A 25-Year Retro-prospective Study on Prosthetic Rehabilitation with Bonded Ceramics of Patients with Amelogenesis Imperfecta.

Abstract

The purpose of the study was to examine the long-term performance of bonded all-ceramic restorations, veneers in particular, in patients with Amelogenesis Imperfecta (AI). There are few studies of long-term outcome using a minimally invasive procedure in these patients. This aspect is essential when treating young patients. All-ceramic restorations, especially veneers, offer a more tissue-preserving treatment but rely on a successful bonding. Due to the defect enamel in AI patients, the bond strength is however lower. A retro-prospective evaluation of 40 subjects with AI (26 women, 14 men) was provided with a total of 360 bonded restorations (282 veneers, 78 crowns). The restorations were evaluated according to complications, survival- and success rate. The patients were observed up to 25,3 years (mean 15,4 ± 4,3 years). The mean age when receiving the restorations was 18,5 (± 4,2) years. There had been 59 (16,4%) restorations with prosthetic complications of which 29 (8.1%) had been remade (6 due to esthetic reasons, all in one patient) and 30 (8.3%) recemented (60% caused by trauma). We found 11 teeth with caries and 3 with endodontic complications. The over-all survival rate was 91,9% and the over-all success rate was 83,6%. Bonded all-ceramic restorations with no active retention in AI patients perform excellent. The most common complications were debonding and fractures. The treatment should be on individual indications and been preceded by a multidisciplinary approach.