Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran.
J Dent. 2020 Sep;100:103420. doi: 10.1016/j.jdent.2020.103420. Epub 2020 Jun 26.
The implant-supported restorations can be made of all-ceramic materials. The purpose of this study was to compare five year clinical outcomes of zirconia-based and metal ceramic implant-supported fixed dental prostheses (FDPs).
In this study, 114 posterior implant-supported FDPs including zirconia-based (52) or metal ceramic (62) restorations were made for 114 patients with a mean age of 59 ± 8.4 years and evaluated in a 5 year follow up. The modified California Dental Association (CDA) guidelines were used to assess the quality of the restorations. The soft tissue status was evaluated using gingival and plaque indices, probing depth and bleeding on probing. Additionally, the bone loss around implants was assessed by parallel priapical radiographs. The visual analogue scale was used regarding patients' satisfaction. The data analysis were performed by Kaplan-Meier, log rank test, Cox regression, Mann-Whitney U and Student's t-test. (α = 0.05).
Five year Kaplan-Meier survival rate of the zirconia-based and metal ceramic FDPs were 98.1 % and 100 % respectively with no significant difference (P = 0.12). The success rates were 81.6 % for zirconia-based and 81.0 % for metal ceramic restorations (P = 0.85). The CDA rating of both studied groups was not significantly different except the marginal gap which was better in zirconia-based FDPs (P < 0.001). Fracture of veneering ceramics occurred in 2.7 % of metal ceramic and 6.4 % of zirconia-based FDPs, which were not considered as failure. Soft tissue status was not affected by the type of restorations except for plaque index which was more favorable for zirconia-based FDPs (P < 0.001). No significant difference was found between marginal bone loss of the two groups (P = 0.30 mesial, P = 0.46 distal).
Zirconia-based and metal ceramic FDPs showed similar promising clinical performance in the 5-year follow-up.
Zirconia-based implant-supported FDPs might be a successful restorative method with acceptable survival rate and patient's satisfaction.
种植体支持的修复体可以由全陶瓷材料制成。本研究的目的是比较氧化锆基和金属陶瓷基种植体支持固定义齿（FDP）的五年临床结果。
本研究共纳入 114 例接受后牙种植体支持 FDP 修复的患者，其中 52 例采用氧化锆基修复体，62 例采用金属陶瓷修复体，患者平均年龄为 59±8.4 岁，随访 5 年。采用改良的加利福尼亚牙科协会（CDA）标准评估修复体质量。采用牙龈和菌斑指数、探诊深度和探诊出血评估软组织状况。此外，通过平行根尖射线照相评估种植体周围的骨丢失。使用视觉模拟评分法评估患者满意度。数据分析采用 Kaplan-Meier、对数秩检验、Cox 回归、Mann-Whitney U 和 Student t 检验（α=0.05）。
氧化锆基和金属陶瓷 FDP 的五年 Kaplan-Meier 生存率分别为 98.1%和 100%，差异无统计学意义（P=0.12）。氧化锆基和金属陶瓷修复体的成功率分别为 81.6%和 81.0%（P=0.85）。除边缘间隙外，两组的 CDA 评分无显著差异，氧化锆基 FDP 的边缘间隙更好（P<0.001）。金属陶瓷 FDP 中有 2.7%发生饰瓷层破裂，氧化锆基 FDP 中有 6.4%发生饰瓷层破裂，但不视为失败。除菌斑指数更有利于氧化锆基 FDP 外（P<0.001），软组织状况不受修复体类型的影响。两组边缘骨丧失无显著差异（近中 P=0.30，远中 P=0.46）。
在 5 年随访中，氧化锆基和金属陶瓷 FDP 表现出相似的良好临床效果。
氧化锆基种植体支持的 FDP 可能是一种成功的修复方法，具有可接受的生存率和患者满意度。
