长达 106 个月的随访：两种黏接策略黏接玻璃纤维桩后存活率和治疗成功率的随机临床试验。

Survival rate and treatment success of glass fiber posts cemented with two adhesive cementation strategies after up to 106 months: a randomized clinical trial.

机构信息

School of Dentistry, Post-Graduate Program in Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Rio Grande do Sul State, Pelotas, Brazil.

Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Rio Grande do Sul State, 97105-900, Santa Maria, Brazil.

出版信息

Clin Oral Investig. 2023 May;27(5):2197-2206. doi: 10.1007/s00784-023-04939-x. Epub 2023 Mar 9.

DOI:10.1007/s00784-023-04939-x

PMID:36894666

Abstract

OBJECTIVES

The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial.

METHODS

A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan-Meier method and Cox regression with 95% confidence interval were used for the statistical analysis.

RESULTS

For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC.

CONCLUSION

Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates.

TRIAL REGISTRATION

NCT01461239 CLINICAL RELEVANCE: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months).

摘要

目的

本研究旨在通过前瞻性、多中心、非劣效性、双盲随机对照试验评估两种纤维桩粘结策略的长期效果。

方法

共纳入 152 颗牙，这些牙均接受了完善的根管治疗，牙冠结构丧失，双侧后牙同时具有接触点。将这些牙随机分为两组，分别采用常规粘结策略（CRC 组：粘结系统+树脂水门汀）（Adper Single Bond+RelyX ARC；3M-ESPE）或自粘结粘结策略（SRC 组：自粘结树脂水门汀；RelyX U100/U200；3M-ESPE）粘结纤维桩。患者的临床和影像学随访率为 93%（142 颗牙，CRC 组 74 颗，SRC 组 68 颗）。主要结局为纤维桩粘结失败（丧失固位力）的存活率。次要结局包括冠粘结失败、纤维桩折断和牙丧失（与纤维桩失败无关）的修复体治疗成功率。每年对这两种结局进行评估。采用 Kaplan-Meier 法和 Cox 回归（95%置信区间）进行统计学分析。

结果

在主要结局（与纤维桩粘结策略直接相关的失败）中，CRC 组和 SRC 组各发生 4 次纤维桩粘结失败、8 次根折和 1 次混合失败（CRC 组为粘结失败合并根折），两种策略的存活率相似（p=0.331），CRC 组为 88.9%，SRC 组为 90.9%。在次要结局（与纤维桩粘结策略无关的失败）中，CRC 组和 SRC 组各发生 8 次冠粘结失败、3 次纤维桩折断和 3 次牙丧失，组间无统计学差异（p=0.701），SRC 组为 77%，CRC 组为 82%。