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 Dec;127:104314. doi: 10.1016/j.jdent.2022.104314. Epub 2022 Sep 30.
Numerous studies investigating the survival time of post and cores have found that loss of retention is the most common cause of failure Nevertheless, investigations focusing on decementation, survival after recementation, and the influencing parameters in a large number of patients with long follow-up periods are lacking. Therefore, the aim of this short communication article is the survival analysis of post and cores after recementation and repeated loss of retention.
During the observation period (2004-2020), 653 patients received 953 post and cores. From these, 112 post and cores which suffered loss of retention were selected. The patient files were analysed for the following parameters: Type of covering prosthetic restoration, location, type of tooth, luting material, post and core material, bone attachment and therapist. The survival time until loss of retention or repeated decementations after recementation was documented. Survival probability was assessed using Kaplan-Meier and Cox regression analyses.
The average time until decementation was 13.33 years. The cumulative decementation rate was 11.8%, while in 42.0% of the cases, post and cores showed multiple losses of retention. A significant influence (Kaplan-Meier analysis) was recorded for the type of covering prosthetic restoration, type of tooth, luting material, post and core material and bone attachment. The multifactorial survival analysis (Cox regression) showed a significant influence of patient's age and the type of covering prosthetic restoration.
Once decementation occurs, recementation neither guarantees definitive fit nor necessarily predetermines repeated decementations.
Post and cores should be avoided under primary crown-retained removable partial dentures (RPD). If this treatment is inevitable, a continuous follow-up is necessary to check the denture for proper fit to the tissues to prevent overloading on the post and core.
大量研究调查了桩核的生存时间,发现丧失固位力是最常见的失败原因。然而,缺乏针对去粘固、重新粘固后的生存情况以及大量患者长期随访中影响因素的研究。因此,本短文的目的是对重新粘固后桩核的生存情况和反复丧失固位力进行分析。
在观察期(2004-2020 年),653 名患者接受了 953 个桩核修复。从中选择了 112 个出现固位力丧失的桩核。分析患者的病历资料,包括覆盖修复体的类型、位置、牙位、粘固材料、桩核材料、骨附着和治疗师。记录从出现固位力丧失到重新粘固后再次去粘固的生存时间。使用 Kaplan-Meier 和 Cox 回归分析评估生存概率。
平均去粘固时间为 13.33 年。累积去粘固率为 11.8%,而在 42.0%的情况下,桩核出现多次固位力丧失。覆盖修复体的类型、牙位、粘固材料、桩核材料和骨附着对生存时间有显著影响(Kaplan-Meier 分析)。多因素生存分析(Cox 回归)显示患者年龄和覆盖修复体类型有显著影响。
一旦出现去粘固,重新粘固既不能保证完全合适,也不一定会导致再次去粘固。
在基牙支持式可摘局部义齿(RPD)中应避免使用桩核。如果这种治疗是不可避免的,需要进行连续随访,检查义齿与组织的适配情况,以防止对桩核的过度加载。