Abstract
The clinical performance of ceramic veneers is influenced by various clinical and material-related factors. Retrospective evaluation of extensive anterior ceramic veneers in the upper and lower jaw 36 months after placement in a private practice. Thirty-seven patients (21 female, 16 male) were restored with adhesively luted extensive ceramic veneers made from a heat-pressed ceramic (Cergo, DeguDent, Hanau, Germany). One dentist restored a total of 130 teeth (maxilla N = 76, mandible N = 54). Adhesive cementation was performed with an etch-and-rinse adhesive (Optibond FL, Kerr Hawe, Karlsruhe, Germany) and a dual-curing composite cement. After 36 months, the survival rate (in situ criteria) according to Kaplan-Meier was 95.1% (95% confidence interval [CI]: 0.88; 1). Reasons for failure were four ceramic fractures and one biological failure in five restored teeth. Of the restorations, 92.8% (95% CI: 0.86;1) were in service without any clinical intervention and rated successful after 36 months. Interventions were necessary in five cases (three recementations, two endodontic treatments). Clinical performance was not influenced by the veneer position (maxillar/mandibular, survival p = 0.3/success p = 0.4). Veneers with more than 50% of exposed dentin demonstrated a significantly increased risk (hazard ratio 10.6, p = 0.026) for a clinical intervention (recementation, endodontic treatment), whereas no effect on the survival rate could be detected (p = 0.17). After 36 months of clinical service, extensive veneer restorations made of a pressable ceramic showed a comparable survival and success rate in the upper and lower jaw. Large areas of exposed dentin (>50%) were associated with lower success rates. Mandibular ceramic veneers made using a heat-pressed ceramic offer the same clinical reliability as do veneers on anterior maxillary teeth. Dentin exposure significantly affects the clinical performance of heat-pressed ceramic veneers.
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