Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, Sendai, Japan.
Division for Regional Community Development, Liaison Center for Innovative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.
PLoS One. 2022 Apr 7;17(4):e0266358. doi: 10.1371/journal.pone.0266358. eCollection 2022.
Evaluation of the clinical performance of computer-aided design/computer-aided manufacturing-produced resin composite crowns (CAD/CAM composite crowns) on molars with a particular focus on placement location.
A retrospective cohort study was performed based on the clinical records of patients with CAD/CAM composite crowns on molars (June 2016 to March 2021). The hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated based the Cox proportional hazard model to evaluate the effect of tooth location on complication type and occurrence. Covariates included crown location (maxilla/mandible, distalmost tooth/not distalmost tooth, and first molar/second or third molar) and endodontically treated (nonvital) or untreated (vital) tooth.
Overall, 362 crowns were evaluated (mean follow-up: 378 days, median: 286 days), and 106 crowns (29.3%) showed complications, most frequently crown debonding. The cumulative success and survival rates were 70.9% and 93.7%, respectively, after 1 year and 49.5% and 86.5%, respectively, after 3 years. There was no significant difference in the HRs and log-rank tests in the Kaplan-Meier curves based on crown location parameters (P > 0.05). However, placement on vital teeth was associated with higher risks than on nonvital teeth (HR, 1.55; 95% CI, 1.03-2.23). In addition, the cement as a covariate yielded a high HR.
The location of CAD/CAM composite molar crowns is unlikely a risk factor for complications; therefore, these crowns can be clinically applied to all molars. However, the application of such molar crowns to vital teeth and the use of a cement other than adhesive resin cement present risks.
评估计算机辅助设计/计算机辅助制造（CAD/CAM）制作的复合树脂牙冠（CAD/CAM 复合冠）在磨牙上的临床性能，特别关注放置位置。
基于 2016 年 6 月至 2021 年 3 月间 CAD/CAM 复合冠在磨牙上的临床记录，进行了一项回顾性队列研究。使用 Cox 比例风险模型估计风险比（HRs）和 95%置信区间（95%CI），以评估牙位对并发症类型和发生的影响。协变量包括牙冠位置（上颌/下颌、最远端牙/非最远端牙、第一磨牙/第二或第三磨牙）和牙髓治疗（非活力）或未治疗（活力）的牙。
共评估了 362 个牙冠（平均随访：378 天，中位数：286 天），其中 106 个牙冠（29.3%）出现并发症，最常见的是牙冠脱落。1 年后的累积成功率和存活率分别为 70.9%和 93.7%，3 年后分别为 49.5%和 86.5%。基于牙冠位置参数的 Kaplan-Meier 曲线中的 HRs 和对数秩检验无显著差异（P > 0.05）。然而，活髓牙上的牙冠比非活髓牙上的牙冠风险更高（HR，1.55；95%CI，1.03-2.23）。此外，将粘结剂作为协变量会产生较高的 HR。
CAD/CAM 复合磨牙冠的位置不太可能是并发症的危险因素；因此，这些牙冠可以临床应用于所有磨牙。然而，将此类磨牙冠应用于活髓牙以及使用非粘结树脂粘结剂会带来风险。
