Electromyographic assessment of jaw muscles in patients with All‐on‐Four fixed implant‐supported prostheses

This study evaluated the electromyographic (EMG) characteristics of masticatory muscles in patients with fixed implant‐supported prostheses according to All‐on‐Four^® principles and in control healthy dentate subjects. Twenty‐six subjects aged 50–74 years were examined. Eighteen were edentulous and had been successfully rehabilitated with (i) mandibular All‐on‐Four^® implant‐supported fixed prostheses and maxillary complete dentures (10 patients) and (ii) mandibular and maxillary All‐on‐Four^® implant‐supported fixed prostheses (eight patients). Eight reference subjects had natural dentition. Surface EMG recordings of the masseter and temporalis muscles were performed during maximum voluntary teeth clenching and during unilateral gum chewing. All values were standardised as percentage of a maximum clenching on cotton rolls. During clenching, a good global neuromuscular equilibrium was found in all participants. During chewing, all groups had similar values of working‐side muscle activities and of chewing frequency. No significant differences in the analysed EMG parameters were found between the patients with mandibular and maxillary All‐on‐Four^® implant‐supported prostheses and the reference subjects. In contrast, standardised pooled muscle activities and standardised muscular activities per cycle were larger in patients with a maxillary removable prosthesis than in control subjects (Kruskal–Wallis test, P < 0·01). Also, patients wearing a complete maxillary denture showed a poor neuromuscular coordination with altered muscular pattern and lower values of the index of masticatory symmetry than dentate control subjects (P < 0·01). EMG outcomes suggest that All‐on‐Four^® implant‐supported prostheses may be considered a functionally efficient treatment option for the rehabilitation of edentulous patients with reduced residual bone volume.     

Effect of Crystallization Firing on Marginal Gap of CAD/CAM Fabricated Lithium Disilicate Crowns

Purpose

To evaluate the marginal gaps of CAD/CAM (CEREC 3) produced crowns made from leucite‐reinforced glass‐ceramic (IPS Empress CAD) blocks (LG), and lithium‐disilicate (IPS e.max CAD) blocks before (LD‐B), and after (LD‐A) crystallization firing.

Materials and Methods

A human molar tooth (#19) was mounted with adjacent teeth on a typodont and prepared for a full‐coverage ceramic crown. The typodont was assembled in the mannequin head to simulate clinical conditions. After tooth preparation 15 individual optical impressions were taken by the same operator using titanium dioxide powder and a CEREC 3 camera per manufacturer's instructions. One operator designed and machined the crowns in leucite‐reinforced glass‐ceramic blocks (n = 5) and lithium‐disilicate blocks (n = 10) using the CEREC 3 system. The crowns were rigidly seated on the prepared tooth, and marginal gaps (μm) were measured with an optical microscope (500×) at 12 points, 3 on each of the M, B, D, and L surfaces of the leucite‐reinforced glass‐ceramic crowns and the lithium‐disilicate crowns before and after crystallization firing. Results were analyzed by two‐way ANOVA followed by a Tukey's post hoc multiple comparison test (α = 0.05).

Results

The overall mean marginal gaps (μm) for the crowns evaluated were: LG = 49.2 ± 5.5, LD‐B = 42.9 ± 12.2, and LD‐A = 57.2 ± 16.0. The marginal gaps for LG and LD‐B were not significantly different, but both were significantly less than for LD‐A.

Conclusions

The type of ceramic material did not affect the marginal gap of CAD/CAM crowns. The crystallization firing process required for lithium‐disilicate crowns resulted in a significant increase in marginal gap size, likely due to shrinkage of the ceramic during the crystallization process. Clinical Relevance: The marginal gap of CAD/CAM‐fabricated lithium disilicate crowns increases following crystallization firing. The marginal gap still remains within clinically acceptable parameters.     

