A prospective, multi-center, practice-based cohort study on all-ceramic crowns
A prospective, multi-center, practice-based cohort study on all-ceramic crowns
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DOI：
10.1016/j.dental.2021.04.005
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发表时间：
2021-07-13
期刊：
影响因子：
5
通讯作者：
Wolf, T. G.
中科院分区：
文献类型：
--
作者：
Wierichs, R. J.;Kramer, E. J.;Wolf, T. G.
目标.这项前瞻性、多中心、基于实践的队列研究旨在分析与全瓷冠成功相关的因素。对放置在基于实践的研究网络（[Ceramic Success Analysis，AG Keramik]）中的全瓷冠进行了分析。对1254例患者（主要是在办公室CAD/CAM）的全瓷冠由101名牙科医生放置，随访超过5年的数据进行了评价。在最后一次随访时，如果牙冠足够，则认为牙冠成功（未失败），而如果牙冠仍在发挥功能，则认为牙冠存活（未丢失）。多水平考克斯比例风险模型用于评估一系列预测因子与成功或生存时间之间的相关性。在平均7.2（2）年[最长：15年]的随访期内，776个牙冠被认为是成功的（年失败率[AFR]：8.4%），1041个牙冠存活（AFR：4.9%）。在根管治疗的牙齿中存在桩导致失败的风险比不存在桩的牙齿低2.7倍（95%CI：1.4-5.0; p = 0.002）。在修复材料和粘接技术方面，混合复合陶瓷和一步粘接剂的失败率分别是镶嵌陶瓷和多步粘接剂的3.4倍和2.2倍（p < 0.001）。使用阻氧凝胶和伊娃器械的失败率比不使用器械的失败率高1.5-1.8倍（p = 0.001）。全瓷冠15年后的AFR相当高。手术因素，但没有病人或牙齿水平的因素与失败显着相关。该研究已在德国临床试验注册中心注册（DRKS-ID：DRKS 00020271）。(C)2021年，任作者。爱思唯尔公司出版代表牙科材料学会
Objectives. The aim of this prospective, multi-center, practice-based cohort study was to analyze factors associated with the success of all-ceramic crowns.Methods. All-ceramic crowns placed in a practice-based research network ([Ceramic Success Analysis, AG Keramik) were analyzed. Data from 1254 patients with (mostly in-office CAD/CAM) all-ceramic crowns placed by 101 dentists being followed up for more than 5 years were evaluated. At the last follow-up visit crowns were considered as successful (not failed) if they were sufficient, whereas crowns were considered as survived (not lost) if they were still in function. Multi-level Cox proportional hazards models were used to evaluate the association between a range of predictors and time of success or survival.Results. Within a mean follow-up period (SD) of 7.2(2)years [maximum:15years] 776 crowns were considered successful (annual failure rate[AFR]:8.4%) and 1041 crowns survived (AFR:4.9%). The presence of a post in endodontically treated teeth resulted in a risk for failure 2.7 times lower than that of restorations without a post (95%CI:1.4-5.0; p = 0.002). Regarding the restorative material and adhesive technique, hybrid composite ceramics and single-step adhesives showed a 3.4 and 2.2 times higher failure rate than feldspathic porce-lain and multi-step adhesives, respectively (p < 0.001). Use of an oxygen-blocking gel as well as an EVA instrument resulted in a 1.5-1.8 times higher failure rate than their non-use (p = 0.001).Significance. After up to 15years AFR were rather high for all-ceramic crowns. Operative factors, but no patient- or tooth-level factors were significantly associated with failure. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00020271). (C) 2021 The Author(s). Published by Elsevier Inc. on behalf of The Academy of Dental Materials.