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 porcelain 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).

中文翻译：

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一项前瞻性、多中心、基于实践的全瓷冠队列研究

目标

这项前瞻性、多中心、基于实践的队列研究的目的是分析与全瓷冠成功相关的因素。

方法

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。评估了 1254 名（主要是办公室内 CAD/CAM）全瓷冠患者的数据，这些患者由 101 名牙医进行了 5 年以上的随访。在最后一次随访时，如果牙冠足够，则认为牙冠成功（未失败），而如果牙冠仍然有效，则认为牙冠存活（未丢失）。使用多级 Cox 比例风险模型来评估一系列预测因素与成功或存活时间之间的关联。

结果

在 7.2(2) 年 [最长：15 年] 的平均随访期 (SD) 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%）。牙髓治疗牙齿中存在桩导致的失败风险比没有桩的修复体低 2.7 倍（95% CI：1.4–5.0；p = 0.002）。在修复材料和粘合剂技术方面，混合复合陶瓷和单步粘合剂的故障率分别比长石瓷和多步粘合剂高 3.4 倍和 2.2 倍（p < 0.001）。使用阻氧凝胶和 EVA 仪器导致故障率比不使用高 1.5-1.8 倍（p ≤ 0.001）。

意义

在长达 15 年之后，全瓷冠的 AFR 相当高。手术因素，但没有患者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 (DRKS-ID: DRKS00020271) 中注册。