The effect of veneers on cosmetic improvement

The Effect of Various Preparation and Cementation Techniques of Dental Veneers on Periodontal Status: A Systematic Review and Meta-Analysis

Dental veneers are widely used to restore or/and enhance dental aesthetics. However, it is not well understood how various veneer preparation and cementation methods affect periodontal health. To provide a quantitative estimate of the overall effect size of the intervention, this study was conducted to synthesize the available evidence on the impact of various dental veneer preparation and cementation methods on periodontal status. A thorough search strategy was implemented using Medical Subject Headings keywords and Boolean operators across various major databases, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Nine papers were ultimately selected for inclusion in the review. Seven studies demonstrated a positive impact of dental veneers on overall periodontal health, while two studies reported a slight worsening. The forest plot analyses showed a somewhat protective effect of dental veneers on periodontal health, with odds ratio of 0.18 and relative risk of 0.34, suggesting that dental veneers may have a positive impact on overall periodontal health. The current study, with considerable heterogeneity among the studies, indicates that dental veneers are associated with an overall positive effect on the periodontal health. However, given the variations in study designs, sample sizes, and follow-up times, additional research may be required to confirm and generalize these results.

Color stability and marginal adaptation of ceramic veneers cemented using different composite resins

BACKGROUND

The purpose of this study was to compare the color stability and marginal adaption of lithium disilicate veneers before and after thermocycling using various resin composite materials employed as cement.

METHODS

Laminate veneer preparation was done on an acrylic tooth according to standardized procedures. The veneer preparations were duplicated into twenty-one dies. The veneers were fabricated from lithium disilicate using the CEREC in Lab system. According to the cement type, the twenty-one die specimens were randomly divided into three equal groups: group I, with light cured adhesive resin cement (N.=7), group II, with flowable light cured composite, and group III, with preheated nano filled composite. The cemented specimens underwent 5000 thermocycling cycles. Color was assessed using a reflective spectrophotometer. The vertical marginal gap, following cementation and thermocycling, was measured using a digital microscope. One-way ANOVA followed by Tukey's post-hoc test was used to statistically assess the data.

RESULTS

After thermocycling, there was no statistically significant difference in ΔE among cement type groups for color stability (P=0.369). However, the preheated composite showed the lowest ΔE mean values. Within adhesive resin cement and flowable composite groups, marginal gap means values recorded after thermocycling were significantly higher than those after cementation (P=0.013 and P<0.001, respectively).

CONCLUSIONS

Although preheated composite cement showed the highest marginal discrepancy, it would be the best choice regarding color stability.

Porcelain Veneers in Vital vs. Non-Vital Teeth: A Retrospective Clinical Evaluation

Nowadays, the ceramic veneer approach can be considered more predictable than direct composite veneer. To date, there is a lack of studies comparing the clinical performance of anterior veneers cemented on vital teeth (VT) and non-vital teeth (NVT). This longitudinal clinical study investigated the performance of ceramic veneers in VT or anterior NVT. A total of 55 patients were evaluated in the study. Two groups were defined based on the vitality status of the teeth (93 teeth-vital and 61 teeth-non-vital). The United States Public Health Service (USPHS) criteria were used to assess the clinical status. The data were evaluated statistically with the Mann-Whitney U test. All restorations were considered acceptable, and only one veneer in VT failed for the criteria of secondary caries. There were no statistically significant differences in any of the criteria evaluated (p ≤ 0.671). The ceramic veneers evaluated showed a satisfactory clinical performance both in VT and NVT.

Reasons for widespread aspiration of esthetics veneers “Hollywood Smile”: A survey among five gulf countries

Purpose:

This study aims to assess the factors that determine the aspiration for “Hollywood smile” among the residents in five Gulf countries.

Materials and Methods:

A survey was conducted among subjects aged 18–60 years. A self-designed 19 items questionnaire was prepared which consisted of multiple choices and open-ended questions. The first part of the survey included demographic questions. The second part included questions related to Hollywood smile. Descriptive statistics were calculated, and the association between different variables was assessed by Chi-square test where P ≤ 0.05 was considered statistically significant.

Results:

A total of 2061 subjects participated in the survey. The majority of participants were females (76.81%), 97.28% of them were aware of the term “Hollywood smile,” and social media was the source of information. Statistically significant difference was noted among participants who underwent treatment according to residency place, age, educational level, and socioeconomic status (SES) and participants who were willing to undergo treatment in future according to gender, age, and SES.

Conclusion:

Subjects of younger age, higher education level, and higher SES underwent treatment. However, 23.83% of people were willing to undergo treatment. This reflects the increasing demand for esthetic treatment in future.

