Naumann Michael, Scholz Patricia, Krois Joachim, Schwendicke Falk, Sterzenbach Guido, Happe Arndt
Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders-Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Clinic for Dental Prosthetics, Center for Dental, Oral and Maxillofacial Medicine, University Hospital Ulm, Ulm, Germany.
Clin Oral Implants Res. 2023 Mar;34(3):209-220. doi: 10.1111/clr.14031. Epub 2023 Feb 3.
The objective of this study is to compare monolithic hybrid abutment crowns (screw-retained) versus monolithic hybrid abutments with adhesively cemented monolithic single-tooth crowns.
Twenty subjects in need of an implant-borne restoration were randomly assigned to receive either a cement-retained (CRR) or a screw-retained (SRR) implant-supported monolithic lithium disilicate (LS ) reconstruction. Each patient received a titanium implant with in internal conic connection. After osseointegration and second-stage surgery, healing abutments were placed for about 10 days. The type of restoration (CRR vs. SRR) was randomly assigned, and the restorations were manufactured of monolithic LS . Both types of restorations, CRR and SRR, were based on a titanium component (Ti-base) that was bonded to the abutment (CRR) or the crown (SRR). The follow-up period for all restoration was 36 months. Clinical outcome was evaluated according to Functional Implant Prosthetic Score (FIPS). Quality of live (OHIP) and patient's satisfaction were assessed using patient-reported outcome measures (PROMs). Primary endpoint was loss of restoration for any reason. Kaplan-Meier curves were constructed and log-rank testing was performed (p < .05).
One restoration of group CRR failed after 6 months due to loss of adhesion between Ti-base and individual abutment. No further biological or technical failures occurred. Kaplan-Meier analysis showed no significant difference between both treatment options (p = .317). There was no statistically significant difference between both types of restoration, neither for FIPS, OHIP, treatment time nor patient satisfaction (p > .05).
Monolithic hybrid abutment crowns (screw-retained) and monolithic hybrid abutment with adhesively cemented monolithic crowns using lithium disilicate showed no statistically significant difference for implant-based reconstructions in this pilot RCT setting.
本研究的目的是比较整体式混合基台冠（螺丝固位）与带有粘结式整体单颗牙冠的整体式混合基台。
20名需要种植体支持修复的受试者被随机分配接受粘结固位（CRR）或螺丝固位（SRR）的种植体支持的整体式二硅酸锂（LS）修复体。每位患者接受一枚具有内部圆锥连接的钛种植体。骨整合和二期手术后，放置愈合基台约10天。随机分配修复体类型（CRR与SRR），修复体由整体式LS制成。CRR和SRR这两种修复体均基于与基台（CRR）或牙冠（SRR）粘结的钛部件（钛基底）。所有修复体的随访期为36个月。根据功能种植修复评分（FIPS）评估临床结果。使用患者报告结局指标（PROMs）评估生活质量（OHIP）和患者满意度。主要终点是因任何原因导致的修复体脱落。构建Kaplan-Meier曲线并进行对数秩检验（p < 0.05）。
CRR组有一枚修复体在6个月后因钛基底与单个基台之间的粘结丧失而失败。未发生进一步的生物学或技术失败。Kaplan-Meier分析显示两种治疗方案之间无显著差异（p = 0.317）。两种修复体类型在FIPS、OHIP、治疗时间或患者满意度方面均无统计学显著差异（p > 0.05）。
在这项初步随机对照试验中，对于基于种植体的修复，整体式混合基台冠（螺丝固位）与带有粘结式整体二硅酸锂牙冠的整体式混合基台在统计学上无显著差异。
