Abstract:
Objective: To evaluate the clinical survival rates and influence factors of different types of resin-bonded fixed partial dentures (RBFPD) used in anterior missing teeth restoration. Methods: Ninety-three RBFPD were delivered to 92 patients [92 patients,43 males and 49 females, average age (46.1±12.8) years] who visited Peking University School and Hospital of Stomatology from January 2006 to December 2021 for restoration of 1 or 2 anterior missing teeth. Altogether 32 cases of glass fiber reinforced RBFPD, 39 cases of glass-based ceramic RBFPD and 22 cases of porcelain-fused-to-metal RBFPD were retrospectively analyzed. The complete survival rate, functional survival rate, patients\' satisfaction and color matching of the restorations were recorded and evaluated every year since the replacement with RBFPD. The Kaplan-Meier survival curve method was used for survival analysis, and the Log-rank analysis was used to compare the effect of the number of missing teeth, position (maxillary or mandibular), cantilever or non-cantilever and gender on the survival rate of the restorations. Results: The overall survival time for the 93 RBFPD was 13.7 years (95%CI: 12.3-15.1 years). There was a decreasing trend in complete survival and functional survival for all three material RBFPD from year to year, but complete and functional survival rates exceeded 90% at year 5 and exceeded 80% at year 10. The complete survival rate of the glass-ceramic RBFPD was higher than the other two during the follow-up period, with a complete survival rate of 90% (35/39) at year 15. The porcelain-fused-to-metal RBFPD had a higher functional survival rate in years 1-8, but the complete and functional survival rates showed a substantial decrease after year 9. The single-factor Log-rank analysis showed that the success rate of porcelain-fused-to-metal RBFPD was significantly higher than that of glass fiber reinforced RBFPD (χ²=7.33, P=0.007), and the success rate of RBFPD with 1 missing tooth restored was significantly higher than that of RBFPD with 2 missing teeth restored (χ²=3.23, P=0.072). The differences in success rates between different restoration positions (maxillary and mandibular), cantilever or non-cantilever, and gender factors were not statistically significant (χ²=2.26, P=0.133; χ²=0.68, P=0.411; χ²=1.07, P=0.300). Conclusions: For the restoration of individual missing anterior teeth, both porcelain-fused-to-metal RBFPD and glass-based ceramic RBFPD achieve a high long-term clinical success rate, with glass-based ceramic RBFPD being more able to ensure long-term restorative result.
目的: 评价粘接固定义齿(RBFPD)修复前牙缺失的长期临床应用效果并分析其影响因素。 方法: 对2006年1月至2021年12月于北京大学口腔医学院·口腔医院修复科就诊的1或2颗前牙缺失患者[92例,男性43例,女性49例,年龄(46.1±12.8)岁]的RBFPD(93件)进行回顾性分析,包括玻璃纤维增强树脂RBFPD(32件)、玻璃陶瓷RBFPD(39件)以及镍铬合金烤瓷RBFPD(22件)。统计修复后RBFPD的完全存活率和功能存活率,利用Kaplan-Meier生存曲线法进行生存分析,Log-rank检验比较缺牙数、修复位置(上颌或下颌)、单端或双端修复以及性别因素对修复体生存率的影响。 结果: 93件RBFPD的总体生存时间为13.7年(95%CI:12.3~15.1年)。3种材料RBFPD的完全存活率及功能存活率呈逐年下降趋势,但修复后5年完全存活率和功能存活率均超过90%,修复后10年完全存活率和功能存活率均超过80%。随访期间玻璃陶瓷RBFPD的完全存活率均高于其他两种RBFPD,修复后15年完全存活率为90%(35/39)。修复后1~8年镍铬合金烤瓷RBFPD功能存活率较高,但修复后9年镍铬合金烤瓷RBFPD完全存活率和功能存活率出现大幅度降低。单因素分析显示,镍铬合金烤瓷RBFPD的生存率显著大于玻璃纤维增强树脂RBFPD(χ²=7.33,P=0.007),修复1颗缺失牙的RBFPD生存率显著大于修复2颗缺失牙的RBFPD(χ²=3.23,P=0.072);而修复位置(上颌或下颌)、单端或双端修复以及性别因素对生存率的影响差异无统计学意义(χ²=2.26,P=0.133;χ²=0.68,P=0.411;χ²=1.07,P=0.300)。 结论: 对于个别前牙缺失,镍铬合金烤瓷RBFPD和玻璃陶瓷RBFPD均可取得较长期的临床成功率,玻璃陶瓷RBFPD能保证长期修复效果。.