criteria. Kaplan-Meier survival and success methods were applied to calculate absolute and relative failures. To determine effects of time and restoration, a mixed logit model was adjusted for the modified USPHS criteria (P < .05).

RESULTS

PICN SCs revealed an estimated Kaplan-Meier survival rate of 93.9% after 3 years. Four clinically unacceptable fractures occurred, which resulted in replacement of the affected SCs. Neither secondary caries nor debonding were recorded. The 3-year Kaplan-Meier success rate was 92.7%. Significant increases in marginal discoloration (P = .0002) and surface roughness (P < .0001) were noted over time. Color match, anatomical form, and marginal adaptation remained favorable over the given observation period.

CONCLUSION

PICN CAD/CAM crowns with reduced thickness showed acceptable survival and success rates over a service time of 36 months. However, extended clinical follow-up periods are needed to evaluate the long-term performance.

摘要

目的

评估 3 年后整体式 CAD/CAM 制造的聚合物渗透陶瓷网络(PICN)单体冠的临床效果。

材料与方法

本队列研究共纳入 34 名患者,共 76 个单冠。采用全冠预备,预备体厚度减少至 1.0-1.5mm。所有整体式 PICN 单体冠(VITA Enamic)均采用 CAD/CAM 系统制作,并采用粘接方式就位。修复后 6、12、24 和 36 个月分别采用改良美国公共卫生署(USPHS)标准进行临床随访评估。Kaplan-Meier 生存和成功方法用于计算绝对和相对失败。为了确定时间和修复体的影响,对改良 USPHS 标准进行了混合逻辑模型调整(P<.05)。

结果

3 年后,PICN 单体冠的估计 Kaplan-Meier 生存率为 93.9%。4 个临床不可接受的冠折发生,导致受影响的单体冠被替换。未记录继发龋或脱粘。3 年 Kaplan-Meier 成功率为 92.7%。随着时间的推移,边缘变色(P=0.0002)和表面粗糙度(P<.0001)显著增加。在观察期内,颜色匹配、解剖形态和边缘适应性仍保持良好。

结论

厚度减少的 PICN CAD/CAM 冠在 36 个月的随访期内具有可接受的生存率和成功率。然而,需要进行更长时间的临床随访,以评估其长期性能。

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