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Abstract：
OBJECTIVE: To investigate the survival rate and clinical failure reasons of onlay and occlusal veneer restorations retrospectively, and to put forward valuable suggestions for the selection of clinical indications.
METHODS: A total of 102 patients and 124 teeth treated by one of the authors from 2016 to 2019 were subjected to CAD/CAM lithium silicate reinforced glass-ceramic onlay or veneer restorations of premolars and molars, including 43 teeth with pulp vitality, 81 endodontic treated teeth, and occlusal thickness of restoration was 1.5 mm. After four years of restoration, retrospective surveys were conducted to record the survival rate of restorations, the causes of restoration failure, and patient satisfaction rates, and the survival rate of restorations between vital teeth and endodontic treated teeth and among restored teeth was statistically analyzed by Chi-square test.
RESULTS: The survival rates of restorations on vital teeth and endodontic treated teeth were 95.5% and 90.0%, respectively, the average survival rate was 90.2%. The survival rates of vital teeth were higher than those of endodontic treated teeth without statistical difference. There was also no statistically significant difference among the tooth locations. The causes of failure included the cracking of the restoration, the loss of the restoration, the fracture of the abutment teeth, secondary caries below the adjacent contact point, and food impaction caused by the loosening of the adjacent contact point. The overall patient satisfaction rate was 91.5%.
CONCLUSIONS: The 4-year survival rate of glass-ceramic onlays and occlusal veneers is lower than that of the full crown restoration, and there are more complications than that of the single-crown restorations. The design of the restoration should be carefully selected based on the vitality of the abutment tooth and the remaining amount of tooth tissue. When there is too little tooth structure left, a post and crown should be selected for restoration. Adequate strength and thickness of the restoration should be ensured to prevent food impaction. Due to the small amount of abutment tooth preparation, it has the advantages of less stimulation of the pulp and periodontal tissue, and can be recommended as a trial restoration.
METHODS: A total of 102 patients and 124 teeth treated by one of the authors from 2016 to 2019 were subjected to CAD/CAM lithium silicate reinforced glass-ceramic onlay or veneer restorations of premolars and molars, including 43 teeth with pulp vitality, 81 endodontic treated teeth, and occlusal thickness of restoration was 1.5 mm. After four years of restoration, retrospective surveys were conducted to record the survival rate of restorations, the causes of restoration failure, and patient satisfaction rates, and the survival rate of restorations between vital teeth and endodontic treated teeth and among restored teeth was statistically analyzed by Chi-square test.
RESULTS: The survival rates of restorations on vital teeth and endodontic treated teeth were 95.5% and 90.0%, respectively, the average survival rate was 90.2%. The survival rates of vital teeth were higher than those of endodontic treated teeth without statistical difference. There was also no statistically significant difference among the tooth locations. The causes of failure included the cracking of the restoration, the loss of the restoration, the fracture of the abutment teeth, secondary caries below the adjacent contact point, and food impaction caused by the loosening of the adjacent contact point. The overall patient satisfaction rate was 91.5%.
CONCLUSIONS: The 4-year survival rate of glass-ceramic onlays and occlusal veneers is lower than that of the full crown restoration, and there are more complications than that of the single-crown restorations. The design of the restoration should be carefully selected based on the vitality of the abutment tooth and the remaining amount of tooth tissue. When there is too little tooth structure left, a post and crown should be selected for restoration. Adequate strength and thickness of the restoration should be ensured to prevent food impaction. Due to the small amount of abutment tooth preparation, it has the advantages of less stimulation of the pulp and periodontal tissue, and can be recommended as a trial restoration.
摘要：
目的：回顾性研究高嵌体和咬合体修复体的存活率和临床失败原因。为临床适应证的选择提出有价值的建议。
方法：2016年至2019年，由其中一位作者治疗的102例患者和124颗牙齿接受了CAD/CAM硅酸锂增强的玻璃陶瓷嵌体或前磨牙和磨牙的贴面修复，包括43颗具有牙髓活力的牙齿，81颗牙髓治疗的牙齿，修复体咬合厚度为1.5mm。经过四年的恢复，进行了回顾性调查，以记录修复体的存活率，修复失败的原因，和患者满意度，用卡方检验对活生牙与牙髓治疗牙之间以及修复牙之间的修复体存活率进行统计分析。
结果:活生牙和牙髓治疗牙修复体的成活率分别为95.5%和90.0%,分别,平均生存率为90.2%。活生牙的存活率高于经牙髓治疗的牙齿，无统计学差异。牙齿位置之间也没有统计学上的显着差异。失败的原因包括修复体的破裂，修复的损失，基牙的骨折,相邻接触点以下的继发性龋齿，和相邻接触点松动引起的食物嵌塞。患者总满意率为91.5%。
结论：玻璃陶瓷嵌体和咬合贴面的4年生存率低于全冠修复，与单冠修复相比，并发症更多。应根据基牙的生命力和牙齿组织的剩余量仔细选择修复体的设计。当剩下的牙齿结构太少时，应选择桩和冠进行修复。应确保修复体足够的强度和厚度，以防止食物嵌塞。由于基牙预备量少，它具有对牙髓和牙周组织刺激小的优点，并可以推荐作为试验恢复。
方法：2016年至2019年，由其中一位作者治疗的102例患者和124颗牙齿接受了CAD/CAM硅酸锂增强的玻璃陶瓷嵌体或前磨牙和磨牙的贴面修复，包括43颗具有牙髓活力的牙齿，81颗牙髓治疗的牙齿，修复体咬合厚度为1.5mm。经过四年的恢复，进行了回顾性调查，以记录修复体的存活率，修复失败的原因，和患者满意度，用卡方检验对活生牙与牙髓治疗牙之间以及修复牙之间的修复体存活率进行统计分析。
结果:活生牙和牙髓治疗牙修复体的成活率分别为95.5%和90.0%,分别,平均生存率为90.2%。活生牙的存活率高于经牙髓治疗的牙齿，无统计学差异。牙齿位置之间也没有统计学上的显着差异。失败的原因包括修复体的破裂，修复的损失，基牙的骨折,相邻接触点以下的继发性龋齿，和相邻接触点松动引起的食物嵌塞。患者总满意率为91.5%。
结论：玻璃陶瓷嵌体和咬合贴面的4年生存率低于全冠修复，与单冠修复相比，并发症更多。应根据基牙的生命力和牙齿组织的剩余量仔细选择修复体的设计。当剩下的牙齿结构太少时，应选择桩和冠进行修复。应确保修复体足够的强度和厚度，以防止食物嵌塞。由于基牙预备量少，它具有对牙髓和牙周组织刺激小的优点，并可以推荐作为试验恢复。