Fatigue analysis of computer‐aided design/computer‐aided manufacturing resin‐based composite vs. lithium disilicate glass‐ceramic

Resin‐based composite molar crowns made by computer‐aided design/computer‐aided manufacturing (CAD/CAM) systems have been proposed as an inexpensive alternative to metal‐ceramic or all‐ceramic crowns. However, there is a lack of scientific information regarding fatigue resistance. This study aimed to analyze the fatigue behavior of CAD/CAM resin‐based composite compared with lithium disilicate glass‐ceramic. One‐hundred and sixty bar‐shaped specimens were fabricated using resin‐based composite blocks [Lava Ultimate (LU); 3M/ESPE] and lithium disilicate glass‐ceramic [IPS e.max press (EMP); Ivoclar/Vivadent]. The specimens were divided into four groups: no treatment (NT); thermal cycling (TC); mechanical cycling (MC); and thermal cycling followed by mechanical cycling (TCMC). Thermal cycling was performed by alternate immersion in water baths of 5°C and 55°C for 5 × 10⁴ cycles. Mechanical cycling was performed in a three‐point bending test, with a maximum load of 40 N, for 1.2 × 10⁶ cycles. In addition, LU and EMP molar crowns were fabricated and subjected to fatigue treatments followed by load‐to‐failure testing. The flexural strength of LU was not severely reduced by the fatigue treatments. The fatigue treatments did not significantly affect the fracture resistance of LU molar crowns. The results demonstrate the potential of clinical application of CAD/CAM‐generated resin‐based composite molar crowns in terms of fatigue resistance.     

Randomized,Controlled Clinical Trial of Bilayer Ceramic and Metal‐Ceramic Crown Performance

Purpose : Analyzing the clinical performance of restorative materials is important, as there is an expectation that these materials and procedures will restore teeth and do no harm. The objective of this research study was to characterize the clinical performance of metal‐ceramic crowns, core ceramic crowns, and core ceramic/veneer ceramic crowns based on 11 clinical criteria. Materials and Methods : An IRB‐approved, randomized, controlled clinical trial was conducted as a single‐blind pilot study. The following three types of full crowns were fabricated: (1) metal‐ceramic crown (MC) made from a Pd‐Au‐Ag‐Sn‐In alloy (Argedent 62) and a glass‐ceramic veneer (IPS d.SIGN veneer); (2) non‐veneered (glazed) lithium disilicate glass‐ceramic crown (LDC) (IPS e.max Press core and e.max Ceram Glaze); and (3) veneered lithia disilicate glass‐ceramic crown (LDC/V) with glass‐ceramic veneer (IPS Empress 2 core and IPS Eris). Single‐unit crowns were randomly assigned. Patients were recalled for each of 3 years and were evaluated by two calibrated clinicians. Thirty‐six crowns were placed in 31 patients. A total of 12 crowns of each of the three crown types were studied. Eleven criteria were evaluated: tissue health, marginal integrity, secondary caries, proximal contact, anatomic contour, occlusion, surface texture, cracks/chips (fractures), color match, tooth sensitivity, and wear (of crowns and opposing enamel). Numerical rankings ranged from 1 to 4, with 4 being excellent, and 1 indicating a need for immediate replacement. Statistical analysis of the numerical rankings was performed using a Fisher's exact test. Results : There was no statistically significant difference between performance of the core ceramic crowns and the two veneered crowns at year 1 and year 2 (p > 0.05). All crowns were rated either as excellent or good for each of the clinical criteria; however, between years 2 and 3, gradual roughening of the occlusal surface occurred in some of the ceramic‐ceramic crowns, possibly caused by dissolution and wear of the glaze. Statistically significant differences in surface texture (p= 0.0013) and crown wear (p= 0.0078) were found at year 3 between the metal‐ceramic crowns and the lithium‐disilicate‐based crowns. Conclusion : Based on the 11 criteria, the clinical performance of ceramic‐ceramic crowns was comparable to that of the metal‐ceramic crowns after 2 years; however, gradual roughening occurred between years 2 and 3, which resulted in differences in surface texture and wear.     

