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Gierthmuehlen PC, Spitznagel FA, Koschate M, Bonfante EA, Prott LS. Influence of ceramic thickness and dental substrate on the survival rate and failure load of non-retentive occlusal veneers after fatigue. J ESTHET RESTOR DENT 2024; 36:373-380. [PMID: 37605963 DOI: 10.1111/jerd.13103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/26/2023] [Accepted: 06/27/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To investigate the effect of ceramic thickness and dental substrate (enamel vs. dentin/enamel) on the survival rate and failure load of non-retentive occlusal veneers. MATERIALS AND METHODS Human maxillary molars (n = 60) were divided into five test-groups (n = 12). The groups (named DE-1.5, DE-1.0, DE-0.5, E-1.0, E-0.5) differed in their dental substrate (E = enamel, DE = dentin/enamel) and restoration thickness (standard: 1.5 mm, thin: 1.0 mm, ultrathin: 0.5 mm). All teeth were prepared for non-retentive monolithic lithium-disilicate occlusal veneers (IPS e.max Press, Ivoclar). Restorations were adhesively cemented (Syntac Classic/Variolink II, Ivoclar) and exposed to thermomechanical fatigue (1.2 million cycles, 1.6 Hz, 49 N/ 5-55°C). Single load to failure was performed using a universal testing-machine. A linear-regression model was applied, pairwise comparisons used the Student-Newman-Keuls method (p < 0.05). RESULTS Three dentin-based occlusal veneers (one DE-1.0, two DE-0.5) revealed cracks after fatigue exposure, which corresponds to an overall-survival rate of 95%. Load to failure resulted in the following ranking: 2142 N(DE-0.5) > 2105 N(E-1.0) > 2075 N(E-0.5) > 1440 N(DE-1.5) > 1430 N(DE-1.0). Thin (E-1.0) and ultrathin enamel-based occlusal veneers (E-0.5) revealed high failure loads and surpassed the standard thickness dentin-based veneers (DE-1.5) significantly (p = 0.044, p = 0.022). CONCLUSION All tested monolithic lithium disilicate occlusal veneers obtained failure loads above physiological chewing forces. Thin and ultrathin enamel-based occlusal veneers outperformed the standard thick dentin-based occlusal veneers. CLINICAL SIGNIFICANCE Minimally invasive enamel-based occlusal veneer restorations with non-retentive preparation design may serve as a conservative treatment option.
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Affiliation(s)
- Petra C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Frank A Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Lea S Prott
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Meer Rownaq Ali AB. Conventional Versus Minimally Invasive Veneers: A Systematic Review. Cureus 2023; 15:e44638. [PMID: 37799216 PMCID: PMC10548404 DOI: 10.7759/cureus.44638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
This systematic review aimed to synthesize and analyze a collection of studies focused on comparing conventional veneers (CVs) and minimal or no-preparation veneers (MPVs) within the domain of prosthodontics. The review sought to explore various attributes, techniques, outcomes, and considerations associated with these two approaches. The key aspects investigated included esthetics, longevity, periodontal health, patient satisfaction, structural influences such as microleakage and marginal fit, cement thickness, and color stability. A systematic literature search was conducted to identify relevant studies published up to the present date. Studies meeting specific inclusion and exclusion criteria were selected for review. Studies pertaining to various methodologies were identified initially as part of the strategy and bias assessment was performed to determine the credibility of their assessments before inclusion in this review. Four comparative assessments gleaned from the selected studies provided a comprehensive overview of the strengths and limitations associated with CVs and MPVs. MPVs demonstrated advantages such as enhanced survival rates and extended mean success periods, implying their potential as viable long-term restorative options. Meticulous patient management and optimal preparation techniques emerged as crucial factors influencing successful outcomes. Structural attributes, including microleakage and marginal fit, varied depending on the preparation techniques employed. Moreover, considerations related to color changes in veneers underscored the intricate interplay between material properties and fabrication methods. The insights underscore the significance of patient-centric care, precision preparation methodologies, and material choices in guiding successful outcomes. However, the diverse methodologies and constraints of certain studies warrant careful interpretation. This study accentuates the potential for future research directions, interdisciplinary collaboration, and the advancement of evidence-based practices within veneer dentistry.
