Вы находитесь на странице: 1из 7

Journal of Dentistry 52 (2016) 1–7

Contents lists available at ScienceDirect

Journal of Dentistry
journal homepage: www.intl.elsevierhealth.com/journals/jden

Review article

Incisal coverage or not in ceramic laminate veneers: A systematic


review and meta-analysis
Rafael Borges Albanesia , Mônica Nogueira Pigozzob , Newton Sesmab , Dalva Cruz Laganáb ,
Susana Morimotoc,*
a
Department of Dentistry, School of Dentistry, University Santa Cecília, Santos, Brazil
b
Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
c
School of Dentistry, Ibirapuera University, São Paulo, Brazil. Interlagos avenue, 1329 São Paulo, Brazil

A R T I C L E I N F O A B S T R A C T

Article history: Background: There is no consensus on whether incisal coverage is a risk or a protective factor in
Received 29 December 2015 preparations for ceramic veneers.
Received in revised form 16 June 2016 Objective: The aim of this systematic review and meta-analysis was to evaluate the survival rates of
Accepted 17 June 2016
preparation designs for ceramic veneers with and without incisal coverage.
Methods: Primary clinical studies with the following characteristics were included: 1) studies related to
Keywords: ceramic laminate veneers and 2) prospective or retrospective studies conducted in humans. From the
Dental laminate
selected studies, the survival rates and failures rates for ceramic veneers were extracted according to
Dental veneers
Tooth preparation
preparation design, with or without incisal coverage. The Cochran Q test and the I2 statistic were used to
Esthetics evaluate heterogeneity. Metaregression, meta-analysis were performed.
Dental Two reviewers searched in the MEDLINE (Pubmed) and Cochrane Central Register of Controlled Trials
Ceramics (Central) electronic databases, from 1977 to June 5, 2016, without language restrictions.
Dental porcelain Results: Eight studies out of 1145 articles initially identified were included for risk of bias and systematic
Systematic review 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.
ã 2016 Elsevier Ltd. All rights reserved.

1. Introduction incisal bevel, and palatal chamfer [22,23], nevertheless, it is


important to note that even for prepless veneers, incisal coverage
Many different protocols have been indicated for laminate can be increased.
veneers, varying with respect to thickness, crown length, type of In previous systematic reviews on the survival rates of
material, incisal coverage, and preparation methods. However, preparation designs for ceramic veneers [4,24,25], only one
data about the relationship between complications and prepara- systematic review [22] addressed the question of the most
tion design remain questionable, as there is no consensus on indicated preparation design; but included only laboratory studies.
whether incisal coverage is a risk or protective factor for the teeth One literature review [20] attempted to explore the survival rates
receiving ceramic veneers [1–21]. of veneers based on different incisal preparation designs from both
Three types of preparation design are generally used for clinical and non-clinical studies. They affirmed that relatively few
ceramic veneers: feathered incisal edge (window), butt joint or studies in the literature used survival estimates, that allowed for
valid study comparisons between the preparation designs. Studies
that preceded ours [4,20,22,24,25] showed the importance and
difficulty of finding clinical evidence on this subject. Up to now, no
* Corresponding author.
systematic review has focused on incisal coverage in primary
E-mail addresses: r.albanesi@hotmail.com (R.B. Albanesi), mpigozzo@usp.br
(M.N. Pigozzo), sesma@usp.br (N. Sesma), dclagana@usp.br (D.C. Laganá), clinical studies, to determine the survival of veneers with and
susanamorimoto@yahoo.com.br (S. Morimoto). without incisal coverage.

http://dx.doi.org/10.1016/j.jdent.2016.06.004
0300-5712/ã 2016 Elsevier Ltd. All rights reserved.
2 R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7

