Randomized Clinical Split-Mouth Study on Partial Ceramic Crowns Luted with a Self-adhesive Resin Cement with or without Selective Enamel Etching: Long-Term Results after 15 Years.
Julia L Pfister, Marianne Federlin, Karl-Anton Hiller, Gottfried Schmalz, Wolfgang Buchalla, Fabian Cieplik, Konstantin J Scholz
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引用次数: 0
Abstract
Purpose: This follow-up of a randomized clinical split-mouth study aimed to investigate the influence of selective enamel etching on the long-term clinical performance of partial ceramic crowns (PCCs) luted with a self-adhesive resin cement.
Materials and methods: 43 patients received two PCCs (Vita Mark II; Cerec 3D) each for the restoration of extensive lesions with multiple cusp coverage, inserted with a self-adhesive resin cement (RelyX Unicem, RXU). Using a split-mouth design, one PCC received additional selective enamel etching (RXU+E) and one did not (RXU-E). Patients were clinically evaluated at baseline and after up to 15 years (median observation period 176 months) using modified USPHS and FDI criteria. The data were analyzed non-parametrically (chi-squared tests, α = 0.05). Clinical survival of all restorations after 15 years was evaluated using the Kaplan-Meier analysis.
Results: After 15 years, 19 patients were available for clinical assessment (recall rate: 56%). Kaplan-Meier analysis showed a cumulative survival of 78.1% for RXU+E and of 42.9% for RXU-E, indicating a significantly higher survival rate for RXU+E (p = 0.004). Regarding the clinical performance of PCCs available for the 15-year evaluation, no statistically significant differences were found between RXU+E and RXU-E using modified USPHS and FDI criteria. Both groups revealed significant deterioration over time regarding surface luster, marginal adaptation, and marginal discoloration. RXU+E resulted in significantly inferior anatomic form over time and a significant improvement in post-operative hypersensitivity compared to baseline.
Conclusion: For posterior PCCs, selective enamel etching can be recommended based on higher survival rates after 15 years. Clinically, deterioration due to aging is similar in both groups.
目的:这是一项随机临床分口研究的随访,旨在研究选择性牙釉质蚀刻对自粘树脂粘固剂稀释的部分陶瓷冠(PCCs)长期临床性能的影响。材料和方法:43名患者接受了两个PCCs(Vita Mark II;Cerec 3D),每个用于修复多个牙尖顶覆盖的广泛病变,并插入自粘树脂水泥(RelyX Unicem,RXU)。使用开口设计,一个PCC接受了额外的选择性搪瓷蚀刻(RXU+E),一个没有(RXU-E)。在基线和长达15年(中位观察期176个月)后,使用改良的USPHS和FDI标准对患者进行临床评估。对数据进行非参数分析(卡方检验,α=0.05)。使用Kaplan-Meier分析评估所有修复体15年后的临床生存率。结果:15年后,19名患者可进行临床评估(召回率:56%)。Kaplan-Meier分析显示,RXU+E和RXU-E的累积生存率分别为78.1%和42.9%,表明RXU+E的生存率显著较高(p=0.004)。关于可用于15年评估的PCCs的临床表现,使用改良的USPHS和FDI标准,RXU+E和RXU-E之间没有发现统计学上的显著差异。随着时间的推移,两组的表面光泽、边缘适应和边缘变色都出现了显著的恶化。随着时间的推移,RXU+E导致解剖形态明显较差,与基线相比,术后超敏反应显著改善。结论:对于后部PCCs,基于15年后较高的生存率,可以推荐选择性釉质蚀刻。临床上,两组患者因衰老而恶化的情况相似。