Craig Reanna, McKenna Gerry
King's College London, London, United Kingdom.
Centre for Public Health, Belfast, United Kingdom.
Evid Based Dent. 2025 Jun 7. doi: 10.1038/s41432-025-01172-1.
Torres C, Mailart M C, Ávila D et al. Influence of glass ionomer-based luting cements on the clinical success of zirconia crowns: randomized clinical trial. Oper Dent 2025; 50: 144-156.
This 24-month prospective, split-mouth randomised clinical trial compared the performance of conventional glass ionomer cement (GIC) and resin-modified glass ionomer cement (RMGIC) for luting full-coverage ceramic-fused-to-zirconia crowns.
Thirty participants were enrolled; 27 attended the 12-month review and 24 were assessed at the 24-month follow-up. Inclusion criteria included adults who needed two anterior or two posterior crowns. Silicone impressions were used to fabricate casts, which were scanned for CAD/CAM milling of zirconia copings. Clinical outcomes were assessed at 7 days, 12 months, and 24 months by calibrated, blinded examiners.
The primary outcome was crown retention; whilst secondary outcomes included fracture, wear, pulpal response, patient satisfaction, plaque and bleeding indices, and marginal integrity. Assessments followed modified USPHS and FDI criteria. An intention-to-treat analysis using last observation carried forward was applied. Fisher's Exact test compared anterior and posterior outcomes, while Kaplan-Meier estimates and log-rank tests were used to evaluate restoration survival (p < 0.05).
Success rates recorded were 93.3% for GIC and 100% for RMGIC. For anterior crowns, GIC success declined to 83.3% at two years, while RMGIC maintained a 100% success rate throughout. Posterior crowns showed 100% success in both groups, with no loss of retention or secondary caries recorded.
Both GIC and RMGIC demonstrated favourable short-term outcomes. However, anterior crowns cemented with GIC were more prone to failure, suggesting that crown location should inform cement selection. Optimising luting agent choice may improve long-term clinical success.
托雷斯 C、马伊拉特 M C、阿维拉 D 等。基于玻璃离子水门汀的粘结剂对氧化锆全冠临床成功率的影响：随机临床试验。《口腔手术学》2025 年；50: 144 - 156。
这项为期 24 个月的前瞻性、半口随机临床试验比较了传统玻璃离子水门汀（GIC）和树脂改性玻璃离子水门汀（RMGIC）用于粘结全瓷熔附氧化锆全冠的性能。
招募了 30 名参与者；27 人参加了 12 个月的复查，24 人在 24 个月随访时接受评估。纳入标准包括需要两颗前牙或两颗后牙全冠的成年人。使用硅橡胶印模制作模型，对模型进行扫描以用于氧化锆基底冠的计算机辅助设计/计算机辅助制造（CAD/CAM）铣削。由经过校准的、不知情的检查人员在 7 天、12 个月和 24 个月时评估临床结果。
主要结果是全冠的固位；次要结果包括折断、磨损、牙髓反应、患者满意度、菌斑和出血指数以及边缘完整性。评估遵循修改后的美国公共卫生服务部（USPHS）和国际牙科联盟（FDI）标准。采用末次观察结转的意向性分析。费舍尔精确检验比较前牙和后牙的结果，而卡普兰 - 迈耶估计法和对数秩检验用于评估修复体的存留率（p < 0.05）。
GIC 的成功率为 93.3%，RMGIC 的成功率为 100%。对于前牙全冠，GIC 的成功率在两年时降至 83.3%，而 RMGIC 在整个观察期内保持 100%的成功率。后牙全冠在两组中的成功率均为 100%，未记录到固位丧失或继发龋。
GIC 和 RMGIC 均显示出良好的短期效果。然而，用 GIC 粘结的前牙全冠更容易失败，这表明全冠的位置应作为粘结剂选择的参考依据。优化粘结剂的选择可能会提高长期临床成功率。
