Luo Jia, Zhang Yifan, Yu Ziyang, Jiang Xi, Li Jianhui, Chen Bo, Di Ping, Lin Ye, Zhang Yu
Department of Stomatology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Prosthodont. 2025 Apr;34(4):365-375. doi: 10.1111/jopr.13991. Epub 2024 Dec 10.
To investigate the mid-to-long term clinical outcomes of the implant-supported cross-arch fixed dental prostheses (IFCDPs) with monolithic zirconia-based frameworks and related risk factors of success and survival.
This retrospective study encompassed individuals exhibiting terminal dentition or edentulism in the maxilla and/or mandible who underwent treatment involving IFCDPs with monolithic zirconia frameworks. Inclusion criteria required a documented follow-up period of at least five years post-definitive prosthesis delivery. Evaluation of outcomes focused on the survival rates of implant and prosthesis, along with the incidence of biological and technical complications. The mixed-effects Cox regression model was employed to analyze the risk factors associated with prosthesis failure and peri-implantitis.
A cohort of 47 patients, consisting of 14 women and 33 men with a mean age of 55.2 ± 12.5 years (range: 25-83), was included in this study. The mean follow-up period was 71.6 ±13.2 months (mean ± SD, range: 60-147). A total of 51 cross-arch prostheses supported by 302 implants, distributed between the maxilla (27 prostheses) and mandible (24 prostheses), were assessed. By the end of the follow-up period, 289 (97.64%) of the 302 implants remained functional. Peri-implantitis was observed in 27 implants (24 in mandible), yielding an overall implant-related success rate of 91.06%. Nine frameworks experienced fractures (eight in mandible), resulting in an overall prosthesis-related survival rate of 82.35%. Subsequent analysis revealed the mandible to be a significant risk factor for framework fracture (HR = 11.64, p = 0.024) and peri-implantitis (HR = 10.88, p = 0.003).
The implant-supported cross-arch fixed dental prostheses featuring monolithic zirconia-based frameworks demonstrated favorable clinical outcomes throughout a 5-13-year observation period. Notably, in the design of monolithic zirconia-based framework prostheses, the mandible emerged as a significant risk factor for framework fractures and an independent risk factor for peri-implantitis.
探讨采用整体式氧化锆基牙桥的种植体支持式跨牙弓固定义齿（IFCDP）的中长期临床疗效以及成功与存活的相关危险因素。
本回顾性研究纳入了上颌和/或下颌出现终末期牙列或无牙症且接受了采用整体式氧化锆牙桥的IFCDP治疗的患者。纳入标准要求在最终义齿交付后有至少五年的记录随访期。对结果的评估集中在种植体和义齿的存活率以及生物学和技术并发症的发生率上。采用混合效应Cox回归模型分析与义齿失败和种植体周围炎相关的危险因素。
本研究纳入了47例患者，其中14例女性，33例男性，平均年龄为55.2±12.5岁（范围：25 - 83岁）。平均随访期为71.6±13.2个月（平均值±标准差，范围：60 - 147个月）。共评估了由302颗种植体支持的51副跨牙弓义齿，分布在上颌（27副义齿）和下颌（24副义齿）。到随访期结束时，302颗种植体中有289颗（97.64%）仍在发挥功能。27颗种植体（24颗在下颌）出现了种植体周围炎，总体种植体相关成功率为91.06%。9个牙桥发生了骨折（8个在下颌），总体义齿相关存活率为82.35%。随后的分析显示，下颌是牙桥骨折（HR = 11.64，p = 0.024）和种植体周围炎（HR = 10.88，p = 0.003）的显著危险因素。
采用整体式氧化锆基牙桥的种植体支持式跨牙弓固定义齿在5至13年的观察期内显示出良好的临床疗效。值得注意的是，在整体式氧化锆基牙桥义齿的设计中，下颌是牙桥骨折的显著危险因素和种植体周围炎的独立危险因素。
