A clinical longitudinal study 323 porcelain laminate veneers. Period of study from 3 to 11 years

Abstract

Objective: The objective of this study was to evaluate the clinical results of 323 porcelain laminate veneers over a period of 3 to 11 years. Material and Methods: This study included 70 patients, aged between 18 and 74 years. Of the 323 total veneers, 124 were of a simple design and 199 were of a functional design. The condition of the soft tissues and hygiene, in addition to the condition of the abutment teeth, the restorations and patient satisfaction were all clinically examined. In carrying out the statistical analysis, a descriptive approach was taken in analyzing the data. The Kaplan Meier method was used for statistically analyzing the survival rates of the porcelain laminate veneers. Results: Analysis of the soft tissue revealed marginal recession in 7.7% of the cases, and in 21.6% of the cases, bleeding was detected on probing. Analysis of the condition of the abutment teeth revealed secondary caries and hypersensitivity in 3.1% of the cases, and changes in pulp vitality were observed in 2.8% of the cases. In studying the condition of the restorations, marginal integrity was observed to be excellent in 98% of the cases, slight marginal pigmentation was present in 39.3% of the cases, fractures were present in 4% of the cases and decementation in 9% of the cases. The degree of patient satisfaction was considered to be excellent in 97.1% of the cases. Conclusions: Porcelain laminate veneers are a predicable treatment option that offer excellent results.

Incisal coverage or not in ceramic laminate veneers: A systematic review and meta-analysis

“…Smales and Etemadi (21) considered incisal coverage a protective factor; on the other hand, Granell-Ruiz et al (9) and Gürel et al (12) reported incisal coverage to be a risk factor for failures. Gürel et al (12) affirmed that the incisal coverage increased the chance of ceramic laminate veneer failure by 2.3 times.…”

“…On the other hand, incisal edge preparation was considered unnecessary to ensure or improve restoration strength, as this thin palatal extension tended to show more cracks. This occurred because the fracture lines propagated due to repeated heavy mechanical loading, that eventually led to a large porcelain fracture in this region (9,16,18). However, there was no consensus about the most indicated preparation design, with or without incisal coverage, and the type of palatal design (butt joint or palatal chamfer) (2, 3, 5-7, 9, 10, 12, 14-16, 18-21).…”

“…Ceramic laminate veneer failures usually occurred either because of fractures or debonding, and these failures can be minimized by careful selection of patients; minimal and homogeneous ceramic thickness; minimal luting composite thickness; a favorable thickness ratio between the porcelain and luting cement; application of a modern adhesive, and satisfactory veneer fabrication. In addition, careful evaluation of occlusion and articulation are always necessary; they require frequent monitoring, and an auxiliary preventive procedure, for example, muscle relaxants and occlusal splints (9,12,18).…”

“…Three articles were kept for the OR analysis of the Group with incisal coverage preparation in comparison with the Group without incisal coverage-preparation (9,12,21). Incisal coverage presented an OR of 1.25 (95% CI: 0.33 -4.73; I²= 65.3%; p= 0.0562); however, it was not statistically significant (36 failures in veneers with incisal coverage out of 506 veneers, and 28 failures in veneers without incisal coverage out of 507 out veneers evaluated) (Fig.…”

“…After evaluating the titles and abstracts, and eliminating duplicates, 181 articles were considered for full-text review. Finally, eight articles (7,9,12,14,15,18,21,23) were included (Fig. 1) for quantitative (Figs.…”