Margvelashvili-Malament Mariam, Thompson Van, Polyakov Valery, Malament Kenneth A
Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.; and Private practice, Boston, Mass.
Professor Emeritus, King's College London Faculty of Dentistry, Oral and Craniofacial Sciences, London, England, United Kingdom.
J Prosthet Dent. 2025 Mar;133(3):737-746. doi: 10.1016/j.prosdent.2024.06.031. Epub 2024 Jul 31.
Long-term clinical data are lacking on the comparative survival of adhesively luted lithium disilicate glass-ceramic complete and partial coverage restorations in patients with severe wear and the effect that different clinical variables have on their survival.
The purpose of this study was to examine the 14-year survival of pressed e.max lithium disilicate glass-ceramic complete and partial coverage restorations in patients with severe wear and to evaluate associated clinical parameters.
Patients demonstrating severe wear and requiring single unit defect-specific partial or complete coverage restorations were recruited in a clinical private practice and received lithium disilicate restorations. The effect of various clinical parameters was evaluated using Kaplan-Meier survival curves to account for attrition bias and other causes of failure. The statistical significance of differences between parameters was determined by using the log rank test (α=.05).
A total of 53 participants (24 men and 29 women) requiring 662 lithium disilicate restorations were evaluated. The mean age of the participants at the time of restoration placement was 60 (range 25 to 85 years). Of 662 units, 551 were anterior and posterior complete and 111 were posterior partial coverage restorations. Six failures (bulk fracture or large chip) requiring replacement occurred with the average time to failure of 4.5 (range 2 to 8) years, yielding a crude estimate of annual failure of 0.1% (cumulative monitoring period of 4650 years, overall survival rate of 98.6%). Of the 551 complete coverage restorations, 4 failed (0 anterior, 4 posterior), yielding a crude estimate of 0.1% annual failure with the survival function time at 14 years. Of the 111 partial coverage restorations, 2 failed, yielding a crude estimate of 0.4% annual failure with the survival function time at 12 years. The only statistically significant difference was seen between anterior crowns and posterior onlays, with no failures in anterior crowns (P<.001). Other clinical variables had no significant effect on survival (P>.05).
Pressed e.max lithium disilicate partial and complete coverage restorations both showed high survival rates in patients with severe wear over 14 years with an overall yearly failure rate of 0.1%. Risk of failure at any age was minimal for both men and women. All anterior crowns survived. The highest annual failure rate (0.4%) was for posterior onlay partial coverage restorations.
缺乏关于严重磨损患者中粘结固位的二硅酸锂玻璃陶瓷全冠和部分冠修复体的比较生存率以及不同临床变量对其生存率影响的长期临床数据。
本研究的目的是研究压制的e.max二硅酸锂玻璃陶瓷全冠和部分冠修复体在严重磨损患者中的14年生存率，并评估相关临床参数。
在一家临床私人诊所招募表现出严重磨损且需要单单位缺损特异性部分或全冠修复体的患者，并为其安装二硅酸锂修复体。使用Kaplan-Meier生存曲线评估各种临床参数的影响，以考虑损耗偏倚和其他失败原因。通过对数秩检验确定参数之间差异的统计学显著性（α = 0.05）。
共评估了53名参与者（24名男性和29名女性），他们需要662个二硅酸锂修复体。修复体放置时参与者的平均年龄为60岁（范围为25至85岁）。在662个修复体中，551个是前后牙全冠，111个是后牙部分冠修复体。发生了6次需要更换的失败情况（大块骨折或大碎片），平均失败时间为4.5年（范围为2至8年），年失败率的粗略估计为0.1%（累积监测期为4650年，总生存率为98.6%）。在551个全冠修复体中，4个失败（前牙0个，后牙4个），14年生存函数时间下年失败率的粗略估计为0.1%。在111个部分冠修复体中，2个失败，12年生存函数时间下年失败率的粗略估计为0.4%。唯一具有统计学显著性的差异出现在前牙冠和后牙高嵌体之间，前牙冠没有失败情况（P <.001）。其他临床变量对生存率没有显著影响（P >.05）。
压制的e.max二硅酸锂部分冠和全冠修复体在严重磨损患者中14年的生存率均较高，总体年失败率为0.1%。男性和女性在任何年龄的失败风险都很小。所有前牙冠均存活。后牙高嵌体部分冠修复体的年失败率最高（0.4%）。