A 30‐Year Follow‐Up of a Patient with Mandibular Complete‐Arch Fixed Implant‐Supported Prosthesis on 4 Implants: A Clinical Report

Mandibular complete‐arch fixed implant‐supported prostheses are recognized as one of the earliest and most popular prostheses in implant dentistry. This prosthesis was the main focus in the early era of osseointegration. Despite its widespread popularity, few clinical reports have described long‐term follow‐up greater than 10 years for this type of prosthesis. This report describes a 30‐year follow‐up of a patient who underwent treatment for a mandibular complete‐arch fixed implant‐supported prosthesis with 4 machined surfaced implants, opposing a maxillary complete denture. This report documents a variety of photographs and radiographs taken over a period of 30 years to compare bone levels at various stages of care and maintenance, including de novo bone formation underneath the distal cantilevers due to functional loading. The biologic and biomechanical response to this treatment protocol and long‐term clinical observations and prosthodontic outcome and maintenance needs are also addressed.     

Is a Fixed Hybrid Prosthesis with Distal Cantilever Appropriate for Maxillofacial Defects? A Report of Two Patients

The most important objectives in restoring the maxillofacial patient are the restoration of function and psychological improvement through esthetics. Acquired maxillary and mandibular defects due to significant trauma or surgery represent a major challenge for the clinician and patient. Dental implant‐retained prostheses represent a well‐documented and reliable treatment option and can also help patients with maxillofacial defects by eliminating denture instability and improving function. Full‐arch fixed dental hybrid prostheses provide functional and psychological advantages and also reduce the load on vulnerable soft and hard tissues in the reconstruction area. Two clinical reports are presented describing the prosthetic rehabilitation using dental implant‐supported fixed hybrid prostheses with clinical and radiographic follow‐up of 3 years.     

Fractographic features of glass‐ceramic and zirconia‐based dental restorations fractured during clinical function

Fractures during clinical function have been reported as the major concern associated with all‐ceramic dental restorations. The aim of this study was to analyze the fracture features of glass‐ceramic and zirconia‐based restorations fractured during clinical use. Twenty‐seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass‐ceramic restorations and 13 zirconia‐based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all‐ceramic single‐tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass‐ceramic, and alumina single‐tooth restorations. Design features seem to be of great importance for fracture initiation.     

Implant‐Supported Fixed Dental Prostheses with CAD/CAM‐Fabricated Porcelain Crown and Zirconia‐Based Framework

Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant‐supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold‐platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax‐up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax‐up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic‐related clinical problems such as chipping and fracture and associated complicated repair procedures in implant‐supported FDPs.     

Full Mouth Rehabilitation with Maxillary Tooth Supported and Mandibular Tooth and Implant Supported Combination Prostheses: A 4-Year Case Report

The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious leverages exerted by the fixed prosthesis by using non rigid components and to equalize the stress applied by the prosthesis on implant and teeth. A case of partially edentulous situation was rehabilitated successfully with a combination of prostheses. Maxillary arch was restored to function with crowns, fixed dental prosthesis and with an extra coronal castable attachment prosthesis and the mandibular arch with a combination of tooth and implant supported attachment prosthesis. The clinical and laboratory steps for the fabrication of these prostheses are explained in this report.     

Clinical evaluation of cemented and adhesively resin-bonded monolithic and partially layered zirconia and lithium disilicate crowns

PurposeZirconia and lithium disilicate crowns are very popular dental restorations. The cement type and layering technique used can profoundly affect the clinical performance of these crowns.This retrospective study is designed to investigate the success rate of cemented and adhesively bonded monolithic and partially layered zirconia and lithium disilicate crowns placed in faculty practice settings.Materials and MethodsPatients who had received zirconia or lithium disilicate crowns at the faculty practice were invited for clinical examination. The examiner used the modified United States Public Health Service (MUSPHS) evaluation criteria to evaluate the crowns. The crowns were either glass ionomer cemented zirconia (GIC-Zr), resin-bonded zirconia (Adh-Zr), or resin-bonded lithium disilicate (Adh-LD). The crowns were also divided into monolithic and layered groups. Inferential analysis was used to examine the differences through bivariate analysis using t-testing and one-way ANOVA.ResultsThirty-five patients, with a combined total of 218 single crowns, agreed to participate in the study. No statistically significant differences in the quality outcome variables considered were found between the groups, except for marginal adaptation, where Adh-Zr achieved significantly higher scores compared to GIC-Zr and Adh-LD. Layered zirconia and lithium disilicate crowns have significantly higher quality outcomes in terms of anatomic form, marginal adaptation, and color match compared to monolithic zirconia and lithium disilicate crowns.ConclusionsConventionally cemented zirconia and adhesively bonded zirconia and lithium disilicate crowns are reliable treatment options with high short-term success rates. Clinical studies with longer follow-up times are needed to investigate their long-term success rates.     

