Invasive Veneers Research Articles

A prospective comparative analysis of the survival rates of conventional vs no-prep/minimally invasive veneers over a mean period of 9\xa0years

ObjectivesThe present study compares the survival rates of 186 conventional and no-prep/minimally invasive porcelain veneers in 35 patients over a mean period of 9 years.Materials and methodsThe veneers were placed on the incisors, canines, and premolars in 35 patients between January 2009 and December 2010. Fourteen patients received 84 conventional veneers, and 21 patients received 102 no-prep/minimally invasive veneers. The restorations were evaluated at baseline and after every 6 months until June 2019 based on modified United States Public Health Service criteria. The data was analyzed by using Wilcoxon–Breslow–Gehan and Taron–Ware tests. Kaplan–Meier survival and success curves were plotted for two groups of veneers. The results were compared by using the log rank test. A test probability of P < .05 was regarded as significant, while a test probability of P < .01 was considered to be statistically significant.ResultsThe mean survival rate, according to the Kaplan–Meier estimator, was 9.67% for conventional veneers and 100% for the no-prep or minimal prep veneers. A total of ten absolute failures were observed in six patients: eight restoration chipping/fractures, one debonding, and one fracturing of the tooth. Mean success rate time for conventional veneers without absolute or relative failures was 9.32 years, and 10.28 years for no-prep/minimally invasive veneers.ConclusionsOver a mean observation period of 9 years, the survival rate of no-prep/minimally invasive veneers exceed that of conventional veneers.Clinical relevanceNo-prep/minimally invasive veneers appear very effective and should always be considered in certain clinical situations.

Direct or Indirect Restoration of Endodontically Treated Maxillary Central Incisors with Class III Defects? Composite vs Veneer or Crown Restoration.

The aim of this ex-vivo study was to evaluate the load capacity of direct or indirect endodontically restored maxillary central incisors with Class III defects, with or without glass-fiber posts. Seventy-two extracted human maxillary central incisors were endodontically treated and bi-proximal Class III cavities were prepared. Specimens were randomly allocated to six groups (n = 12): direct restoration with composite (C); direct restoration with composite and additional glass-fiber post (CP); ceramic veneer restoration (V), ceramic veneer restoration and additional glass-fiber post (VP), ceramic crown restoration (Cr), ceramic crown restoration and additional glass-fiber post (CrP). Specimens were exposed to thermomechanical loading (TML: 1.2 million cycles, 1 to 50 N; 6000 thermal cycles between 5°C and 55°C for 1 min each), and subsequently linearly loaded until failure (Fmax [N]) at an angle of 135 degrees 3 mm below the incisal edge on the palatal side. Statistical tests were performed using the Kruskall-Wallis and Mann-Whitney U-Test. During dynamic loading by TML, one early failure occurred in group C, CP, and CrP. Subsequent linear loading resulted in mean fracture load values [N] of C = 483 ± 219, CP = 536 ± 281, V = 908 ± 293, VP = 775 ± 333, Cr = 549 ± 258, CrP = 593 ± 259. The Kruskal-Wallis test showed significant differences of load capacity between groups (p < 0.05). Mann-Whitney U-test revealed significantly lower maximum fracture load values of group C compared to group V (p = 0.014), after Bonferroni-Holm correction. Non-restorable root fracture was the most frequent type of failure. Endodontically treated maxillary central incisors with Class III defects directly restored with composite are as loadable as indirect crown restorations. Compared to full-coverage restorations, less invasive veneers appear to be more beneficial. Additional placement of glass-fiber posts shows no positive effect.

No-Preparation and Minimally Invasive Veneers in Clinical Practice : Part 1

No-Preparation and Minimally Invasive Veneers in Clinical Practice : Part 1

Bleaching Discoloured Teeth

The bleaching of teeth has encountered some legislative problems over the past few years but it is now possible to use both vital and non-vital bleaching techniques in the UK. Hydrogen peroxide has a long history of use and would appear to be safe to use to change the appearance of discoloured teeth. It is conservative of tooth tissue and may delay the need for more invasive veneers and crowns. This article describes some of the methods of bleaching using hydrogen peroxide that are currently available.