Longevity and risk factors of CAD-CAM manufactured implant-supported all-ceramic crowns - A prospective, multi-center, practice-based cohort study.

Autor: Wierichs RJ; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Unit for Practice-based Research, School of Dental Medicine, University of Bern, Switzerland. Electronic address: richard.wierichs@unibe.ch., Kramer EJ; Arbeitskreis Zahnärztliche Therapie e.V., Germany; Private practice Norden, Germany., Reiss B; German Society of Computerized Dentistry, Berlin, Germany., Roccuzzo A; Unit for Practice-based Research, School of Dental Medicine, University of Bern, Switzerland., Raabe C; Department of Oral Surgery and Implantology, Goethe University, Carolinum̥, Frankfurt am Main, Germany; Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland., Yilmaz B; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland., Abou-Ayash S; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthetic Dentistry and Material Science, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Jazyk: angličtina
Zdroj: Dental materials : official publication of the Academy of Dental Materials [Dent Mater] 2024 Nov; Vol. 40 (11), pp. 1962-1969. Date of Electronic Publication: 2024 Sep 24.
DOI: 10.1016/j.dental.2024.09.008
Abstrakt: Objectives: The aim of this prospective, multi-center, practice-based cohort study was to analyze factors associated with the success of implant supported all-ceramic single-unit crowns, made by computer-aided-design/computer-aided-manufacturing (CAD-CAM).
Methods: All-ceramic crowns placed in a private practice-based research network (Ceramic Success Analysis, AG Keramik) were analyzed. Data from 567patients with CAD-CAM implant supported all-ceramic crowns placed between 2008-2023 by 54dentists were evaluated. Firstly, all crowns with at least one follow-up control were included (n = 907). Secondly, all crowns being followed up for ≥ 5years and all failures were included (n = 151). At the latest follow-up visit, crowns were considered as successful (not failed) if they were still in function without the need for additional therapy. Multi-level Cox proportional hazards models were used to evaluate the association between a range of predictors and time of success.
Results: Within a mean follow-up period (SD) of 2.5 (2)years (first scenario) and 6.2 (1.2)years (second scenario) [maximum:12years], 27crowns failed (annual failure rate [AFR]:0.74 %). The main failure types were decementation, (n = 11), fracture of the ceramic (n = 4) or Ti-Base (n = 4). In 5-year-scenario, crowns fabricated in the laboratory had 26times lower failure rate than those fabricated chairside (95 %CI:0.0-0.7;p = 0.038). Furthermore, the use of a silane (HR:0.051;95 %CI:0.0-0.5;p = 0.014) and etching of the ceramic (HR:0.053;95 %CI:0.0-0.8;p = 0.035) resulted in a significantly higher risk for failure than their non-use.
Significance: For CAD-CAM manufactured implant supported all-ceramic crowns, high success rates were found in up to 12-year evaluation. Furthermore, after 5years, no patient-or implant-level factors, but operative-level factor (i.e.fabrication method, use of silane/etching) were significantly associated with failure. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00020271).
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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