Electromyographic analysis of masticatory and neck muscles in subjects with natural dentition, teeth-supported and implant-supported prostheses

Objectives: To compare the electromyographic (EMG) characteristics of masticatory and neck muscles in patients with natural dentition, teeth‐supported prostheses and implant‐supported prostheses. Materials and methods: Twenty‐five subjects aged 40–80 years were examined. Five patients had maxillary and mandibular implant‐supported fixed prostheses; five patients had mandibular implant‐supported fixed prosthesis and maxillary removable complete denture; seven patients had implant‐supported fixed prosthesis (one arch) and natural dentition or full‐arch tooth‐fixed prosthesis (one arch); and eight control subjects had natural dentition or single tooth‐fixed prostheses. Surface EMG of masseter, temporal and sternocleidomastoid muscles was performed during maximum teeth clenching and unilateral gum chewing. Interarch dental contacts were assessed with shim stocks. Results: All groups had similar interarch dental contacts (P>0.05). During clenching, patients with maxillary and mandibular implant‐supported fixed prostheses had unbalanced standardized masseter and temporalis anterior activities (74%), with significantly larger values found in the other patients and control subjects (all mean values larger than 86%, P=0.017). All patients chewed with significantly larger muscular potentials than control subjects (on average, 1434–2100 μV s vs. 980 μV s, P=0.04), and had altered muscular patterns (left side, P=0.021). The patients with one arch with natural dentition/tooth fixed prostheses had chewing muscular patterns similar to the control subjects. Conclusions: Clenching with the analyzed prostheses was performed with a relative increment of temporalis activity. Neuromuscular coordination during chewing was larger in patients who maintained their teeth or dental roots, independently from the number of dental contacts.     

Prosthetic Rehabilitation and Management of an MTA‐Treated Maxillary Central Incisor with Root Perforation and Severe Internal Resorption

Root canal perforation and root resorption are challenging clinical conditions to correctly diagnose and treat, especially when they occur in anterior teeth. This clinical report describes the computed tomography findings, endodontic treatment, prosthetic rehabilitation, and clinical outcome of an iatrogenic root perforation and internal resorption in a maxillary central incisor. The case management consisted of endodontic retreatment, periodontal surgery, and prosthetic rehabilitation. Gray mineral trioxide aggregate (MTA) was used to fill the resorption space and seal the perforation. The prosthetic treatment was performed with glass fiber‐reinforced dowels and all‐ceramic crowns. No signs or symptoms, including discomfort, pain, or esthetic defects were observed in 30 months of follow‐up.     

Six‐Year Survival of a Mini Dental Implant‐Retained Overdenture in a Child with Ectodermal Dysplasia

Patients with ectodermal dysplasia (ED) experience several problems caused by abnormal development and functioning of the head and neck region. In addition to developmental nasal cartilage abnormalities and absence of sweat glands, hair, and eyebrows, edentulism or developmental disorders of teeth (cone‐shaped teeth) are commonly observed in these types of patients. ED is also characterized by underdeveloped alveolar ridges, a decreased occlusal vertical dimension, reduced salivary secretion, and dry oral mucosa, which make prosthetic rehabilitation difficult. Few studies of intraosseous dental implant‐retained prostheses have described adverse effects on craniofacial growth and esthetic and functional disadvantages, while some researchers have described the advantages of this treatment option as an alternative option in these cases. Due to the associated alveolar bone deficiency, dental mini‐implant therapy may be a treatment option for these patients; however, there are isolated cases in the literature regarding the rehabilitation of ED patients with mini‐implant‐supported overdentures. This clinical report describes the rehabilitation of a 6‐year‐old child with ED using a maxillary removable partial prosthesis and a mini‐implant‐retained mandibular overdenture. The clinical and radiographic findings of this prosthetic rehabilitation during the 6‐year follow‐up are also presented.     

