Effect of Preparation Designs on the Prognosis of Porcelain Laminate Veneers: A Systematic Review and Meta-Analysis.

Abstract

To investigate the association between preparation designs and prognosis of porcelain laminate veneers (PLVs). Electronic and manual literature searches were performed in Medline, Embase, CENTRAL, and Scopus databases for randomized controlled trials and retrospective and prospective cohort studies comparing any two of three preparation designs. The quality of the included studies was assessed using the Newcastle-Ottawa scale. Pooled hazard ratios and risk ratios were used to evaluate the difference between two preparation designs. Subgroup analyses, sensitivity analysis, and evaluation of publication bias were performed if possible. Of 415 screened articles, 10 studies with moderate to high quality were included in the meta-analysis. Comparison of preparations with incisal coverage to preparations without coverage revealed a significant result based on time-to-event data (hazard ratio=1.81, 95% confidence interval [CI]=1.18-2.78, I2=12.5%), but the result was insignificant based on dichotomous data (risk ratio=1.04, 95% CI=0.59-1.83, I2=42.3%). The other comparisons between any two of overlap, butt-joint, and window types revealed no statistically significant difference. Subgroup analyses regarding the porcelain materials, location of prosthesis, and tooth vitality could account for only part of the heterogeneity. No evidence of publication bias was observed. Within the limitation of the present study, it can be concluded that preparation design with incisal coverage for PLVs exhibits an increased failure risk compared to those without incisal coverage. The failure risk of the overlap type may be higher than the butt-joint type but must be validated in further studies.