A previous systematic review [26] that sought different (tetracycline/bruxism); 5) not a ceramic veneer; 6) studies
outcomes, found that the influence of incisal coverage showed containing the same sampling (only the most recent study was
divergence among publications, and did not allow for the clinical considered); 7) studies without survival/success rate of veneers
outcome and survival rate to be associated with the preparation and the impossibility of calculating this data; 8) dropout rate
design. Thus, for the present systematic review, the authors higher than 30%; 9) no description of incisal preparation design or
searched the scientific literature again to find articles that no number of each design.
contained tooth preparation descriptions, numbers of subjects,
and failures, that would allow inclusion of a larger number of 2.3. Data collection process
articles. With this in mind, the authors also sought to include
retrospective studies. Two calibrated reviewers (RBA, MNP) collected the data from
The data on preparation for ceramic laminate veneers, obtained the papers selected, and organized them in structured tables.
from randomized controlled trials (RTCs), have usually not shown Cohen’s Kappa values between examiners was 0.91, and a new
the consequences of incisal coverage separately, thereby making it calibration was performed to solve disagreements. Discrepancies
difficult to correlate the preparation design with clinical outcomes, and doubts were settled by discussion and data checking; however,
and the effectiveness of protecting the remaining tooth structure. when these were not resolved by consensus, a third examiner (SM)
There is a gap in this information [2,3,5–7,9,10,12,14,15,18–21,24] was consulted.
that justifies the elaboration of a systematic review about
preparation involving incisal coverage, in order to put forward 2.4. Analysis of risk of bias
scientific evidence. The aim of this systematic review was to
evaluate the survival rates of different preparations for ceramic Two calibrated examiners (RBA, MNP) used the Newcastle-
laminate veneers with and without incisal coverage, The null Ottawa Scale (NOS) [29] to assess the risk of bias in the studies
hypothesis was that the incisal coverage had no influence on the included. Any disagreement between the reviewers was resolved
survival rates of ceramic veneers. by a third author (SM). With the NOS, studies can be awarded a
maximum of one star for each numbered item within the Selection
2. Methods and Outcome categories. A maximum of two stars can be given for
the comparability category. Thus, the following topics were used:
2.1. Eligibility criteria and search strategy A) Selection—A1) the representativeness of the exposed individu-
als was considered when the study population included men and
This review was conducted in accordance with the PRISMA women, with a minimum age difference of 35 years between the
guideline [27] and registered at the PROSPERO (CRD42015016606). participants, A2) clear description of the exclusion criteria, with
The PICOS question (Population, Intervention, Comparison, Out- the non exposed group drawn from the same community as the
come, and Study design) was defined, where P = patients who exposed group, A3) ascertainment of the exposure factor by secure
received laminate veneers; I = ceramic veneers; C = (not applicable record, A4) demonstration that the outcome of interest was not
in the present study); O = survival rate; and S = RCTs and cohort present when the study started; B) Comparability—B1) two study
studies. The question focused on was: “In patients with ceramic control factors were used to measure the comparability between
laminate veneers, will the tooth preparation designs, with or groups (B10 —standardized protocol for tooth preparation and B100 —
without incisal coverage, have an influence on the survival rates of no more than 2 operators to perform the clinical procedures) and
these veneers?”. C) outcome—C1) assessment of the outcome must be made
An electronic database search in the advanced mode, was independently, by blind assessment, or by reference to secure
performed of the PubMed and Cochrane Central Register of records, C2) the follow-up period must be long enough for
Controlled Trials (1977-June 5, 2016). The references of articles outcomes to occur, in this case 3 years was considered, C3) subjects
included were checked manually. There were no limitations on lost during the follow-up period, unlikely to introduce bias, must
language. One study [28] was translated from Chinese and be fewer than 30%. Each study included could receive a maximum
analyzed. of 9 stars. Studies with !6 points were considered to have high
The final search strategy for the Medline database was: methodological quality, while a score <6 points indicated low
((((ceramic*) OR porcelain*)) AND (((((failure) OR survival) OR quality.
success) OR clinical evaluation) OR follow up)) AND ((veneer*) OR
laminate*), and for the Cochrane database, it was: ((laminate or 2.5. Study characteristics
veneer) and (ceramic or porcelain) and (dental or tooth or teeth) and
(clinical and trial or clinical)). In order to identify sources in heterogeneity of the outcome
between the studies selected according to Table 2, detailed
2.2. Study selection and eligibility criteria information about the way each study was conducted was
displayed to facilitate analysis.
Studies were selected by title and abstract for screening
according to these inclusion criteria: A—studies about ceramic 2.6. Measures and statistical analysis
laminate veneers and B—human cohort studies (prospective and
retrospective) and RCTs. Articles without abstracts were included Descriptive analysis and meta-analysis by using random effect
for evaluation of their full texts. Articles without abstracts, or with models were performed based on the estimated survival of
abstracts providing insufficient descriptions to enable decisions, preparation designs for ceramic laminate veneers, with and
were included for evaluation of the complete text. without incisal coverage. This estimated survival rate (Kaplan-
Eligibility was determined after evaluating the full texts Meier) and variance were used for meta-analysis. If the article did
according to the previously defined exclusion criteria: 1) cavity not present the variance (or standard error), the authors calculated
preparations and/or clinical procedures with no adequate or it by analyzing the number of failures and accounting for
unusual descriptions (partial veneer/fragments/unusual bonding censorship during the follow-up time. These data were searched
procedures); 2) case reports; 3) literature or systematic reviews, in the text, or a count was taken on a Kaplan-Meier graph. The
protocols, interviews, or in vitro studies; 4) isolated groups Greenwood formula was used to calculate the variance assuming
R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7 3

