Department of Medicine and Dental Medicine, Danube Private University, Steiner Landstraße 124, 3500, Krems-Stein, Austria.
Conservative Department, College of Dentistry, University of Sulaimani, Madam Mitterrand Street 30, Sulaimani, Kurdistan Region, 46001, Iraq.
BMC Oral Health. 2021 Dec 7;21(1):625. doi: 10.1186/s12903-021-01987-1.
BACKGROUND/PURPOSE: How long do lithium disilicate restorations last before they fail? The aim of this study was to assess the success rate of four different types of restorations made from lithium disilicate.
A total of 87,203 ceramic restorations, classified into four different types (inlay or onlay, veneers (Vs), single crowns (SCs), and fixed partial dentures (FPDs)), were used. All were made of lithium disilicate (IPS e.Max CAD) with Cerec Inlab CAD/CAM system (Sirona Dental Systems, Bensheim, Germany). They were reported by dentists and entered in the database of the private B&R Dental Center between March 2015 and June 2020 and assessed retrospectively up to a period of 5 years based on the following parameters: failure rate and cause of failures (ceramic fracture, debonding, marginal adaptation, color match, endodontic intervention, periodontal disease, and secondary caries). Failure distribution according to gender, arch, and teeth type was also evaluated. The time-dependent time-to-failure/complication and their differences were calculated in months according to the Kaplan Meier and log-rank tests. The Chi-squared test (p 0.05) was used to assess the variations in causes of failure rates between different restorations.
Kaplan Meier test showed overall cumulative survival probability of lithium disilicate restorations for up to years was 85.08%. Inlay/onlay and Vs ceramic restorations showed highest cumulative survival probability (99.4%, 98.6, respectively). FPDs had the least cumulative survival probability (52.9%) which was significantly (P < 0.00001) higher than for other ceramic restorations using the log-rank test. Moreover, overall time-dependent time-to-failure/complication occurred after 52.373 months according to Kaplan-Meier (CI: lower bound: 51.875 months; upper bound: 52.871 months). Ceramic fracture in both FPDs and SCs (27.6% and 26.6%, respectively) and debonding in Vs (12.7%) were significant as the main reasons for failure (P = 0.000). The failure rate was significantly higher for the maxillary arch than the mandibular arch (P = 0.021). Fracture and marginal discrepancy were more frequent in the molar region (77.5% and 14.75%, respectively) and significantly higher here than in the anterior and premolar regions (P = 0.000).
The medium-term performance of lithium disilicate is ideal. Ceramic fracture was the most common cause of failure in SCs and FPDs. FPDs presented with the highest failure rate based on evaluation for up to 5 years.
背景/目的：锂硅玻璃陶瓷修复体在失效前能使用多久？本研究旨在评估四种不同类型的锂硅玻璃陶瓷修复体的成功率。
共使用了 87203 个陶瓷修复体，分为四种不同类型（嵌体或高嵌体、贴面（Vs）、单冠（SCs）和固定局部义齿（FPDs））。所有修复体均由锂硅玻璃陶瓷（IPS e.Max CAD）制成，采用 Cerec Inlab CAD/CAM 系统（德国 Sirona Dental Systems）制作。这些修复体由牙医报告，并在 2015 年 3 月至 2020 年 6 月期间录入私人 B&R 牙科中心的数据库中，并根据以下参数进行回顾性评估，最长评估期为 5 年：失败率和失败原因（陶瓷破裂、脱粘、边缘适应性、颜色匹配、根管治疗干预、牙周病和继发龋）。还评估了根据性别、牙弓和牙齿类型的失败分布情况。根据 Kaplan-Meier 和对数秩检验计算了时间依赖性失败/并发症的时间和差异（以月为单位）。卡方检验（p<0.05）用于评估不同修复体之间失败率原因的差异。
Kaplan-Meier 检验显示，锂硅玻璃陶瓷修复体在 5 年内的累积生存率为 85.08%。嵌体/高嵌体和贴面陶瓷修复体的累积生存率最高（分别为 99.4%和 98.6%）。FPDs 的累积生存率最低（52.9%），与其他陶瓷修复体相比差异有统计学意义（P<0.00001，对数秩检验）。此外，根据 Kaplan-Meier，总体时间依赖性失败/并发症发生在 52.373 个月后（CI：下限：51.875 个月；上限：52.871 个月）。FPDs 和 SCs 中的陶瓷破裂（分别为 27.6%和 26.6%）和 Vs 中的脱粘（12.7%）是主要的失败原因（P=0.000）。上颌弓的失败率明显高于下颌弓（P=0.021）。磨牙区的破裂和边缘不匹配更为常见（分别为 77.5%和 14.75%），明显高于前牙和前磨牙区（P=0.000）。
锂硅玻璃陶瓷的中期性能理想。陶瓷破裂是 SCs 和 FPDs 中最常见的失败原因。FPDs 在长达 5 年的评估中失败率最高。