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Unterschütz L, Fuchs F, Mayer LA, Koenig A, Challakh N, Schulz-Kornas E, Ziebolz D, Hahnel S. Influence of dental prophylaxis procedures on the tooth veneer interface in resin-based composite and polymer-infiltrated ceramic veneer restorations: an in vitro study. Clin Oral Investig 2023; 27:2595-2607. [PMID: 36502509 PMCID: PMC10264478 DOI: 10.1007/s00784-022-04816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the influence of dental prophylaxis cleaning procedures and artificial aging on veneers in human teeth. The external marginal and internal tooth veneer as well as the restoration surfaces were examined. MATERIAL AND METHODS Thirty-two extracted premolars were restored with resin-based composite (RBC) and polymer-infiltrated ceramic network (PICN) veneers. Artificial aging by alternating thermocycling and subsequent prophylaxis procedure (glycine-based powder air polishing or ultrasonic scaling) was conducted for five consecutive cycles. The external marginal interface was examined by height profile measurements and the internal interface was investigated using micro X-ray computed tomography. In addition, the surface texture of the veneer surface was analyzed using confocal laser scanning microscopy. RESULTS The application of both prophylaxis procedures resulted in a deepening of the marginal interface (10 µm ± 8 µm) for materials. Furthermore, the internal interface of PICN restorations showed marginal gaps after both treatments and artificial aging (16 µm ± 3 µm). In contrast to the RBC specimens, a significant increase in surface roughness was identified for PICN veneers after ultrasonic scaling. CONCLUSIONS The marginal and internal interface regions in veneers fabricated from PICN and RBC were affected by prophylaxis procedures. Furthermore, it may result in increased veneer surface roughness, especially in PICN and after ultrasonic scaling, which might affect bioadhesion and longevity. CLINICAL RELEVANCE After dental prophylaxis procedures, examination of the marginal and the internal interface as well as the veneer surface provides a precise insight into damage mechanisms and offers an assessment of longevity.
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Affiliation(s)
- Lena Unterschütz
- Department of Prosthetic Dentistry and Dental Material Science, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthetic Dentistry and Dental Material Science, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.
| | - Laura-Antonia Mayer
- Department of Prosthetic Dentistry and Dental Material Science, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Andreas Koenig
- Department of Prosthetic Dentistry and Dental Material Science, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Nadia Challakh
- Department of Cariology, Endodontology and Periodontology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Kam Hepdeniz O, Temel UB. Clinical survival of No-prep indirect composite laminate veneers: a 7-year prospective case series study. BMC Oral Health 2023; 23:257. [PMID: 37138297 PMCID: PMC10158390 DOI: 10.1186/s12903-023-02949-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 04/06/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The no preparation technique which is a reversible form of treatment characterized by the absence of tooth tissue preparation and preserves the soft tissue architecture while preserving all natural tooth structures is indicated in cases where the tooth structure allows material to be added. The aim of this study is to evaluate the clinical performance and survival rates of indirect composite laminate veneers with no preparation after 7 years. MATERIALS AND METHODS A total of 80 indirect composite veneers were placed on maxillary anterior teeth in 35 patients (n = 80). Diastema (n = 64), wedge tooth anomalies (n = 9) and re-shaping (n = 7) were the main indications for veneer treatments. All laminate veneers were fabricated with an indirect microhybrid composite material (Gradia, GC Dental). No tooth preparation was performed. Light-cured resin cement (Choice 2, Bisco) was used to lute the veneers. Composite veneers were evaluated using Modified United States Public Health Service criteria. Survival rates of the veneers were calculated using Kaplan-Meier statistics. The data containing the results of the USPHS criteria at baseline, 2 years and 7 years was statistically analyzed using Wilcoxon Signed Rank test at the 0.05 level of significance. RESULTS The overall survival rate was 91.3%. After 7 years, 7 absolute failures including 4 debonding (marginal adaptation, score 4) and 3 fractures (fracture of restoration, score 3) were noted. Color match was scored as 1 (n = 34) and 2 (n = 15). Slightly rough surfaces (41 of 73 laminates) and slight marginal discoloration (15 of 73 laminates) were noted. The overall scores after 84 months were significantly higher than the baseline scores for the marginal adaptation (p = 0.008), color match (p = 0.000), marginal discoloration (p = 0.000), surface roughness (p = 0.000), and fracture of restoration (p = 0.001) criteria. CONCLUSIONS In this study, indirect composite veneers without any preparation on maxillary anterior teeth showed acceptable performance in terms of both survival rate and quality of restorations. This procedure offers a predictable and successful treatment that ensures maximum preservation of the intact tooth.
