Four-year clinical performance of a lithia disilicate-based core ceramic for posterior fixed partial dentures.
Four-year clinical performance of a lithia disilicate-based core ceramic for posterior fixed partial dentures.
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发表时间：
2008-03
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通讯作者：
J. Esquivel-Upshaw;H. Young;Jack Jones;Mark C. K. Yang;K. Anusavice
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作者：
J. Esquivel-Upshaw;H. Young;Jack Jones;Mark C. K. Yang;K. Anusavice
目的：本研究的目的是测试的假设，3个单位的固定部分义齿（FPD），从一个中等高强度的核心陶瓷将充分抵抗断裂后区，如果制造的最小连接器的大小为4 mm。材料和方法30陶瓷FPD核心框架使用热压技术和二硅酸锂为基础的核心陶瓷制备。在牙体预备前测量每个患者的最大咬合力。测量每个FPD的连接器高度和宽度。患者在骨水泥固定4年后每年召回一次，并使用11项临床标准进行评价。所有FPD均由2名独立临床医生进行检查，每个标准的评级为1至4（4 =优秀; 1 =不可接受）。结果骨折率每年约为3%，非骨折型固定床中总体评分良好的比例每年减少6%以上，其中总体评分良好定义为所有11项标准中的3或4级。几乎没有证据表明使用树脂增强型玻璃离子骨水泥（Protec CEM）或双固化树脂骨水泥（Variolink II）在骨折率或总体评分方面有任何差异（4年的P值分别为0.30、0.63、0.97和0.71）。从抗断裂性的角度来看，30个陶瓷FPD中有4个在4年评价期内断裂，成功率为86.7%。另一个FPD被替换，因为一个基牙远离边缘的龋齿病变。一例FPD骨折与咬合力最大（1，031 N）的受试者相关。其他2例骨折与连接器高度小于3 mm的FPD相关。其余FPD在4年期间的所有标准均为良好至极好。结论：FPD断裂与连接器高度小于4 mm相关;因此，假设可接受。
PURPOSE The objective of this research was to test the hypothesis that 3-unit fixed partial dentures (FPDs) made from a moderately high-strength core ceramic will adequately resist fracture in posterior regions if fabricated with a minimal connector size of 4 mm. MATERIALS AND METHODS Thirty ceramic FPD core frameworks were prepared using a hot-pressing technique and a lithia disilicate-based core ceramic. The maximum occlusal force was measured for each patient prior to tooth preparation. Connector heights and widths were measured for each FPD. Patients were recalled annually after cementation for 4 years and evaluated using 11 clinical criteria. All FPDs were examined by 2 independent clinicians, and rankings for each criterion were made from 1 to 4 (4 = excellent; 1 = unacceptable). RESULTS The fracture rate was approximately 3% per year, and the proportion of good overall ratings in the nonfractured FPDs was reduced by more than 6% per year, where a good overall rating was defined to be a rank of 3 or 4 in all 11 criteria. There was little evidence that the use of either resin-reinforced glass-ionomer cement (Protec CEM) or dual-cure resin cement (Variolink II) made any difference in terms of fracture rate or overall rating (P= .30, .63, .97, and .71 for the 4 years, respectively). From a fracture resistance perspective, 4 of the 30 ceramic FPDs fractured within the 4-year evaluation period, representing an 86.7% success rate. Another FPD was replaced because of a caries lesion on 1 abutment tooth away from the margin. One FPD fracture was associated with the subject having the greatest occlusal force (1,031 N). The other 2 fractures were associated with FPDs that exhibited connector heights of less than 3 mm. All criteria were ranked good to excellent during the 4-year period for the remaining FPDs. CONCLUSION Fractured FPDs were associated with a connector height of less than 4 mm; thus, the hypothesis was accepted.