Management of a Fractured Multiunit Maxillary Implant‐Supported Fixed Prosthesis with Stripped Abutment Screws Using a Hybrid Cement‐Retained and Screw‐Retained Design: A 5‐Year Follow‐Up Clinical Report

Fracture and loosening of implant‐supported prostheses (ISPs) are complications encountered in routine dental practice. In the present report, management of a fractured maxillary full‐arch cement‐retained (CR) fixed dental prosthesis supported by six implants is presented. Due to stripped screws, complications were encountered that prevented the retrieval of two of the six abutment screws, which was managed by using a hybrid retention approach, whereby a single full‐arch CR and screw‐retained (SR) ISP was used. The techniques used to successfully retrieve four of the abutment screws are described. The final retention design involved a combination of three CR and three SR restorations, which offers the advantages of both retention designs.     

Fracture Loads of All‐Ceramic Crowns under Wet and Dry Fatigue Conditions

Purpose: The aim of this study was to test the hypothesis that fracture loads of fatigued dental ceramic crowns are affected by testing environment and luting cement. Materials and Methods: One hundred and eighty crowns were prepared from bovine teeth using a lathe. Ceramic crowns were prepared from three types of ceramic systems: an alumina‐infiltrated ceramic, a lithia‐disilicate‐based glass ceramic, and a leucite‐reinforced ceramic. For each ceramic system, 30 crowns were cemented with a composite resin cement, and the remaining 30 with a resin‐modified glass ionomer cement. For each ceramic system and cement, ten specimens were loaded to fracture without fatiguing. A second group (n = 10) was subjected to cyclic fatigue and fracture tested in a dry environment, and a third group (n = 10) was fatigued and fractured in distilled water. The results were statistically analyzed using one‐way ANOVA and Tukey HSD test. Results: The fracture loads of ceramic crowns decreased significantly after cyclic fatigue loading (p≤ 0.05); furthermore, fracture loads of crowns fatigued in a wet environment were statistically lower than those in a dry environment (p < 0.05). Crowns luted with a composite resin cement showed statistically greater fracture loads than those luted with a resin‐modified glass ionomer cement (p≤ 0.05). Conclusions: Fracture load of the three ceramic systems was found to be influenced by ceramic composition. Moreover, cement and fatigue condition influenced the fracture loads of the crown specimens evaluated in this study.     

Within-subject comparison of maxillary long-bar implant-retained prostheses with and without palatal coverage: patient-based outcomes

Although maxillary implant overdentures are used in oral rehabilitation, different designs have not been compared previously in clinical trials. This crossover trial was designed to measure differences in patient satisfaction with maxillary long-bar implant overdentures with and without palatal coverage opposed by a fixed mandibular implant-supported prosthesis. Data were also gathered on new conventional dentures and on maxillary conventional dentures opposed by mandibular fixed prostheses. Sixteen participants were selected from a population wearing conventional dentures. Fifteen received new upper and lower dentures (1 drop-out). Four implants were placed in the maxilla and mandible (2 drop-outs). A mandibular fixed prosthesis was inserted in 13 participants, who were then divided into 2 groups. One group (n = 7) received long-bar overdentures with palate, then long-bar overdentures without palate. The other group (n = 6) received the same treatments in the reverse order. Mastication tests and psychometric evaluations using Visual Analog Scales and Categorical Scales were performed throughout the study. General satisfaction was very high with both maxillary implant-supported prostheses, as were ratings of almost all psychosocial and functional variables. There were no significant differences between treatments, suggesting that patients are equally satisfied with long-bar overdentures with and without palate when these are opposed by mandibular fixed prostheses. However, the ratings given to the maxillary implant prostheses were not significantly higher than for new conventional maxillary prostheses. This suggests that maxillary implant prostheses should not be considered as a general treatment of choice in patients with good bony support for maxillary conventional prostheses.     

