Influence of enamel preservation on failure rates of porcelain laminate veneers.
The purpose of this study was to evaluate the failure rates of porcelain laminate veneers (PLVs) and the influence of clinical parameters on these rates in a retrospective survey of up to 12 years. Five hundred eighty laminate veneers were bonded in 66 patients. The following parameters were analyzed: type of preparation (depth and margin), crown lengthening, presence of restoration, diastema, crowding, discoloration, abrasion, and attrition. Survival was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict PLV failure. Forty-two veneers (7.2%) failed in 23 patients, and an overall cumulative survival rate of 86% was observed. A statistically significant association was noted between failure and the limits of the prepared tooth surface (margin and depth). The most frequent failure type was fracture (n = 20). The results revealed no significant influence of crown lengthening apically, presence of restoration, diastema, discoloration, abrasion, or attrition on failure rates. Multivariable analysis (Cox regression model) also showed that PLVs bonded to dentin and teeth with preparation margins in dentin were approximately 10 times more likely to fail than PLVs bonded to enamel. Moreover, coronal crown lengthening increased the risk of PLV failure by 2.3 times. A survival rate of 99% was observed for veneers with preparations confined to enamel and 94% for veneers with enamel only at the margins. Laminate veneers have high survival rates when bonded to enamel and provide a safe and predictable treatment option that preserves tooth structure.
New York University College of Dentistry, New York, NY, USA. dentis@superonline.com
Galip
G
Gurel
Newton
N
Sesma
Marcelo A
MA
Calamita
Christian
C
Coachman
Susana
S
Morimoto
D000328:Adult; D000368:Aged; D000538:Aluminum Silicates / Q000737:chemistry; D016556:Crown Lengthening; D001840:Dental Bonding / Q000379:methods; D003743:Dental Enamel / Q000473:pathology*; D003776:Dental Porcelain / Q000737:chemistry*; D019232:Dental Restoration Failure; D003801:Dental Veneers; D003804:Dentin / Q000473:pathology; D003970:Diastema / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000473:pathology; D008875:Middle Aged; D017680:Potassium Compounds / Q000737:chemistry; D019279:Resin Cements / Q000737:chemistry; D012189:Retrospective Studies; D016019:Survival Analysis; D014072:Tooth Abrasion / Q000473:pathology; D019217:Tooth Attrition / Q000473:pathology; D014075:Tooth Discoloration / Q000473:pathology; D019231:Tooth Preparation, Prosthodontic / Q000379:methods*; D055815:Young Adult
D000538:Aluminum Silicates; D017680:Potassium Compounds; D019279:Resin Cements; D003776:Dental Porcelain; C016447:feldspar