Klinische Bewährung computergestützt gefertigter Teilkronen aus einer zirkonoxidverstärkten Lithiumsilikat-Keramik nach einer Beobachtungszeit von 5 Jahren
Prospective practice-based clinical evaluation of chairside-fabricated partial crowns composed of a zirconia-reinforced lithium silicate ceramic: 5-year results
von Emanuel Niklas Schmidt
Datum der mündl. Prüfung:2024-01-30
Erschienen:2024-01-03
Betreuer:Prof. Dr. Sven Rinke
Gutachter:Prof. Dr. Sven Rinke
Gutachter:Prof. Dr. Michael Hülsmann
Dateien
Name:DA-Schmidt-eDiss.pdf
Size:5.28Mb
Format:PDF
Zusammenfassung
Englisch
Objectives: Prospective practice-based clinical evaluation of chairside-fabricated ceramic partial crowns (CCPCs) made from a glaze-fired zirconia-reinforced lithium silicate (ZLS) ceramic (Celtra Duo, Dentsply Sirona, Germany). Materials and Methods: Seventy-one patients were restored with 92 adhesively luted CCPCs (Cerec SW 4.2/Cerec MC XL) in 3 private dental clinics (C1-C3). Time-dependent (Kaplan–Meier) survival rates (SVR) and success rates (SCR) were calculated. Possible covariates of SVRs and SCRs evaluated in a Cox regression model included restoration position (premolar/molar), cementation material (Variolink/Calibra), and operator (C1-C3). Results: Fifty-nine patients with 73 crowns attended regular annual follow-ups (observational period: 58.0±15 months). Four complete failures (2 tooth fractures, 1 restoration fracture, and 1 endodontic failure) were recorded. Additionally, 3 biological and 2 technical complications required clinical intervention to maintain function. All failures and interventions occurred in 1 of the 3 centers (5-year SCR: C1 +C2: 100%; C3: 71%; 95% confidence interval: [0.55; 0.87]). Restorations placed in C1 and C2 showed a significantly reduced risk for failure/intervention (hazard ratio=0.103, p=0.026) compared with restorations placed in C3. Conclusions: ZLS-CCPCs showed good 5-year clinical performance. However, SVRs and SCRs were significantly influenced by the operator. Additional clinical data are required for a more detailed investigation of this effect. Clinical Significance: Based on this mid-term evaluation, ZLS-ceramics appear suitable for the chairside fabrication of adhesively luted monolithic posterior restorations. Clinical performance is significantly affected by the specific clinical experience of the operator.
Keywords: clinical study; partial crown; survival; success; ceramic; CAD/CAM; CCPC