Keramische Kronen auf Zähnen und Implantaten

Cantner, Friederike Catherine (2020): Keramische Kronen auf Zähnen und Implantaten: klinische Ergebnisse aus der Praxis. Dissertation, LMU München: Medizinische Fakultät

Abstract

The objective of this clinical study was to compare and assess the clinical performance of tooth-supported and implant-supported zirconia single crowns with a sintered veneering cap. In this prospective study 118 patients with a total of 220 single crowns placed on 106 teeth (69 vital teeth, 37 endodontically treated teeth) and 114 implants in molar and premolar regions were examined during a mean observation period of 42 months. The restorations were evaluated for technical failures like veneering porcelain fractures (chipping), surface quality, marginal fit, as well as the interface quality of coping and sintered veneering. The soft tissue status was assessed using the modified Silness and Löe plaque and gingival index (mPI) and modified Muehlemann sulcus bleeding index (mSBI). Tooth-supported crowns were checked on secondary caries and hypersensitivity during the follow-up period. Recalls were performed every six months. The 3-year Kaplan–Meier success probability was 98.2 % and 100 % for implant- and tooth-supported crowns, respectively. A significant difference between implant-supported and tooth-supported zirconia single crowns in terms of their chipping rate could be detected (p=0.039). Fractures of the veneering material were registrated on two implant-supported restorations (1.8%). No veneering fractures occurred on tooth-supported single crowns. The plaque and gingival index and sulcus bleeding index showed stable and healthy soft peri-implant and periodontal tissues. Neither loss of vitality nor secondary caries occurred on tooth-supported crowns. Zirconia-based single crowns with a sintered veneering cap on both tooth and implant abutments showed promising clinical results, however, the dental implants were more prone to complications. The objective of this clinical study was to evaluate the clinical performance of implant-supported zirconia crowns with a sintered veneering cap. Furthermore the influence of the type of retention (screw-retained vs. cemented single crowns) was analyzed. Fifty-eight patients were accommodated with 114 implants, inserted in the molar and premolar regions. Zirconia-based crowns with a sintered veneering cap were either screw-retained (n=53) or cemented (n=61) on the implant. Recalls were performed every six months. The state of soft tissue was documented by the modified plaque and gingiva index (mPI) and sulcus bleeding index (mSBI). The restorations were evaluated for technical failures like veneering porcelain fractures, surface qualities, marginal fitting. Neither implant loss nor crown fractures occurred. After a mean clinical service time of 36.9 months fractures of the veneering porcelain were registered in 1.8% of the cases. The Kaplan-Meier survival probability regarding eventless restorations was 98.2%. Chipping of the veneering porcelain was registered in two cemented crowns without statistical influence of the type of retention. The indices showed healthy soft periimplant tissues in both groups. Implant supported zirconia crowns with a sintered veneering cap demonstrated good clinical performance. The type of retention had no influence on technical complications.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: Dental implants, Implant-supported restorations, All-ceramic restorations, Screw-retention, Chipping
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 20. August 2020
• 1. Bericht­erstatter:in: Beuer, Florian