Randomized, controlled clinical trial of bilayer ceramic and metal-ceramic crown performance.
Randomized, controlled clinical trial of bilayer ceramic and metal-ceramic crown performance.
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DOI：
10.1111/j.1532-849x.2012.00913.x
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发表时间：
2013-04
期刊：
影响因子：
--
通讯作者：
Anusavice K
中科院分区：
文献类型：
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作者：
Esquivel-Upshaw J;Rose W;Oliveira E;Yang M;Clark AE;Anusavice K
分析修复材料的临床性能是很重要的，因为人们期望这些材料和程序能够修复牙齿而不会造成伤害。本研究的目的是根据11项临床标准来描述金属-陶瓷冠、核心陶瓷冠和核心陶瓷/贴面陶瓷冠的临床性能。一项irb批准的随机对照临床试验作为单盲先导研究进行。制备了以下三种类型的全冠：(1)由Pd-Au-Ag-Sn-In合金（argent 62）和玻璃陶瓷贴面（IPS d.SIGN贴面）制成的金属陶瓷冠（MC）；(2)无贴面（釉面）二硅酸锂玻璃陶瓷冠（LDC） （IPS e.max压芯和e.max陶瓷釉）；(3)贴有玻璃陶瓷贴面的二硅酸锂玻璃陶瓷冠（LDC/V） （IPS Empress 2芯和IPS Eris）。单单元冠随机分配。每3年召回患者一次，由两名经过校准的临床医生进行评估。31例患者共放置36个冠。三种冠型各研究12个冠。评估了11项标准：组织健康、边缘完整性、继发龋病、近端接触、解剖轮廓、咬合、表面纹理、裂纹/碎片（骨折）、颜色匹配、牙齿敏感性和磨损（冠和对立牙釉质）。数字排名从1到4不等，4表示优秀，1表示需要立即更换。采用Fisher精确检验对数值排名进行统计分析。第1年和第2年烤瓷冠与两种贴面冠的性能差异无统计学意义（p < 0.05）。所有的牙冠在每个临床标准中都被评为优秀或良好；然而，在2至3岁之间，一些陶瓷冠的咬合面逐渐变粗糙，可能是由于釉的溶解和磨损造成的。在第3年，金属陶瓷冠和二硅酸锂基冠在表面织构（p = 0.0013）和冠磨损（p = 0.0078）方面存在统计学差异。综合11项指标，陶瓷冠2年后的临床表现与金属-陶瓷冠相当；然而，在第2年至第3年之间，逐渐变粗，导致表面纹理和磨损的差异。
Analyzing the clinical performance of restorative materials is important, as there is an expectation that these materials and procedures will restore teeth and do no harm. The objective of this research study was to characterize the clinical performance of metal-ceramic crowns, core ceramic crowns, and core ceramic/veneer ceramic crowns based on 11 clinical criteria. An IRB-approved, randomized, controlled clinical trial was conducted as a single-blind pilot study. The following three types of full crowns were fabricated: (1) metal-ceramic crown (MC) made from a Pd-Au-Ag-Sn-In alloy (Argedent 62) and a glass-ceramic veneer (IPS d.SIGN veneer); (2) non-veneered (glazed) lithium disilicate glass-ceramic crown (LDC) (IPS e.max Press core and e.max Ceram Glaze); and (3) veneered lithia disilicate glass-ceramic crown (LDC/V) with glass-ceramic veneer (IPS Empress 2 core and IPS Eris). Single-unit crowns were randomly assigned. Patients were recalled for each of 3 years and were evaluated by two calibrated clinicians. Thirty-six crowns were placed in 31 patients. A total of 12 crowns of each of the three crown types were studied. Eleven criteria were evaluated: tissue health, marginal integrity, secondary caries, proximal contact, anatomic contour, occlusion, surface texture, cracks/chips (fractures), color match, tooth sensitivity, and wear (of crowns and opposing enamel). Numerical rankings ranged from 1 to 4, with 4 being excellent, and 1 indicating a need for immediate replacement. Statistical analysis of the numerical rankings was performed using a Fisher’s exact test. There was no statistically significant difference between performance of the core ceramic crowns and the two veneered crowns at year 1 and year 2 (p > 0.05). All crowns were rated either as excellent or good for each of the clinical criteria; however, between years 2 and 3, gradual roughening of the occlusal surface occurred in some of the ceramic-ceramic crowns, possibly caused by dissolution and wear of the glaze. Statistically significant differences in surface texture (p = 0.0013) and crown wear (p = 0.0078) were found at year 3 between the metal-ceramic crowns and the lithium-disilicate-based crowns. Based on the 11 criteria, the clinical performance of ceramic-ceramic crowns was comparable to that of the metal-ceramic crowns after 2 years; however, gradual roughening occurred between years 2 and 3, which resulted in differences in surface texture and wear.