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首页> 外文期刊>The Journal of Prosthetic Dentistry >Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.
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Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure.

机译：对152例患者中729颗种植体支持的金属陶瓷冠和固定局部义齿的瓷器破坏的回顾性分析：陶瓷失败的患者特异性和种植体特异性预测因子。

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STATEMENT OF PROBLEM: Porcelain fracture associated with an implant-supported, metal ceramic crown or fixed partial denture occurs at a higher rate than in tooth-supported restorations, according to the literature. Implant-specific and patient-specific causes of ceramic failure have not been fully evaluated. PURPOSE: The purpose of this retrospective study was to evaluate the potential statistical predictors for porcelain fracture of implant-supported, metal ceramic restorations. MATERIAL AND METHODS: Over a 6-month period, a consecutive series of patients having previously received implant-supported, metal ceramic fixed restorations were examined during periodic recall appointments. The number of supporting implants, number of dental units, type of restoration, date of prosthesis insertion, location in the dental arch, opposing dentition, type of occlusion, presence of parafunctional habits, use of an occlusal protective device, presence or absence of ceramic fractures, gender, and age were recorded for each patient. The generalized estimating equation (GEE) approach was used for the intrasubject correlated measurements analysis of categorical outcomes (presence or absence of ceramic fractures) to determine which patient- and implant-specific factors would predict porcelain fracture (alpha=.05). RESULTS: Data were collected from 152 patients representing 998 dental units (390 single crowns and 94 fixed partial dentures) supported by 729 implants. Porcelain fractures of 94 dental units occurred in 35 patients. The fractures were significantly (P<.05) associated with opposing implant-supported metal ceramic restorations, bruxism, and not wearing a protective occlusal device. Metal ceramic prostheses (single crown or fixed partial dentures) had approximately 7 times higher odds of porcelain fracture (odds ratio (OR)=7.06; 95% confidence interval (CI): 2.57 to 19.37) and 13 times greater odds of a fracture requiring either repair or replacement (OR=13.95; 95% CI: 2.25 to 86.41) when in occlusion with another implant-supported restoration, as compared to opposing a natural tooth. In addition, patients exhibiting bruxism or not wearing an occlusal device had approximately 7 times higher odds (OR=7.23; 95% CI: 3.86 to 13.54), and 2 times higher odds (OR=1.92; 95% CI: 1.01 to 3.67) of porcelain fracture when compared to patients without bruxism and patients not wearing an occlusal device. CONCLUSIONS: Implant-supported metal ceramic single crowns and fixed partial dentures were found to have a significantly higher risk of porcelain fracture in patients with bruxism habits, when a protective occlusal device was not used, and when the restoration opposed another implant-supported metal ceramic restoration.
机译：问题陈述：据文献报道，与种植体支撑的金属陶瓷冠或固定的局部义齿相关的瓷器骨折的发生率高于牙齿支撑的修复体。陶瓷失败的特定于种植体和患者的原因尚未得到充分评估。目的：这项回顾性研究的目的是评估植入物支持的金属陶瓷修复体瓷器断裂的潜在统计预测指标。材料和方法：在6个月的时间里，在定期召回预约期间检查了一系列先前接受过植入物支持的金属陶瓷固定修复体的患者。支持植入物的数量，牙齿单位的数量，修复的类型，假体的插入日期，牙弓的位置，对牙列，咬合的类型，超功能习惯的存在，使用咬合保护器，是否存在陶瓷记录每位患者的骨折，性别和年龄。广义估计方程（GEE）方法用于分类结果（陶瓷骨折的存在与否）的受试者内部相关测量分析，以确定哪些患者和植入物特定的因素可以预测瓷器骨折（alpha = .05）。结果：收集了152例患者的数据，这些患者由729个种植体支持，代表998个牙科单位（390个单冠和94个固定局部义齿）。 35例患者发生了94个牙科单元的瓷质骨折。与相对的种植体支持的金属陶瓷修复体，磨牙症以及未佩戴保护性咬合装置相关的骨折明显（P <.05）。金属陶瓷假体（单冠或固定局部义齿）的瓷器破裂几率高约7倍（优势比（OR）= 7.06; 95％置信区间（CI）：2.57至19.37），而骨折所需几率高13倍与天然牙相反时，与另一种种植体支持的修复体咬合时，可进行修复或置换（OR = 13.95; 95％CI：2.25至86.41）。此外，患有磨牙症或未佩戴咬合器的患者的几率大约高7倍（OR = 7.23; 95％CI：3.86至13.54）和2倍的几率更高（OR = 1.92; 95％CI：1.01至3.67）与没有磨牙症患者和未佩戴咬合装置的患者相比，瓷器骨折的发生率高。结论：在没有磨牙性咬合习惯的情况下，当修复体与另一种种植体支持的金属陶瓷相对时，种植体支持的金属陶瓷单冠和固定局部义齿在磨牙症患者中瓷器骨折的风险显着更高。恢复。

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