Esthetic Rehabilitation of Retained Primary Teeth—A Conservative Approach

With the advancement in ceramic restorations bonded to tooth structure, the treatment has become a feasible and conservative option to restore teeth with alteration in shape when owing to high demand in esthetics, with or without minimum tooth preparation. This article describes a report of a 32‐year‐old woman who was dissatisfied with her smile. The patient reported that she still had deciduous teeth, and that the maxillary lateral incisors had been restored with direct resin composite to correct the teeth shape. After discussing the restorative possibilities, a decision was made to place all‐ceramic crowns (lithium disilicate glass‐ceramic) with minimal tooth preparation, which figures as a conservative full‐coverage approach. An esthetic outcome resembling a natural‐looking smile resulted in the patient's satisfaction. Bonding of all‐ceramic crowns onto minimally prepared deciduous teeth figures as a conservative treatment in case of partial anodontia, which decreases the chance of root resorption induced by trauma and benefits from good adhesion to enamel.     

Strength and fracture pattern of monolithic CAD/CAM-generated posterior crowns.

OBJECTIVES: This study evaluated the strength and fracture pattern of monolithic posterior CAD/CAM crowns hypothesizing that zinc-phosphate cemented lithium disilicate crowns might show the same fracture strength as adhesively cemented crowns. METHODS: Two sets of monolithic posterior crowns each with uniform occlusal and lateral wall thickness of 1.5mm were fabricated from three types of block ceramic (1) lithium disilicate glass, (2) leucite glass and (3) feldspathic ceramic using CEREC 3 CAD/CAM. Crowns (n = 15) of ceramics (1), (2) and (3) each were (A) zinc-phosphate cemented, (B) adhesively cemented on resin-based composite dies and loaded until fracture. Load data was analyzed using ANOVA and Scheffé tests. Crack pattern was evaluated on an additional three sample cross-sections for each group at start of fracture. RESULTS: Radial cracks originated early at the cementation interfaces and cone cracks were observed finally at the loading sites. Mean load values (SD) of A-crowns at fracture start/end (1) 807 (91) N/2082 (192) N; (2) 915 (193) N/1130 (166) N; (3) 985 (199) N/1270 (301) N were all significantly (P < 0.001) lower when compared to their B-crown analogs (1) 1456 (205) N/2389 (84) N; (2) 1684 (395) N/2469 (171) N; (3) 1548 (304) N/2392 (75) N, rejecting the authors hypothesis. A-1 crowns had significantly (P < 0.001) higher fracture load than A-2 and A-3 crowns. The A-1 crown fracture load data, even if significantly (P < 0.001) lower, came close to the B-1 values. SIGNIFICANCE: Adhesive cementation balanced the strength of weak ceramics with that of strong ceramic and recommended itself for leucite glass ceramic and feldspathic ceramic crowns. Zinc-phosphate cementation appeared feasible for lithium disilicate crowns.     

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目的    探讨Vita In-Ceram Zirconia渗透陶瓷全瓷修复体的修复效果 ,为临床应用提供参考。方法    对2008年3—5月广东省深圳牙科医疗中心门诊收治的59例接受全瓷修复的患者,共使用Vita In-Ceram Zirconia渗透陶瓷全瓷修复体81件 ,其中上颌61件 ,下颌20件;前牙全冠44个 ,后牙全冠27个 ,前牙固定桥4个, 后牙固定桥6个。通过3～24个月的观察 , 采用美国加利福尼亚牙科学会的质量评价体系对Vita In-Ceram Zirconia渗透陶瓷前、 后牙全冠与前、后牙固定桥修复进行临床效果评价。结果    观察期间失访2例患者4件修复体,对剩余57例患者77件修复体的临床观察结果表明 , Vita In-Ceram Zirconia 渗透陶瓷全冠具有良好的边缘密合性 ,色泽稳定 ,强度高 ,其失败率为0.030 %。结论    在严格选择适应证的前提下,Vita In-Ceram Zirconia渗透陶瓷修复是一种效果良好的全瓷修复方式。