Fig. 1. Flow diagram with information from all of the phases of study selection based on PRISMA [27].

that censorship occurred uniformly over time, together with 3.3. Study characteristics
failures. The odds ratio (OR) was calculated for preparation
designs, with and without incisal coverage. The years of publication of the studies included ranged from
Cochran Q test was performed (p < 0.001, CI 95%) to evaluate 1987 to 2016. The information and characteristics of each study are
the heterogeneity among the studies, and the presence of provided in Table 2. Of the studies with the same sample [11,13,17],
heterogeneity was analyzed using the inconsistency test the most recent one was considered.
(I2 > 50%) [30]. All meta-analyses were undertaken using the
software program R package version 3.6-0 (R Foundation for 3.4. Measures and statistical analysis
Statistical Computing, Vienna, Austria).
Meta-regression was performed on the influence of the type of 3.4.1. Meta-regression and heterogeneity analysis
follow-up time on the survival rates intended to clarify sources of Meta-regression showed no association between survival rate
heterogeneity in the studies included. and follow-up time (p = 0.8007) (test of moderators-coefficient
2.3). Because meta-regression analysis for these thresholds
3. Results demonstrated no association with the survival rate, meta-analysis
was possible.
3.1. Study selection
3.5. Meta-analyses
The search strategies used yielded 1145 articles. After evaluat-
ing the titles and abstracts, and eliminating duplicates, 181 articles 3.5.1. Survival rate
were considered for full-text review. Finally, eight articles For the Group with incisal coverage (N = 1186), seven articles
[7,9,12,14,15,18,21,23] were included (Fig. 1) for quantitative (Figs. 2 were included, and the cumulative survival rate was 88% (95% CI:
and 3) and risk of bias analysis (Table 1). The flowchart diagram 80%–93%; I2 = 87,44%; p < 0.001) (Fig. 2–A).
shows the search results and all reasons for exclusions (Fig. 1). For the Group without incisal coverage (N = 188), two articles
were included, and the cumulative survival rate was 91% (95% CI:
3.2. Analysis of risk of bias 81%–97%; I2 = 72,13; p = 0.0582) (Fig. 2–B).

The purpose of the NOS of this study was to investigate the risk 3.6. Odds ratio (OR)
of bias of the articles. Assessment of the methodological quality of
each article is summarized in Table 1. Of the 8 studies selected, that Three articles were kept for the OR analysis of the Group with
met the inclusion criteria, only 1 (Fradeani et al., 2005) was incisal coverage preparation in comparison with the Group
considered to have high risk of bias, with NOS scores <6. without incisal coverage-preparation [9,12,21]. Incisal coverage
Otherwise, 7 studies (Magne et al., 2000; Peumans et al., 2004; presented an OR of 1.25 (95% CI: 0.33–4.73; I2 = 65.3%; p = 0.0562);
Smales & Etemadi, 2004; Granell-Ruiz et al., 2010; Layton & however, it was not statistically significant (36 failures in veneers
Walton, 2012; Gürel et al., 2013; Özturk & Bolay, 2014) had with incisal coverage out of 506 veneers, and 28 failures in veneers
relatively low risk of bias with NOS scores !6. without incisal coverage out of 507 out veneers evaluated) (Fig. 3).
4 R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7

Fig. 2. A: Forest plot of with-incisal-coverage group (estimated cumulative overall survival rate—seven included studies). B: Forest plot of without-incisal-coverage group
(estimated cumulative overall survival rate—two included studies).

