窄直径或标准直径钛锆植入体支持的氧化锆单冠在后牙部位的应用:随机对照试验的一年结果。

Nabeel H M Alsabeeha, Fatemeh Amir-Rad, Sunyoung Ma, Maanas Shah, Haifa Hannawi, Andrew Tawse-Smith, Warwick J Duncan, Zaid H Baqain, Momen A Atieh
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引用次数: 0

摘要

用种植体支持的修复体替代缺失牙已成为一种标准的治疗方法,在不同的临床适应症中具有可靠的长期疗效。8 一项对前后区 4363 个金属陶瓷种植体支持的单冠进行的系统回顾报告显示,五年内的存活率高达 98.3%,令人印象深刻。9 然而,与这些修复体相关的生物和修复并发症的发生率高达 13.5%。在后牙区,最近一项短期随机对照试验10 的系统回顾报告显示,金属陶瓷种植体支持单冠的存活率为 99.1%。近年来,高强度全陶瓷材料以及数字化设计和生产工艺的引入,使得修复体的制作速度更快,美观度更高,成本效益更高11。以氧化锆为基础的牙齿和种植体固定修复体的使用越来越广泛,5 年累计存活率高达 89.4% 至 100%。12 这些修复体通常由氧化锆骨架组成,骨架上贴面一层玻璃陶瓷,以增加半透明性,从而提高美观度。13 然而,陶瓷层的崩裂一直是一个挥之不去的问题,这使得人们开始关注全解剖整体氧化锆修复体的使用。在牙槽骨宽度有限的后嵴用种植体替代缺失牙在手术上具有挑战性,因此有人提出了窄直径种植体的概念。然而,对于窄直径种植体的治疗效果,尤其是后牙部位的治疗效果,文献仍存在争议。19-21 如果考虑在后牙部位使用整体氧化锆种植体支持的单冠进行单牙替换,则只能获得短期到中期的治疗效果22-26。在一到三年的观察期内,牙冠的存活率在 84% 到 100% 之间,而修复体的并发症在 0% 到 14% 之间。在三项研究中,22、23、25 在前磨牙和磨牙部位使用了标准直径的钛种植体来支撑单冠。其余两项研究由 Mühlemann 等人(2020 年)和 Zumstein 等人(2023 年)分别报告了同一队列的一年和三年结果。在这些研究中,直径为 3.3 毫米的钛锆(TiZr)窄种植体仅用于磨牙部位。据报告,种植体和牙冠在一年和三年后的存活率分别为 97.4% 和 84%。在 Zumstein 等人(2023 年)的报告中观察到的较低存活率是由于五个种植体断裂以及随后各自的牙冠脱落造成的。除了这两份报告,目前还没有其他关于在后牙部位使用窄直径 TiZr 种植体支撑整体氧化锆单冠的结果的信息。因此,这种治疗方法的有效性需要通过精心设计的临床试验来进一步研究。因此,我们进行了一项随机对照试验,以评估后牙区窄直径或标准直径钛锆(TiZr)种植体支持的单体氧化锆单冠的各种种植、修复和患者报告结果。本报告的重点是一年的修复效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Monolithic Zirconia Single Crowns Supported by Narrow- or Standard-Diameter Titanium-Zirconia Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial.

Purpose: To compare the prosthetic outcomes of screw-retained monolithic zirconia (Zr) single crowns supported by either narrow-diameter (3.3 mm) or standard-diameter (4.1 mm) tissue-level titanium-zirconia (TiZr) implants in posterior sites.

Materials and methods: A total of 18 participants, each with a missing molar or premolar tooth requiring an implantsupported single crown, were randomly assigned to either the test or control group. All participants received screwretained monolithic Zr single crowns supported by single tissue-level TiZr implants. Test group participants received narrow-diameter implants (3.3 mm), whereas control group participants received standard-diameter implants (4.1 mm). A modified version of the United States Public Health Service (USPHS) criteria was used to assess the prosthetic outcome across 12 parameters after 1 year of function. Data were analyzed descriptively, and statistical analysis was performed using a statistical software (SPSS, Version 28.0; IBM) with the level of significance set at P < .05.

Results: Of the 18 single crowns delivered, 16 were available for review at the 1-year follow-up, including 7 in the test group and 9 in the control group. Patient characteristics and crown site distribution were similar, with no significant differences observed between the two groups (chi-square test; P < .05). There were no crown failures, meaning a crown survival rate of 100% was achieved after 1 year. The prosthetic outcome based on USPHS criteria was comparable between the two groups with no significant differences observed (chi-square test; P < .05). There were 19 prosthetic events in total (10 in the test group and 9 in the control group), with no significant differences between the groups (chi-square test; P < .05). Loss of proximal contact was the dominant event, with a total of eight events (three in the test group and five in the control group). Patient satisfaction after 1 year was high in both treatment groups, with no significant differences detected.

Conclusions: Screw-retained monolithic Zr single crowns supported by either narrow- or standard-diameter tissue-level TiZr implants in posterior sites have comparable prosthetic outcomes after 1 year. Long-term results from well-designed trials are still needed to validate the findings of the present study.

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