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直接金属增强复合固定局部义齿即刻修复的耐用性。

Longevity of immediate rehabilitation with direct metal-wire reinforced composite fixed partial dentures.

机构信息

Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.

Private clinic, Wetzikon, Switzerland.

出版信息

Dent Mater. 2022 Oct;38(10):e257-e265. doi: 10.1016/j.dental.2022.06.008. Epub 2022 Jun 17.

Abstract

OBJECTIVES

This study aimed to analyze the longevity of direct metal-wire reinforced composite fixed partial dentures (MRC-FPD) and factors influencing their survival and success.

METHODS

Within one private practice 513 MRC-FPD were directly applied. The preparation of a proximal cavity in abutment teeth was not limited. MRC-FPD were reinforced by one to three metal-wires. At the last follow-up MRC-FPD were considered successful, if they were still in function without any need of therapy. MRC-FPD were considered as survived, if they were repaired or replaced. Multi-level Cox proportional hazard models were used to evaluate the association between clinical factors and time.

RESULTS

Mean follow-up period (range) was 59(2-249) months. Seventy-three bridges did not survive (cumulative survival rate(CSR):86%) and further 129 bridges had received a restorative follow-up treatment (CSR:61%). AFR was 2.2% for survival and 8.6% for success. In multivariate analysis MRC-FPD with> 1 wire showed a up to 2.3x higher failure rate than MRC-FPD with one wire(p ≤ 0.023). Dentist's experience in designing MRC-FDP (p ≤ 0.017), patient's caries risk (p ≤ 0.040) and bruxism (p = 0.033) significantly influenced the failure rate: the more experience, the lower caries risk and bruxism, the lower the failure rate.

SIGNIFICANCE

For directly prepared metal-wire reinforced composite bridges high survival and moderate success rates were observed. MRC-FPD might, thus, be an immediate, short- and medium-term solution for replacing missing teeth. However, several factors on the levels of practice (dentist's experience in designing MRC-FDP), patient (bruxism, caries risk) and restoration (number of wires) were identified as significant predictors for the failure rate. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00021576).

摘要

目的

本研究旨在分析直接金属丝增强复合固定局部义齿(MRC-FPD)的寿命,并分析影响其生存和成功的因素。

方法

在一家私人诊所,共直接应用了 513 个 MRC-FPD。基牙近中腔的制备不受限制。MRC-FPD 通过一根至三根金属丝增强。在最后一次随访时,如果 MRC-FPD 仍在正常使用而无需任何治疗,则认为其成功;如果需要修复或更换,则认为 MRC-FPD 存活。采用多级 Cox 比例风险模型评估临床因素与时间之间的关系。

结果

平均随访时间(范围)为 59(2-249)个月。73 个桥体未存活(累积存活率(CSR):86%),129 个桥体接受了修复随访治疗(CSR:61%)。生存率为 2.2%,成功率为 8.6%。多因素分析显示,使用>1 根金属丝的 MRC-FPD 失败率比使用 1 根金属丝的 MRC-FPD 高 2.3 倍(p≤0.023)。牙医设计 MRC-FDP 的经验(p≤0.017)、患者的龋齿风险(p≤0.040)和磨牙症(p=0.033)显著影响失败率:经验越丰富,龋齿风险和磨牙症越低,失败率越低。

意义

对于直接制备的金属丝增强复合桥,观察到高存活率和中等成功率。因此,MRC-FPD 可能是一种即刻、短期和中期修复缺失牙的方法。然而,在实践层面(牙医设计 MRC-FDP 的经验)、患者层面(磨牙症、龋齿风险)和修复层面(金属丝数量)上,有几个因素被确定为失败率的显著预测因素。本研究已在德国临床试验注册中心(DRKS-ID:DRKS00021576)注册。

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