Bischof Frank M, Mathey Ayse A, Stähli Alexandra, Salvi Giovanni E, Brägger Urs
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Clin Oral Implants Res. 2024 Dec;35(12):1640-1654. doi: 10.1111/clr.14351. Epub 2024 Aug 23.
Tooth- and implant-supported fixed dental prostheses are well-documented and aesthetic treatment alternatives, and after a comprehensive periodontal treatment, a protocol with a good long-term prognosis if the maintenance program is strictly followed.
To reexamine a pre-existing patient cohort in order to obtain estimated long-term survival and complication outcomes of fixed dental prostheses.
For this study, patients treated with fixed dental prostheses between 1978 and 2002 were reexamined between 2019 and 2020. The restorations were divided in single crowns and fixed dental prostheses supported by teeth (TSC, FPTDP) and implants (ISC, FPIDP). Survival and complication rates were obtained. Kaplan-Meier functions were used to model complication probabilities, and average hazard ratios of different strata were compared using weighted Cox regression.
The mean observation time of 40 patients and 223 reconstructions was 20.3 (±9.7, 1.2-36.2) years. The estimated survival rates were 84% (CI: 77%-92%) for TSC, 63% (CI: 51%-79%) for FPTDP, 87% (CI: 71%-100%) for ISC, and 64% (CI: 34%-100%) for FPIDP after 25 years. Biological complications included carious lesions (10.6%), periodontitis (7.9%), and peri-implantitis (6.8%). Technical complications included chipping (20.2%) and loss of retention (10.8%).
Biological complications lead to abutment loss in more than two-thirds of cases, regardless of the type of abutment (tooth or implant). Technical complications are less associated with abutment loss than biological complications.
牙支持和种植体支持的固定义齿是有充分文献记载的美观治疗选择，在进行全面的牙周治疗后，如果严格遵循维护计划，该方案具有良好的长期预后。
重新检查一组既往患者，以获得固定义齿的估计长期生存率和并发症结果。
在本研究中，对1978年至2002年间接受固定义齿治疗的患者于2019年至2020年间进行了重新检查。修复体分为单冠以及由牙齿支持的固定义齿（TSC、FPTDP）和由种植体支持的固定义齿（ISC、FPIDP）。获得了生存率和并发症发生率。采用Kaplan-Meier函数对并发症概率进行建模，并使用加权Cox回归比较不同分层的平均风险比。
40例患者和223个修复体的平均观察时间为20.3（±9.7，1.2 - 36.2）年。25年后，TSC的估计生存率为84%（CI：77% - 92%），FPTDP为63%（CI：51% - 79%），ISC为87%（CI：71% - 100%），FPIDP为64%（CI：34% - 100%）。生物学并发症包括龋损（10.6%）、牙周炎（7.9%）和种植体周围炎（6.8%）。技术并发症包括崩瓷（20.2%）和固位丧失（10.