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Affiliation(s)
- Ozge Kam Hepdeniz
- Department of Restorative Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey.
| | - Ugur Burak Temel
- Department of Restorative Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
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Milian R, Lefrançois E, Radzikowski A, Morice S, Desclos-Theveniau M. Pre-orthodontic restorative treatment of microdontia diastema teeth using composite injection technique with a digital workflow-Case report. Heliyon 2023; 9:e15843. [PMID: 37215809 PMCID: PMC10196518 DOI: 10.1016/j.heliyon.2023.e15843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/13/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
Restorative treatment of microdontia teeth is often considered as the final step of post-orthodontic treatment. Based on digital workflow, this clinical report presents pre-orthodontic reshaping of anterior teeth in the smile disharmony of a young patient using bilayering composite injection technique. Transparent silicone indexes for dentin and enamel fillings were fabricated from three-dimensional-printed models of the digital wax-up. This noninvasive, simple and straightforward injection technique was able to provide semipermanent reversible aesthetic restorations while awaiting for adulthood and definitive prosthodontic solution. Closure of diastemas before orthodontic treatment were carried out to restore functional contact point and to guide future teeth movements.
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Affiliation(s)
- Romain Milian
- Private Practice, Cesson-Sévigné and University Hospital, Rennes, France
| | | | | | - Samuel Morice
- Registered Dental Technician, Private Dental Laboratory ARGOAT, Ploumagoar, France
| | - Marie Desclos-Theveniau
- U1317 INSERM, INRAE, Univ Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Department of Dentistry, University Hospital, Rennes, France
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Treatment of Tooth Wear Using Direct or Indirect Restorations: A Systematic Review of Clinical Studies. Bioengineering (Basel) 2022; 9:bioengineering9080346. [PMID: 36004871 PMCID: PMC9404995 DOI: 10.3390/bioengineering9080346] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/17/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Tooth wear is considered a well-developed issue in daily clinical practice; however, there is no standard protocol for treatment. The aim of this manuscript was to systematically review the literature to evaluate the clinical outcomes of direct or indirect restorations for treating tooth wear. A literature search was conducted through the PubMed MedLine, Scopus, ISI Web of Science, Scielo, and EMBASE databases up to 29 April 2022. Clinical studies evaluating the clinical performance of direct or indirect restorations for treating tooth wear for a minimum follow-up of 6 months were included in the review. A total of 2776 records were obtained from the search databases. After full-text reading, 16 studies were included in the qualitative analysis. Considering the high heterogenicity of the studies included, a meta-analysis could not be performed. All studies included the rehabilitation of anterior and posterior teeth with extensive wear, using both indirect and direct restorations for a maximum follow-up of 10 years. Restoration materials included ceramo-metal crowns, full gold crowns, lithium disilicate ceramic, zirconia, polymer infiltrated ceramic networks, and resin composites. Most of the reports assessed the survival rate of the restorations and the clinical features using the United States Public Health Service (USPHS) Evaluation System criteria. Contradictory discoveries were perceived concerning the type of restoration with better clinical performance. Considering the current literature available, there is no evidence in the superiority of any restoration technique to ensure the highest clinical performance for treating tooth wear.
