Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany.
Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany.
J Dent. 2022 Feb;117:103923. doi: 10.1016/j.jdent.2021.103923. Epub 2021 Dec 23.
The retrospective survival study (1995-2004) by Balkenhol et al. [1]. led to changes in the decision-making process for treatment with post and cores (special focus on the covering prosthetic restoration while deciding for treatment with post and cores, high primary friction at the try-in stage for conventional cementation, only indirect fabrication technique, no semi-precious alloy) in our clinic. The aim of this study was to examine the influence of these changes on the survival probability.
In the observation period (2004-2020) 653 patients received in total 953 post and cores. The patient files were analysed due to the parameters: Type of covering prosthetic restoration, location, type of tooth, luting material, post and core material, bone attachment, therapist and cause of failure. According to the previous study the survival probability was assessed using Kaplan-Meyer analysis. Cox regression was used to assess the risk of failure and identify possible covariates.
The average survival time of the post and cores was 10.9 years. The cumulative failure rate was 28.2%. A significant influence on the survival time (Kaplan-Meyer analysis) could be found for the parameters: Type of covering prosthetic restoration, location, type of tooth, post and core material and bone attachment. The multifactorial survival analysis (Cox regression) showed a significant influence of the age of the patient at the time of fitting the post, the type of covering prosthetic restoration and the bone attachment.
The changes in the decision-making process did not lead to a better survival probability.
The conclusions stated in the previous study were not strict enough. Treatments with post and cores should be critically scrutinized on the basis of covering prosthetic restoration and bone attachment. Post and cores under primary crown retained RPDs should be avoided because of the bad survival probability.
Balkenhol 等人进行的回顾性生存研究(1995-2004 年)[1]。导致我们诊所的治疗决策发生变化,即采用桩核(特别关注覆盖义齿修复体时的决策、常规黏固时试戴阶段的高初始摩擦力、仅采用间接修复技术、不使用半贵金属)。本研究的目的是检查这些变化对生存概率的影响。
在观察期(2004-2020 年)内,共有 653 名患者接受了 953 个桩核修复。通过患者档案分析参数:覆盖义齿修复体的类型、位置、牙齿类型、黏固材料、桩核材料、骨附着、治疗师和失败原因。根据之前的研究,使用 Kaplan-Meier 分析评估生存概率。Cox 回归用于评估失败风险并确定可能的协变量。
桩核的平均生存时间为 10.9 年。累积失败率为 28.2%。参数对生存时间(Kaplan-Meier 分析)有显著影响:覆盖义齿修复体的类型、位置、牙齿类型、桩核材料和骨附着。多因素生存分析(Cox 回归)显示,患者在安装桩核时的年龄、覆盖义齿修复体的类型和骨附着对生存时间有显著影响。
决策过程的变化并没有导致更好的生存概率。
之前研究中的结论不够严格。基于覆盖义齿修复体和骨附着,应仔细审查桩核治疗。应避免在主要冠保留 RPD 下使用桩核,因为其生存概率较差。