An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: Influence of occlusal splint in patients with bruxism

Abstract

The aim of this study was to perform a 8-year prospective clinical investigation on the survival rate of feldspathic ceramic veneers, as well as analyse the influence of the occlusal splint in patients with parafunctional bruxism. METHODS Three hundred and sixty-four veneers fabricated using conventional feldspathic ceramic were provided in 64 patients. The patient sample included 40 individuals with bruxism. During the follow-up period, the effect of wearing the occlusal splint on the incidence of failure (fracture and/or debonding) in patients with bruxism was also assessed. The survival rate of veneers was determined using the Kaplan-Meier estimator. Statistical significance was set at p < 0.05 with a confidence interval of 95%. RESULTS The occurrence of fracture for the feldspathic veneers tested in this study was 7.7%, while only 1.9% of the total number of veneers debonded. The overall survival rate was 93.7% after 3 years, 91% after 5 years, and 87.1% after 8 years. Patients with bruxism using an occlusal splint showed a survival rate of 89.1% after 7 years, while the survival rate in patients with bruxism using no occlusal splint was 63.9% (p < 0.05). CONCLUSION This study confirmed that feldspathic veneers may represent a suitable clinical solution for indirect aesthetic restorations. Such a treatment may be an option also for those patients affected by bruxism, as long as they regularly wear an occlusal splint. However, patients with bruxism using no occlusal splint may still present a potential high-risk of failure and/or debonding.

Rehabilitation of the frontal teeth with palatal veneers by using T-Scan occlusal analysis - case report

“…The majority of clinical studies reviewed report a low incidence of fractures. However, other authors indicate a much higher rate of fractures, especially in case of bruxism [20].…”

A Utilização De Laminados Cerâmicos Em Pacientes Com Bruxismo

“…Em casos de desgastes palatinos, lingual e vestibular as facetas são uma opção adequada para tratamento em paciente bruxista, pois temos um resultado previsível quando se refere à estética e função 9,[25][26] .…”

“…Tal desafio e associação restauradora tem-se apresentado dificultosa devido à multifatoriedade do bruxismo, a intensidade da força gerada sobre os tecidos dentários e a ausência de "cura" do hábito. Essa combinação possui uma linha tênue visto que, apesar de possuírem boas características físicas e químicas, a utilização desses foliados dentários mostra-se frágil 9 .…”

“…Nos termos de Lima 6 , os cinco processos a Nesses casos, associado à terapêutica restauradora, em alguns casos é necessário o acompanhamento multidisciplinar com outros profissionais da saúde dentro e fora da odontologia e também o uso de métodos e tratamentos auxiliares como a placa miorrelaxante, botox, atividade física e acompanhamento profissional 6,36 . Autores confirmam ser de suma importância a participação de outros profissionais para o tratamento e acompanhamento do paciente e do uso de placa protetora pós-implantação das lentes evitando futuras fraturas 9 .…”

“…Apesar das cerâmicas odontológicas apresentarem alta resistência, biocompatibilidade e estética [7][8][9] . O tratamento restaurador para este fenômeno parafuncional é ainda discutível, sendo de responsabilidade do cirurgião dentista conscientizar o paciente da sua real situação e explicando-o sobre as possibilidades terapêuticas.…”