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Blasi A, Blasi I, Henarejos-Domingo V, Castellano V, Blasi JI, Blasi G. The PGO concept: Prosthetically guided orthodontics concept. J ESTHET RESTOR DENT 2021; 34:750-758. [PMID: 34612577 DOI: 10.1111/jerd.12825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/11/2021] [Accepted: 09/13/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this case report is to present a novel digital approach of guiding orthodontics and periodontal surgery by creating interim restorations that represent the final shape of the teeth before starting the treatment. CLINICAL CONSIDERATIONS The patient presented with worn dentition, super-erupted maxillary and mandibular anterior teeth, and altered passive eruption, all this creating a gummy smile. Following a digital wax-up design, a digital orthodontic set-up, and the digital bracket bonding, temporary restorations, and bracket indirect bonding trays were fabricated. Restorations' cementation, bracket bonding, and periodontal surgery were performed the same day. After 14 months of orthodontic treatment, teeth were restored with final ceramic restorations. One year and 6 months was the total treatment duration. CONCLUSION Prosthetically guided orthodontic concept allows the use of digital technology to simulate the final outcome of the patient treatment before starting dental therapy. This technique not only improves the communication between specialists, it also reduces treatment time and increases precision and predictability. CLINICAL SIGNIFICANCE The prosthetically guided orthodontics (PGO) concept has the goal to start interdisciplinary therapy with a simulation of the final outcome. Giving the worn teeth their proper size through interim restorations prior to orthodontic therapy will guide the orthodontist from the beginning of the treatment and will improve communications between all the specialists. Through a digital approach, a digital wax-up and an orthodontic digital set-up the objectives of treatment can be established early on.
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Affiliation(s)
- Alvaro Blasi
- Private Practice, Barcelona, Spain.,Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia, USA.,Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Ignacio Blasi
- Private Practice, Barcelona, Spain.,Department of Orthodontics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Victor Henarejos-Domingo
- Private Practice, Barcelona, Spain.,Department of Orthodontics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Vincenzo Castellano
- Private Practice, Bologna, Italy.,Department of Aesthetic and Restorative Dentistry, University of Bologna, Bologna, Italy
| | | | - Gonzalo Blasi
- Private Practice, Barcelona, Spain.,Division of Periodontics, University of Maryland School of Dentistry, Baltimore, Maryland, USA.,Department of Periodontics, Universitat Internacional de Catalunya, Barcelona, Spain
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Crins LAMJ, Opdam NJM, Kreulen CM, Bronkhorst EM, Sterenborg BAMM, Huysmans MCDNJM, Loomans BAC. Randomized controlled trial on the performance of direct and indirect composite restorations in patients with severe tooth wear. Dent Mater 2021; 37:1645-1654. [PMID: 34497023 DOI: 10.1016/j.dental.2021.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/09/2021] [Accepted: 08/19/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The study aimed to evaluate survival and failure behavior of Direct Composite Restorations (DRC) and Indirect Composite Restorations (ICR) on molars and anterior teeth, in a Randomized Controlled Trial (RCT). METHODS Patients with generalized severe tooth wear were included, and randomly assigned to one of 2 protocols: (1) DCR: All teeth were restored with directly applied micro-hybrid composite restorations (Clearfil AP-X, Kuraray) for load bearing areas and nano-hybrid composite restorations (IPS Empress Direct, Ivoclar Vivadent) for buccal veneers; (2) ICR: First molars were restored with indirect composite 'tabletop' restorations and maxillary anterior teeth were restored with indirect palatal veneer restorations (Clearfil Estenia C&B, cemented with Panavia F, Kuraray). Remaining teeth were restored directly. Restorations were evaluated after 3 years, focusing on clinical acceptability. Statistical analysis was performed using Kaplan Meier curves, Annual Failure Rates (AFRs), and univariate Cox regression analyses (p < 0.05). RESULTS 41 patients (age: 36.6 ± 6.6y) were evaluated after 3 years (40.0 ± 2.2 m). 408 restorations on first molars and palatal veneers on maxillary anterior teeth were part of this RCT, with 220 DCRs and 188 ICRs. No differences in survival between treatment modality for palatal veneers for any failure criteria were found. Tabletop restorations on first molars showed a considerable higher failure rate for ICR compared to DCR (p = 0.026, HR: 3.37, 95%CI = 1.16-9.81). SIGNIFICANCE In this RCT, directly applied composite restorations showed superior behavior compared to the indirect composite restorations, when used in the molar region.
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Affiliation(s)
- L A M J Crins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands.
| | - N J M Opdam
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - C M Kreulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - E M Bronkhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - B A M M Sterenborg
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - M C D N J M Huysmans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
| | - B A C Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, The Netherlands
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