Benedikt C Spies1,2, Marc Balmer3, Ronald E Jung3, Irena Sailer4, Kirstin Vach5, Ralf-Joachim Kohal1. 1. Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. 2. Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany. 3. Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland. 4. Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland. 5. Institute for Medical Biometry and Statistics, Center for Medical Biometry and Medical Informatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Abstract
OBJECTIVES: To assess survival/success rates and patient-reported outcome of zirconia-based posterior single crowns (SCs) supported by zirconia implants in a prospective two-center study after five years of observation. MATERIAL AND METHODS: Forty-five patients were restored with 45 zirconia implant-supported posterior SCs composed of zirconia frameworks hand-layered with a leucite-reinforced feldspathic ceramic. Survival rates of SCs were assessed and technical success was evaluated according to modified United States Public Health Care (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models were used to evaluate time effects on response variables. RESULTS: Forty patients were available after a mean observation period of 61.0 ± 1.4 months. One SC had to be replaced, resulting in a Kaplan-Meier (KM) survival estimate for the SCs of 97.5 ± 2.47%. Since nine reconstructions showed at least in one category a major deviation from the ideal (five major chippings, four with increased occlusal roughness, one significant crevice, and one pronounced over-contouring), the KM success estimate was 79.3 ± 5.8%. Incidence of chipping (n = 19) and occlusal roughness (n = 35) was frequent (p < 0.001). All PROMs at prosthetic delivery except for speech (p = 0.139) showed significantly improved VAS scores (81%-94%; p < 0.001) compared to pre-treatment evaluations. Thereafter, no decrease in satisfaction could be observed until the 5-year follow-up (93%-97%). CONCLUSION: Veneered zirconia-based SCs supported by zirconia implants showed high survival rates and highly satisfied patients' needs. However, significant incidence of technical complications is compromising the clinical long-term outcome for this indication.
OBJECTIVES: To assess survival/success rates and patient-reported outcome of zirconia-based posterior single crowns (SCs) supported by zirconia implants in a prospective two-center study after five years of observation. MATERIAL AND METHODS: Forty-five patients were restored with 45 zirconia implant-supported posterior SCs composed of zirconia frameworks hand-layered with a leucite-reinforced feldspathic ceramic. Survival rates of SCs were assessed and technical success was evaluated according to modified United States Public Health Care (USPHS) criteria. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Wilcoxon matched-pairs signed-rank test, mixed-effects ordered logistic regression, and linear mixed models were used to evaluate time effects on response variables. RESULTS: Forty patients were available after a mean observation period of 61.0 ± 1.4 months. One SC had to be replaced, resulting in a Kaplan-Meier (KM) survival estimate for the SCs of 97.5 ± 2.47%. Since nine reconstructions showed at least in one category a major deviation from the ideal (five major chippings, four with increased occlusal roughness, one significant crevice, and one pronounced over-contouring), the KM success estimate was 79.3 ± 5.8%. Incidence of chipping (n = 19) and occlusal roughness (n = 35) was frequent (p < 0.001). All PROMs at prosthetic delivery except for speech (p = 0.139) showed significantly improved VAS scores (81%-94%; p < 0.001) compared to pre-treatment evaluations. Thereafter, no decrease in satisfaction could be observed until the 5-year follow-up (93%-97%). CONCLUSION: Veneered zirconia-based SCs supported by zirconia implants showed high survival rates and highly satisfied patients' needs. However, significant incidence of technical complications is compromising the clinical long-term outcome for this indication.
Authors: Frank Akito Spitznagel; Marc Balmer; Daniel B Wiedemeier; Ronald Ernst Jung; Petra Christine Gierthmuehlen Journal: Clin Oral Implants Res Date: 2021-11-05 Impact factor: 5.021