Conceitos atuais sobre a performance clínica e principais falhas do tratamento restaurador com laminados cerâmicos: uma revisão da literatura / Current status on clinical performance and main failures of laminate veneers: a review of the literature

O objetivo do presente estudo foi revisar a literatura dos últimos cinco anos e identificar os índices de sobrevivência, principais causas de falha relatadas e verificar a confiabilidade dos laminados cerâmicos como tratamento estético e funcional em longo prazo. Métodos: foi realizada uma busca ativa na Biblioteca Nacional de Medicina dos Estados Unidos (pubmed.ncbi.nlm.nih.gov), através da base de dados Medline, dos últimos cinco anos (2015-2020) na língua inglesa, utilizando os descritores: Laminate Veneers, Porcelain Laminate Veneers e Ceramic Laminate Veneers, que resultou em 35 artigos. Após a leitura dos resumos, foram excluídos 9 estudos que utilizaram laminados cerâmicos não produzidos em cerâmicas feldspáticas, ou vidro ceramizados reforçados por cristais de leucita, ou dissilicato de lítio. Foram selecionados 26 artigos categorizados como: relatos de caso, estudos clínicos, estudos in vitro e revisões de literatura. Resultados: os estudos apontaram índices de sobrevivência de 100%, após 2 anos de cimentação, até valores superiores a 80%, após 14 anos. As três principais causas de falhas apontadas foram: desadaptação de marginal (37%), pigmentação das margens (30%) e fratura ou lascamento das restaurações (3%). Considerações finais: dentro das limitações do estudo, foi possível concluir que as principais causas de falha estão associadas às margens da restauração, no entanto, os laminados cerâmicos podem atingir índices elevados de sobrevivência mesmo 14 anos após a cimentação, mostrando um alto nível de confiabilidade. (AU)

The objective of the present study was to identify the survival rate and cause of failure of ceramic laminate veneers. Methods: An active search of the last five years (2015 ­ 2020) was carried out in the United States National Library of Medicine (pubmed.ncbi.nih.gov) the MEDLINE database, in English, using the descriptors: Laminate Veneers, Porcelain Laminate Veneers and Ceramic Laminate Veneers, which resulted in 35 papers. After reading the abstracts, 9 studies that evaluated ceramic laminates that were not produced using felspathic porcelain, leucite-reinforced glass-ceramicc, or lithium disilicate glass-ceramic were excluded. Twenty-six scientific papers were selected, categorized as: Case reports, clinical studies, in vitro studies and literature reviews. Result: The studies showed survival rates between 100% after two years of cementation up to values above 80% after 14 years. The three causes of failure identified were: marginal misfit (37%), pigmentation of the margins (30%), and fracture or chipping of the restorations (3%). Final Considerations: Within the limitations of this study, it was possible to conclude that the leading causes of failure are associated with the restoration's margins. However, ceramic laminates can achieve high survival rates even 14 years after cementation, showing a high-reliability level.(AU)

Subepithelial connective tissue graft conjugated to minimally invasive ceramic laminates-1 year follow-up.

OBJECTIVE: Commonly, esthetic procedures involve ceramic laminates and gingivectomy. However, the clinical demand caused by dental wear and gingival recessions due to parafunctional habits is increasing. Thus, in addition to restoring the anatomical and esthetic dental form, it is also necessary to restore the lost gingival volume. CLINICAL CONSIDERATIONS: This article presents a case report of the treatment of a patient with marked incisal wear and gingival recessions. Initially, endodontic treatment of the upper lateral incisors was performed, which presented with pulp necrosis due to the marked wear caused by bruxism. Subsequently, the patient was treated with a subepithelial connective graft by a technique proposed by Zucchelli, along with minimally invasive ceramic laminates and finished with a myorelaxant plaque. CONCLUSIONS: This proposed approach aimed for and achieved esthetic excellence, and full recovery of function, which is of extreme clinical relevance. Ultimately, the stability of the surgery and the laminates after 1 year of follow-up is presented. CLINICAL SIGNIFICANCE: Patients with bruxism in addition to incisal and occlusal wear are more likely to have gingival recessions. The esthetic planning of these patients should contemplate interdisplinarity temporomandibular disorder, periodontics, and dentistry for the recovery of the function and reaching esthetic excellence.

Princípios odontológicos na harmonização do sorriso: laminados cerâmicos / Dental principles in smile harmonization: dental veneers

Na abordagem clínica, perante a necessidade de harmonização do sorriso por meio de laminados cerâmicos, são possíveis várias técnicas de execução e planejamento. Sendo assim, este estudo apresentou um caso clínico de incisivos laterais superiores conoides, cujo tratamento seguiu princípios científicos de planejamento, seleção da técnica de preparo e de material para obter um tratamento estético e funcional previsível com laminados cerâmicos.

Several techniques are possible on the need to harmonize the smile by ceramic laminates. For this, this study presented a clinical case of peg-shaped lateral incisors following the scientific principles of planning, selection, preparation technique and material to generate a esthetic and functionally predictable treatment with these restoration types.