Esthetic Dentistry on Twitter: Benefits and Dangers

Objectives

The demand for esthetic dentistry is growing, and social media constitute the main driving force behind this revolution. Twitter is a leading social media platform; however, there is a lack of research on the pattern of communications and the impact of Twitter on esthetic dentistry. The purpose of this study was to analyze the content of tweets related to esthetic dentistry and to investigate how Twitter has affected the perception of, and demand for, esthetic dentistry. Moreover, it aimed to assess the potential benefits and risks of esthetic dentistry advertising strategies on Twitter as a potential social media platform.

Materials and Methods

Using a specialized web scrapping tool made available by the Python programming language, a total of 54,000 public tweets were downloaded from Twitter at real-time by matching specific keywords. The downloaded tweets were manually filtered, and 13,787 tweets were included and categorized into four tweet sets by content.

Results

The main categories were tweets regarding specific cosmetic procedure, totaling 56.53% (43.2% for veneers, 13.3% for whitening), advertisements (36.72%), information (5.53%), and general cosmetic dentistry (1.22%). Negative opinions towards veneers and whitening were the most common themes (68.03% and 43.44%). For veneers, illegal use for kids was the most common negative theme (59.7%) and being destructive for whitening (86.3%). Positive opinions counted 6.26% of veneers and 4.3% of whitening tweets. Advertising for whitening products was the second most common between all tweets (16.6%), and advertising for dental practices was the third (14.7%). Presenting facilities/services was the most common marketing strategy for dental practices (49.7%). Twitter was weakly used to circulate educational content (5.5%) and to post reviews (0.75%).

Conclusion

Twitter was extensively used to share experiences/opinions towards dental cosmetic interventions. Advertising is another vital use of this platform. However, circulating information was the least common use of this social media. Additionally, tweeters were rarely to post online reviews and specific advices and recommendations regarding esthetic dentistry. Moreover, females tended to participate and tweet more significantly in cosmetic-related topics than males. This platform should be tailored efficiently to target users' priorities and to improve health literacy and self-care. Twitter was weakly used to circulate educational content according to this study and rarely used to share online reviews.

Quo vadis, esthetic dentistry? Ceramic veneers and overtreatment-A cautionary tale

The increased emphasis on orofacial esthetics, experienced both by dental professionals and the lay public, results in an environment where overtreatment can easily occur. Patients on the one hand feel pressure from esthetic norms that are often unrealistic, while dental professionals are compelled to deliver immediate results many times without considering what is best for the ill-informed patient. This article is an illustrated cautionary tale against overtreatment disguised as esthetic dentistry. Representative clinical examples illustrate how porcelain veneers are used without following sound operatory principles, as well as how these cases have been resolved.

The Success of Dental Veneers According To Preparation Design and Material Type

BACKGROUND:

Due to their high aesthetic outcome and long-term predictability, laminate veneers have become a common restorative procedure for anterior teeth. However, because of the variety in the preparation designs and the material types, the clinician faces a dilemma of which approach to use.

AIM:

To compare the survival rate of dental veneers according to different preparation designs and different material types. The sub-aim is to reach a favourable preparation design and material based on scientific evidence.

METHODS:

Comprehensive electronic search of the dental literature via PUBMED, MEDLINE and Scopus databases was performed using the following keywords: “porcelain veneers”, “composite veneers”, “all-ceramic veneers”, “success of porcelain veneers”, “preparation design”, “preparation geometry”, “patient’s satisfaction”. Additionally, references from the selected studies and reviews were searched for more information.

RESULTS:

Under the limitations of the available literature, the clinician preference is the decisive factor for choosing the preparation design. Nonetheless, incisal overlap preparation seems to have the most predictable outcome from all the preparation designs.

CONCLUSION:

Porcelain veneers show excellent aesthetic results and predictable longevity of the treatment, while composite veneers can be considered as a good conservative option, but with less durability.

The restorative management of microdontia

Microdontia is a dental abnormality that will often present to the dental practitioner due to the aesthetic concerns of the patient. Treatment is therefore aimed at addressing the aesthetics issue of the patient and this can present a number of challenges which may require a multidisciplinary approach in its management. This article presents the restorative management of localised and generalised microdontia.

