287件CAD/CAM二氧化锆全瓷修复体3年临床疗效观察

Clinical evaluation of 287 CAD / CAM zirconia ceramic restorations: A 3-year follow up

目的:探讨CAD/CAM氧化锆全瓷修复体的临床疗效及失败原因。方法:对206例患者、287件CAD/CAM氧化锆全瓷修复体进行3年前瞻性随访研究,按照美国加州牙科协会(CDA)制定的标准,通过Kaplan-Meier生存分析、Log-Rank检验及卡方检验,统计累积生存率,分析修复体类型、修复牙位、基牙桩核与否等因素对全瓷修复体生存率的影响。结果:观察期内CAD/CAM二氧化锆修复体有5件发生瓷崩裂,4件出现明显牙龈炎症,3件基牙发生根尖周炎;修复体3年累积生存率为95.7%。其中单冠、联冠、固定桥的3年累积生存率分别为96.3%、93.6%、95.7%(P>0.05),前牙组与后牙组的3年累积生存率分别为94.5%、96.3%(P>0.05),基牙桩核组与非桩核组3年累积生存率分别为95.0%、96.1%(P>0.05)。结论:CAD/CAM二氧化锆修复体3年累积生存率较高,修复体类型、修复牙位及基牙桩核与否对其生存率影响均无显著性差异;瓷崩裂是最常见的失败原因。

Objective： To evaluate the clinical performance of CAD/CAM zirconia all-ceramic restorations. Methods： 287 all-ce- ramic Zireonia restorations in 206 patients were included in a 3-year prospectively survey with California Dental Association Standard （CDA） as a reference. The effects and the related factors such as restoration type, tooth region, fiber reinforced composite application on survival rate were analyzed. Kaplan-Meier survival analysis and Log-Rank test were used for data analysis. Results： Chipping frac- tures in 5 restorations, intense gingivitis at 4 restorations and periapieal inflammation for 3 restorations were observed during the obser- vation period. The 3-year cumulative survival rate （CSR） of CAD/CAM zirconia restorations was 95.7% , The differences among the CSR of single crowns （96.3%） , linked crowns （93.6%） and fixed partial dentures （95.7%）were not statistically significant （P 〉 0.05 ）. The difference was not statistically significant （P 〉 0.05 ） between the CSR of the anterior region group （94.5 % ） and posterior region group （ 96.3 % ） as well as difference （ P 〉 0.05 ） between the CSR of fiber reinforced composite group （ 95.0% ） and without fiber reinforced composite group（ 96. 1% ）. Conclusion： The cumulative survival rate of CAD/CAM zirconia all-ceramic restorations is high. Chipping fracture is the main reason of failure. Restoration type, tooth region and fiber reinforced composite have no significant effect on the survival of zirconia restorations.