氧化锆粘结方法的临床疗效：系统评价。

Clinical efficacy of methods for bonding to zirconia: A systematic review.

机构信息

Postgraduate Tutor, School of Dentistry, King's College London, London, United Kingdom; Private practice, Gold Coast, Australia.

Researcher, The University of Queensland School of Dentistry, Brisbane, Australia.

出版信息

J Prosthet Dent. 2021 Feb;125(2):231-240. doi: 10.1016/j.prosdent.2019.12.017. Epub 2020 Feb 27.

DOI:10.1016/j.prosdent.2019.12.017

PMID:32115220

Abstract

STATEMENT OF PROBLEM

The polycrystalline nature of zirconia hinders its ability to bond to tooth structure. Consequently, durable bonding to zirconia has been challenging. In vitro studies have evaluated various methods of bonding to zirconia, but clinical data are sparse.

PURPOSE

The purpose of this systematic review was to critically appraise clinical studies investigating the survival rate of resin-bonded zirconia fixed partial dentures (FPDs), inlay-retained zirconia FPDs, and zirconia veneers.

MATERIAL AND METHODS

Searches were performed in MEDLINE, EMBASE, PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. Clinical studies of over 12 months duration involving bonded zirconia restorations between 1990 and July 2018 were reviewed. All suitable studies were assessed for quality by using a "Questionnaire for selecting articles on Dental Prostheses".

RESULTS

Eight studies were ultimately included. Three studies examined posterior inlay-retained FPDs with estimated survival rates of 12.1% at 10 years, 95.8% at 5 years, and 100% at 20 months. Five studies reviewed anterior, resin-bonded FPDs, all of which had a 3- to 10-year survival rate of 100%. Debonds occurred in all studies, but the prostheses could usually be rebonded.

CONCLUSIONS

With correctly designed buccal and lingual coverage retainers and minimal if any veneering porcelain, zirconia-based, posterior, inlay-retained FPDs seem to have a high clinical survival rate. The role of bonding efficacy in this survival rate is unknown. Anterior, cantilevered, resin-bonded zirconia FPDs seem to have a high clinical survival rate. While these prostheses can debond, fracture of the entire prosthesis is unlikely, so they may be rebonded. To bond zirconia, the use of airborne-particle abrasion with 50-μm alumina (AlO) at 0.1 to 0.25 MPa in combination with a phosphate monomer-containing adhesive resin is recommended until further studies become available. Dental dam isolation is also recommended during zirconia bonding.

摘要

问题陈述

氧化锆的多晶性质阻碍了它与牙体结构的结合能力。因此，持久的氧化锆粘结一直具有挑战性。体外研究已经评估了各种粘结氧化锆的方法，但临床数据很少。

目的

本系统评价的目的是批判性地评价研究粘结氧化锆固定局部义齿（FPD）、嵌体粘结氧化锆 FPD 和氧化锆贴面的临床研究的存活率。

材料与方法

在 MEDLINE、EMBASE、PubMed、Web of Science、Scopus、Cochrane Library 和 Google Scholar 中进行了检索。回顾了 1990 年至 2018 年 7 月期间持续时间超过 12 个月的涉及粘结氧化锆修复体的临床研究。使用“牙科修复体选择文章问卷”评估所有合适的研究的质量。

结果

最终纳入了 8 项研究。3 项研究检查了后牙嵌体粘结 FPD，10 年的估计存活率为 12.1%，5 年为 95.8%，20 个月为 100%。5 项研究回顾了前牙、树脂粘结 FPD，所有研究的 3 至 10 年存活率均为 100%。所有研究都发生了脱粘，但通常可以重新粘结修复体。

结论

对于设计正确的颊舌覆盖保持器，并且如果有任何饰面瓷，氧化锆基、后牙嵌体粘结 FPD 似乎具有高的临床存活率。粘结效果在这个存活率中的作用尚不清楚。前牙、悬臂式、树脂粘结氧化锆 FPD 似乎具有高的临床存活率。虽然这些修复体可能会脱粘，但整个修复体断裂的可能性不大，因此可以重新粘结。为了粘结氧化锆，建议使用空气颗粒喷砂，以 0.1 至 0.25 MPa 的压力喷射 50-μm 的氧化铝（AlO），并结合含有磷酸盐单体的粘结树脂，直到有进一步的研究结果。在粘结氧化锆时，还建议使用牙间隔离带。