Balancing the risks and benefits associated with cosmetic dentistry - a joint statement by UK specialist dental societies

Cosmetic dentistry has become increasingly popular, largely as a result of social trends and increased media coverage. This understandable desire for the alleged 'perfect smile' needs to be tempered with an appropriate awareness of the significant risks associated with invasive cosmetic procedures such as veneers and crowns. Patients need to be properly informed that elective removal of healthy enamel and dentine can result in pulpal injury and poorer periodontal health in the longer term, particularly if they are young. The duty of candour means that they ought to be informed that aggressive reduction of sound tooth tissue is not biologically neutral and results in structural weakening of their teeth. Less invasive procedures such as bleaching on its own or for example, combined with direct resin composite bonding, can satisfy many patient's demands, while still being kinder to teeth and having much better fall-back positions for their future requirements. It is the opinion of the British Endodontic Society, British Society for Restorative Dentistry, Restorative Dentistry UK, Dental Trauma UK, British Society of Prosthodontics and the British Society of Paediatric Dentistry that elective invasive cosmetic dental treatments can result in great benefit to patients, but that some aggressive treatments used to achieve them can produce significant morbidities in teeth which were previously healthy. This is a worrying and growing problem with many ethical, legal and biologic aspects, but many adverse outcomes for patients who request cosmetic dental improvements are preventable by using biologically safer initial approaches to treatment planning and its provision.

The Prosthodontic Pathway for Patients with Anomalies Affecting Tooth Structure

There are a number of anomalies that affect the structure of the dental hard tissues which impact upon the form, function and aesthetics of the dentition. Understanding the challenges these conditions pose will enable dentists to manage the functional and aesthetic problems with restorative techniques better. This article will present cases that demonstrate the different conditions, the restorative challenges experienced and a variety of restorative treatments in the management of these conditions. Clinical relevance: Awareness of different anomalies affecting tooth structure that may present to the dental practitioner is necessary. Clinicians should appreciate the specific restorative challenges that may arise in treating such patients and the possible treatment options that may be available.

Management of the single discoloured tooth. Part 2: Restorative options

This is the second article of a two part series covering the aetiology, prevention and broad range of management options for the single discoloured tooth. The article covers situations where masking and simulation techniques with direct composite are required. Direct composite, indirect composite and ceramic veneers are then considered, as well as full coverage crowns. The option of extraction of the affected tooth and its prosthodontic replacement will also be considered. Clinical cases are used to illustrate various scenarios.

CLINICAL RELEVANCE

The single discoloured tooth is a commonly encountered clinical problem in general dental practice. A wide variety of management options exist and it is recommended that general dental practitioners consider adopting minimally invasive techniques in the first instance before moving on to more invasive therapies.

Factors to consider when treatment planning for patients seeking comprehensive aesthetic dental treatment

Co-operation between specialties, improvements in dental materials, bonding technology, increase in public awareness of 'cosmetic dentistry' and patients' desires to improve their appearance, mean that, increasingly, dental practitioners are being asked how elective treatment may be used to improve their patients' smiles. Traditionally, a dentist's role has been to treat disease and promote oral health. Elective, invasive dental treatment needs careful consideration and, often, interdisciplinary planning. The issues dentists may need to consider and discuss with their patients are outlined with reference to dental literature.

CLINICAL RELEVANCE

Requests to dentists to embark upon complex elective treatments to improve their patients' dental appearance are on the increase. It is important that clinicians appropriately assess cases prior to committing to a treatment plan. Considerations to be taken when assessing these patients are discussed.

Biologically based restorative management of tooth wear

The prevalence and severity of tooth wear is increasing in industrialised nations. Yet, there is no high-level evidence to support or refute any therapeutic intervention. In the absence of such evidence, many currently prevailing management strategies for tooth wear may be failing in their duty of care to first and foremost improve the oral health of patients with this disease. This paper promotes biologically sound approaches to the management of tooth wear on the basis of current best evidence of the aetiology and clinical features of this disease. The relative risks and benefits of the varying approaches to managing tooth wear are discussed with reference to long-term follow-up studies. Using reference to ethical standards such as “The Daughter Test”, this paper presents case reports of patients with moderate-to-severe levels of tooth wear managed in line with these biologically sound principles.

Aesthetic composite veneers for an adult patient with amelogenesis imperfecta: a case report

This case has been presented as part of the continual assessment requirement for the MSc in Aesthetic Dentistry, King's College Dental Institute. Amelogenesis imperfecta (AI) is a hereditary disorder of enamel formation, affecting both the permanent and deciduous dentitions. It can be classified into hypoplastic, hypomaturation and hypocalcified types and presents with different hereditary patterns. The aim of this article is to provide an overview of amelogenesis imperfecta, including a detailed case report for an aesthetically concerned adult patient presenting in general practice with a Witkop's Type IA defect managed with the placement of direct, layered resin composite veneers.

CLINICAL RELEVANCE

Amelogenesis imperfecta patients are susceptible to the restorative cycle of replacement restorations like any other patient, but start with a distinct disadvantage.This case report demonstrates a minimally invasive, relatively simple and cost-effective option for the aesthetic correction of a case of hypoplastic amelogenesis imperfecta with layered composite veneers. Dent Update 2011; 38:594-603