ABSTRACT
BACKGROUND: There is no consensus on whether incisal coverage is a risk or a protective factor in preparations for ceramic veneers. OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the survival rates of preparation designs for ceramic veneers with and without incisal coverage. METHODS: Primary clinical studies with the following characteristics were included: 1) studies related to ceramic laminate veneers and 2) prospective or retrospective studies conducted in humans. From the selected studies, the survival rates and failures rates for ceramic veneers were extracted according to preparation design, with or without incisal coverage. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. Metaregression, meta-analysis were performed. Two reviewers searched in the MEDLINE (Pubmed) and Cochrane Central Register of Controlled Trials (Central) electronic databases, from 1977 to June 5, 2016, without language restrictions. RESULTS: Eight studies out of 1145 articles initially identified were included for risk of bias and systematic assessment. No study was identified for crystalline ceramic veneers. The estimated survival rate for laminate veneers with incisal coverage was 88% and 91% for those without incisal coverage. Incisal coverage presented an OR of 1.25. CONCLUSIONS: Irrespective of the preparation designs, with or without incisal coverage, ceramic veneers showed high survival rates. As regard implications for future clinical research studies, randomized clinical studies are necessary to compare preparation designs with and without incisal coverage, and to provide clear descriptions of these preparation designs.
Subject(s)
Dental Veneers , Ceramics , Dental Porcelain , Humans , Prospective Studies , Retrospective StudiesABSTRACT
PURPOSE: The aim of this study was to perform a systematic review and meta-analysis based on clinical trials that evaluated the main outcomes of glass-ceramic and feldspathic porcelain laminate veneers. MATERIALS AND METHODS: A systematic search was carried out in Cochrane and PubMed databases. From the selected studies, the survival rates for porcelain and glass-ceramic veneers were extracted, as were complication rates of clinical outcomes: debonding, fracture/chipping, secondary caries, endodontic problems, severe marginal discoloration, and influence of incisal coverage and enamel/dentin preparation. The Cochran Q test and the I(2) statistic were used to evaluate heterogeneity. RESULTS: Out of the 899 articles initially identified, 13 were included for analysis. Metaregression analysis showed that the types of ceramics and follow-up periods had no influence on failure rate. The estimated overall cumulative survival rate was 89% (95% CI: 84% to 94%) in a median follow-up period of 9 years. The estimated survival for glass-ceramic was 94% (95% CI: 87% to 100%), and for feldspathic porcelain veneers, 87% (95% CI: 82% to 93%). The meta-analysis showed rates for the following events: debonding: 2% (95% CI: 1% to 4%); fracture/chipping: 4% (95% CI: 3% to 6%); secondary caries: 1% (95% CI: 0% to 3%); severe marginal discoloration: 2% (95% CI: 1% to 10%); endodontic problems: 2% (95% CI: 1% to 3%); and incisal coverage odds ratio: 1.25 (95% CI: 0.33 to 4.73). It was not possible to perform meta-analysis of the influence of enamel/dentin preparation on failure rates. CONCLUSION: Glass-ceramic and porcelain laminate veneers have high survival rates. Fracture/ chipping was the most frequent complication, providing evidence that ceramic veneers are a safe treatment option that preserve tooth structure.
