Clinical longevity of ceramic laminate veneers bonded to teeth with and without existing composite restorations up to 40 months

Abstract

This study evaluated the survival rate of ceramic laminate veneers bonded to teeth with and without existing composite restorations (ECR). Twenty patients (mean age: 49.7 years) received 92 feldspathic ceramic laminate veneers (Shofu Vintage AL) on the maxillary teeth (intact teeth: n = 26; teeth with ECR: n = 66). Preparations with incisal overlap were made, and ECR of good quality were not removed but conditioned using silica coating (CoJet) and silanization (ESPE-Sil). Enamel and dentin were etched with 38% H3PO4 for 15-30 s and rinsed 30 s; adhesive resin (Excite) was applied, and laminate veneers were then cemented (Variolink Veneer). Restorations were evaluated at baseline and thereafter every 6 months using modified United States Public Health Service criteria. Mean observation period was 21.6 months. Overall, five absolute failures were encountered (fractures: n = 3; chipping: n = 1; debonding: n = 1), resulting in a survival rate of 94.6% (Kaplan-Meier). Survival rates of the laminates bonded to teeth without (96%) and with ECR (93.5%) did not show significant differences (p > 0.05). Slight marginal defects (16 of 87 laminates) and slight marginal discoloration at the margins were noted (12 of 87 laminates) until the final recall. Secondary caries and endodontic complications were not detected in any of the teeth. The clinical survival of ceramic laminate veneers up to 40 months was not significantly influenced when they were bonded onto intact teeth or onto teeth with ECR. When no caries is present, it may not be necessary to replace existing composite restorations prior to cementation of ceramic laminate veneers.