Comparison of Failure and Complication Risks of Porcelain Laminate and Indirect Resin Veneer Restorations: A Meta-Analysis

Abstract

F ull crowns have long been the most common choice for treatment of unesthetic anterior teeth caused by discoloration, defects, or malformation. However, this treatment causes extensive loss of sound tooth substance. 1 Minimally invasive treatments have become possible due to the development of acid etching and bonding techniques. One of these options is veneer restorations (VRs). The most commonly used VRs can be divided into three categories: direct resin VRs, indirect resin VRs, and porcelain laminate VRs. 2 Clinically, porcelain laminate and indirect resin VRs are more popular than direct resin VRs due to shorter chairside operating time and more ideal edge shapes. Additionally, unlike direct resin VRs, the indirect resin and porcelain VRs share similar repair processes that involve tooth preparation, veneer fabrication, and cementation. With the widespread application of indirect resin and porcelain laminate VRs, their longevities have become a focus of attention. Purpose: To evaluate and compare the failure and complication risks of porcelain laminate and indirect resin veneer restorations (VRs) by means of a meta-analysis. Methods: An electronic database search was performed in MEDLINE (PubMed), EMBASE (Ovid), and the Cochrane Central Register of Controlled Trials (CENTRAL) databases, and a gray literature search was performed on OpenGrey. All database searches were completed by March 2018. Two authors individually screened the literature according to the inclusion and exclusion criteria. The quality and risk of bias of the included studies were evaluated using the Newcastle-Ottawa scale (NOS) and the Cochrane Handbook for Systematic Reviews of Interventions (CHSRI). The Mantel-Haenszel method was used to synthesize the data of the included studies. All statistical analyses were performed using the software Stata 14.0, and the results were expressed as risk ratio (RR) with 95% confidence interval (CI). Results: Five studies-two randomized controlled trials (RCTs) and three clinical controlled trials (CCTs)-were included in this review. Of the three CCTs, two were assessed to be low quality, and the third was considered high quality. The two RCTs were rated as unclear risk of bias. The meta-analysis results showed the risk of failure for indirect resin VRs was higher than for porcelain laminate VRs (RR: 0.15, 95% CI: 0.06-0.40; P = .000). Fracture and debonding were the main complications leading to failure. For risk of fracture, an RR of 0.18 (95% CI: 0.04-0.71) and a statistically significant difference (P = .015) were found in favor of porcelain laminate VRs. For risk of debonding, there was no statistically significant difference (P = .108) found between the two types of VRs. The results of the sensitivity analysis (RR: 0.09, 95% CI: 0.02-0.45; P = .004) suggested that this conclusion was reliable. Conclusion: The survival rate of porcelain laminate VRs was higher than indirect resin VRs, and the latter had a higher risk of fracture. However, there was no statistically significant difference in the risk...

Conceitos atuais sobre a performance clínica e principais falhas do tratamento restaurador com laminados cerâmicos: uma revisão da literatura

“…Uma revisão descritiva 25 e duas revisões sistemáticas com metanálise 24,26 também foram incluídas no presente estudo. Esses estudos apresentaram dados semelhantes aos coletados na presente revisão: baixas porcentagens de ocorrência de desunião da restauração (2%), fratura ou lascamento (4%), cárie secundária (1%), descoloração marginal severa (2%) 24 .…”

“…Esses estudos apresentaram dados semelhantes aos coletados na presente revisão: baixas porcentagens de ocorrência de desunião da restauração (2%), fratura ou lascamento (4%), cárie secundária (1%), descoloração marginal severa (2%) 24 . Liu et al 26 (2019) também consideraram a fratura dos laminados como uma das principais causas de falha seguida pela desunião, apontando propriedades mais vantajosas para laminados construídos em cerâmica comparados aos confeccionados em compósito.…”

“…Liu et al 26 2019 Metanálise sobre a comparação de falhas e taxas de risco entre laminados cerâmicos e de resina composta indireta.…”

Dentin Exposure after Tooth Preparation for Laminate Veneers: A Microscopical Analysis to Evaluate the Influence of Operators’ Expertise

“…In recent decades, laminate veneers (LVs) have become a widespread treatment option for the possibility of meeting the demand for long-lasting, highly aesthetic, and minimally invasive restorations [ 1 , 2 , 3 ].…”

“…With LVs, the teeth are considerably preserved, thanks to the reduced thickness required by the new biomimetic ceramic materials and by the efficient bond with enamel [ 1 ]. The survival rate of LVs is negatively affected by veneer preparations extending into dentin, allowing enamel an optimal adhesion [ 1 , 2 , 3 , 12 , 13 , 14 ].…”