Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
Department of Prosthodontics and Biomaterials, Centre of Implantology, Faculty of Medicine, RWTH University Hospital, Pauwellsstr. 30, 52074, Aachen, Germany.
Clin Oral Investig. 2017 Jul;21(6):2083-2089. doi: 10.1007/s00784-016-1998-6. Epub 2016 Nov 28.
The objective of this prospective clinical study was to evaluate the clinical performance of chair-side generated monolithic lithium disilicate crowns after 72 months.
Forty-one posterior full contour crowns made of lithium disilicate ceramic were inserted in 34 patients with a chair-side CAD/CAM technique. One crown per patient was randomly selected for evaluation at baseline, 6, 12, 24, 36, 48, 60 and 72 months according to the modified US Public Health Service criteria.
After a mean examination time of 73.2 months (SD ± 1.7 months), 25 crowns were available for re-examination. Within the observation period, three failures occurred due to one crown fracture after 2.9 years, an abutment fracture after 6.0 years, and one severe endodontic problem after 6.1 years. One lithium disilicate crown showed a loss of retention after 2 years but could be reinserted. There were two events of caries below the crown margin, one after 24 and another one after 48 months. Both teeth received cervical adhesive composite fillings. Two abutment teeth changed their sensibility perception from positive to negative within the first 13 months. The failure-free rate was 87.6%, and the complication-free rate was 70.1% after 6 years according to the Kaplan-Meier analysis.
Due to the fact that there was only one severe technical complication and the severe biological complications were in a normal range, the clinical performance of monolithic lithium disilicate crowns in the posterior region was completely satisfying.
The chair-side application of monolithic lithium disilicate crowns can be recommended.
本前瞻性临床研究的目的是评估椅旁制作的整体式硅酸锂瓷冠 72 个月后的临床性能。
采用椅旁 CAD/CAM 技术制作 41 个后牙全瓷冠,将其植入 34 名患者中。根据改良的美国公共卫生服务标准,每位患者随机选择 1 个牙冠,在基线、6、12、24、36、48、60 和 72 个月时进行评估。
平均随访 73.2 个月(SD±1.7 个月)后,25 个牙冠可进行复查。在观察期内,由于 1 个牙冠在 2.9 年后发生冠折、1 个基牙在 6.0 年后发生折裂、1 个牙在 6.1 年后发生严重牙髓问题,共发生 3 次失败。1 个硅酸锂瓷冠在 2 年后发生固位丧失,但可重新就位。有 2 个牙冠边缘下方发生龋病,1 个发生在 24 个月后,另 1 个发生在 48 个月后。这两颗牙均接受了颈缘黏接复合树脂充填。2 个基牙在最初 13 个月内从阳性变为阴性。根据 Kaplan-Meier 分析,无失败率为 87.6%,6 年后无并发症率为 70.1%。
由于只有 1 例严重技术并发症,严重的生物学并发症在正常范围内,因此在后牙区使用整体式硅酸锂瓷冠的临床效果完全令人满意。
椅旁应用整体式硅酸锂瓷冠可被推荐。