Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Department of Surgical Sciences, Dental School, Turin, Italy.
Dent Mater. 2022 Aug;38(8):e203-e219. doi: 10.1016/j.dental.2022.06.018. Epub 2022 Jul 12.
The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and function. Recently, partial adhesive restorations have been widely proposed to increase the survival rate of endodontically treated teeth. The primary purpose of this review is to assess the failure rate of indirect partial adhesive restorations on endodontically treated teeth (ETT), considering the follow-up period.
The indications reported in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) were used to draft the present review. The study was constructed on PICO questions: population (patients who need indirect adhesive restorative treatment on endodontically treated teeth with onlay and overlay), intervention (onlay and overlay), control (patients with onlay and overlay on endodontically treated teeth) and outcome (failure rate and types of failure for onlay and overlay). The asked scientific question was: what are the failure rate and types of failure for adhesive indirect partial restorations on ETT?
The overall failure rate that emerges is 0.087 with a ratio of 121/1254, I 80 % p-value< 0.001. Moreover, by meta-regression with covariates the follow-up period reports a coefficient of 0.013 with a P-value< 0.001. In conclusion, the indirect partial restorations on endodontically treated teeth displayed overall acceptable outcomes in terms of success from 2 to 4 years after their placement with only 4.32 % of failure. Failures increase after 7 years up to 12-30 years with failure rates of approximatively 10.65 % and 20.94 %. The analysis of the included articles reporting the causes of restorations failures showed that 15.51 % of cases were related to the loss of dental element.
Besides the survival rates of indirect adhesive restorations on endodontically treated posterior teeth, it was highlighted that the majority of failures appeared restorable. Thus, partial restorations seemed able to prevent the ETT tooth loss.
龋病或外伤导致牙冠部分缺失，需进行根管治疗，随后进行修复，以确保正确的解剖结构和功能。最近，广泛提出了部分黏接修复，以提高根管治疗后的牙齿的存活率。本综述的主要目的是评估在根管治疗后的牙齿（ETT）上进行间接部分黏接修复的失败率，同时考虑随访时间。
本综述使用 PRISMA（系统评价和荟萃分析的首选报告项目）报告的指标进行起草。该研究构建于 PICO 问题之上：人群（需要对根管治疗后的牙齿进行间接黏接修复治疗的患者，包括嵌体和高嵌体）、干预（嵌体和高嵌体）、对照（根管治疗后的牙齿进行嵌体和高嵌体的患者）和结局（嵌体和高嵌体的失败率和失败类型）。所提出的科学问题是：在 ETT 上进行黏接间接部分修复的失败率和失败类型是什么？
总体失败率为 0.087，比率为 121/1254，I 80 % p 值<0.001。此外，通过具有协变量的元回归，随访时间报告的系数为 0.013，P 值<0.001。总之，间接部分修复在 ETT 上的放置后 2 至 4 年内总体上显示出可接受的结果，只有 4.32 %的失败率。在 7 年后，失败率增加到 12-30 年，失败率约为 10.65 %和 20.94 %。对报告修复失败原因的文章进行分析后显示，15.51 %的病例与牙体丧失有关。
除了根管治疗后的后牙间接黏接修复的存活率外，还强调了大多数失败是可修复的。因此，部分修复似乎能够防止 ETT 牙齿丧失。
