Klotz Anna-Luisa, Hagspiel Stefanie, Büsch Christopher, Zenthöfer Stephanie, Rammelsberg Peter, Zenthöfer Andreas
Dental School, Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Clin Oral Investig. 2024 Dec 21;29(1):26. doi: 10.1007/s00784-024-06090-7.
Clinical data on the performance of double-crown-retained removable dental prostheses (dcRDPs), especially beyond university studies, are rare. The objective of this retrospective clinical study was to evaluate the survival and complication-freeness probabilities of dcRDPs and to identify risk factors for failure and complications in a dental practice setting.
Anonymized practice data of 174 patients (56.9% female) fitted with a total of 213 dcRDPs (mean of 3.3 abutment teeth per dcRDP) were evaluated up to 11 years after prothesis placement (mean observation time of 3.9 years). Probabilities of survival and complication freeness were calculated on the prosthesis- and abutment level and visualized using the Kaplan-Meier method. Factors influencing failure and complications were computed using Cox regression analyses (R Ver. 7; alpha < 0.05).
During our observation period, 39 (18%) of the dcRDPs failed. The mean (95% CI) overall survival was 94% (90-97%) after 2 years and 86% (80-92%) after 5 years. DcRDP survival correlated with lower patient age and more abutment teeth (P < 0.05), while other analyzed factors did not. The probability of absence of prosthesis-related complications was 92% after 2 years and 80% after 5 years. The probability of no technical complications of abutments (teeth/implants) was 85% after 2 years and 78% after 5 years, and the probability of no biological complications was 87% after 2 years and 72% after 5 years. In total, 141 dcRDPs (66.2%) faced at least one complication during the observation period.
Double-crown-retained prostheses fitted in a dental practice had acceptable mid-term survival rates and common technical and biological complications that were frequently easily manageable. However, prosthesis performance depended on the quality and number of abutment teeth/implants. Within the limitations of this retrospective analysis, the outcomes we observed in a dental practice are comparable to, albeit slightly worse than, those found in university studies.
Evaluation of the clinical performance of dcRDPs fitted in a dental practice is important to estimate durability and complication patterns in order to weigh treatment decisions.
关于双冠固位可摘义齿（dcRDPs）性能的临床数据，尤其是大学研究之外的数据很少。这项回顾性临床研究的目的是评估dcRDPs的生存率和无并发症概率，并确定牙科诊所环境中失败和并发症的风险因素。
对174例患者（56.9%为女性）的匿名临床数据进行评估，这些患者共佩戴了213副dcRDPs（每副dcRDPs平均有3.3个基牙），随访时间长达义齿修复后11年（平均观察时间为3.9年）。在义齿和基牙水平上计算生存率和无并发症概率，并使用Kaplan-Meier方法进行可视化。使用Cox回归分析（R软件版本7；α<0.05）计算影响失败和并发症的因素。
在我们的观察期内，39副（18%）dcRDPs失败。2年后的平均（95%CI）总生存率为94%（90 - 97%），5年后为86%（80 - 92%）。dcRDPs的生存率与患者年龄较低和基牙数量较多相关（P<0.05），而其他分析因素则无关。2年后无义齿相关并发症的概率为92%，5年后为80%。基牙（牙齿/种植体）无技术并发症的概率2年后为85%，5年后为78%，无生物学并发症的概率2年后为87%，5年后为72%。在观察期内，共有141副dcRDPs（66.2%）至少面临一种并发症。
牙科诊所中佩戴的双冠固位义齿具有可接受的中期生存率，常见的技术和生物学并发症通常易于处理。然而，义齿性能取决于基牙/种植体的质量和数量。在这项回顾性分析的局限性内，我们在牙科诊所观察到的结果与大学研究中的结果相当，尽管略差。
评估牙科诊所中佩戴的dcRDPs的临床性能对于估计耐久性和并发症模式以权衡治疗决策很重要。
