title: Clinical performance of porcelain laminate veneers for up to 20 years.
abstract: OBJECTIVE
  The aim of this clinical retrospective study was to evaluate the clinical quality, success rate, and estimated survival rate of anterior veneers made of silicate glass-ceramic in a long-term analysis of up to 20 years.
  
  
  METHODS
  Anterior teeth in the maxillae and mandibles of 84 patients (38 men, 46 women) were restored with 318 porcelain veneer restorations between 1987 and 2009 at the Medical University Innsbruck, Innsbruck, Austria. Clinical examination was performed during patients' regularly scheduled maintenance appointments. Esthetic match, porcelain surface, marginal discoloration, and integrity were evaluated following modified California Dental Association/Ryge criteria. Veneer failures and reasons for failure were recorded. The study population included 42 (50.0%) patients diagnosed with bruxism and 23 (27.38%) smokers. The success rate was determined using Kaplan-Meier survival analysis.
  
  
  RESULTS
  The mean observation time was 118 ± 63 months. Twenty-nine failures (absolute: 82.76%, relative: 17.24%) were recorded. The main reason for failure was fracture of the ceramic (44.83%). The estimated survival rate was 94.4% after 5 years, 93.5% at 10 years, and 82.93% at 20 years. Nonvital teeth showed a significantly higher failure risk (P = .0012). There was a 7.7-times greater risk of failure associated with existing parafunction (bruxism, P = .0004). Marginal discoloration was significantly greater in smokers (P ⋜ .01).
  
  
  CONCLUSIONS
  Porcelain laminate veneers offer a predictable and successful restoration with an estimated survival probability of 93.5% over 10 years. Significantly increased failure rates were associated with bruxism and nonvital teeth, and marginal discoloration was worse in patients who smoked.
authors.affiliation: Clinical Department of Restorative and Prosthetics Dentistry, Innsbruck Medical University, Austria. ulrike.beier@i-med.ac.at
authors.forename: Ulrike Stephanie
authors.initials: US
authors.lastname: Beier
authors.forename: Ines
authors.initials: I
authors.lastname: Kapferer
authors.forename: Doris
authors.initials: D
authors.lastname: Burtscher
authors.forename: Herbert
authors.initials: H
authors.lastname: Dumfahrt
mesh_terms: D000328:Adult; D000538:Aluminum Silicates / Q000737:chemistry; D002012:Bruxism / Q000150:complications; D002516:Ceramics / Q000737:chemistry; D003116:Color; D003481:Cuspid; D018772:Dental Marginal Adaptation; D003776:Dental Porcelain / Q000737:chemistry / Q000592:standards; D019232:Dental Restoration Failure; D003801:Dental Veneers / Q000592:standards; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor; D008297:Male; D010512:Periodontal Index; D017680:Potassium Compounds / Q000737:chemistry; D012189:Retrospective Studies; D012907:Smoking; D013499:Surface Properties; D016019:Survival Analysis; D019553:Tooth, Nonvital / Q000150:complications
chemical_list: D000538:Aluminum Silicates; D017680:Potassium Compounds; C493120:lithia disilicate; D003776:Dental Porcelain; C016447:feldspar; C078519:leucite; C023506:Glass ceramics