Fig. 3. Odds ratio (OR) outcome for comparison of with- and without-incisal-coverage group- OR: 1.25 (95% CI: 0.33–4.73; I2 = 65.3%; p = 0.0562).

4. Discussion aggressive dental preparation and thus maintain tooth structure


[20]. Significant differences in the amounts of dental structure
The preparation and design specifications have been recognized removed were quantified between preparation designs. Ceramic
as factors affecting the service duration of ceramic laminate veneers were the least invasive preparation designs (removing
veneers [6] that area valid conservative alternative, as they avoid approximately 3% to 30% by weight of the coronal tooth structure),

Table 1
Results of the risk of bias (NOS) of eight studies included.

Quality criteria A-Selection B-Comparability C-Outcome Total (stars)

A1 A2 A3 A4 B1 C1 C2 C3
Magne et al. (2000) * * * ** * * * 8
Peumans et al. (2004) * * * * ** * * * 9
Smales & Etemadi (2004) * * * * * * * 7
Fradeani et al. (2005) * * * * * 5
Granell-Ruiz et al. (2010) * * * * * * 6
Layton & Walton (2012) * * * ** * * 7
Gürel et al. (2013) * * * ** * * 7
Öztürk & Bolay (2014) * * * * ** * * * 9
R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7 5

Table 2
Study characteristics of eight studies included.

Author Year Material Idiom Country Inclusion Evaluation Follow Setting/ Age N Drop Study N Survival
period criteria up operator range patients out (%) veneers (%)
period (y)
Öztürk & 2014 Glass- English Turkey 2008– Modified USPHS 6 m- 2y University/ 18–51 28 0 PC 125 91,2
Bolay ceramic 2011 1op
(2014)
Gürel et al. 2013 Feldspathic/ English Turkey 1997– Proposal by ns-12y Private/ 23–73 66 0 RC 580 86
(2013) Glass 2009 author 1op
ceramic
Smales & 2004 Feldspathic English Australia 1989– Ns 5y-7y Private/ 16- 50 0 RC 110 95,8a
Etemadi porcelain 1993 2op ! 51 85,5b
(2004]
Granell-Ruiz 2009 Glass- English Spain 1999– Ns 3y-11y University/ 18–74 70 0 RC 323 84.7a
et al. (2010) ceramic 2005 ns op 94b
Layton & 2012 Feldspathic English Australia 1990– Walton’s six- 1y-21y Private/ 15–73 155 19.35 PC 499 91
Walton porcelain 2010 field 1op
(2012) Classification
Fradeani et al. 2005 Feldspathic/ English Italy 1991– Modified CDA/ ns-12y Private/ 19–66 46 0 RC 182 94.4
(2005) Glass- 2002 Ryge 2op
ceramic
Magne et al. 2000 Feldspathic English ns 1992– Proposal by 4,5 y ns/1 op 18–52 16 0 RC 48 85
(2000) porcelain 1996 author
Peumans 2004 Feldspathic English Belgium 1990– Proposal by 5y and Private/ 19–69 25/22 12 PC 87/81 64
et al. (2004) porcelain 1991 author 10y 1op

Legend: ns = not specified; y = year; m = month; w = week; N = Number; ns op = not specified operator; RC = Retrospective cohort; PC = Prospective cohort; * = same sample;
** = average.
a
With incisal coverage.
b
Without incisal coverage.

and for all-ceramic and metal-ceramic crowns, approximately 63% The clinical parameters for lengthening the incisal edge are
to 72% was removed. For a metal-ceramic crown, the amount of determined, based on occlusal and aesthetic factors. Professionals
tooth structure removed was 4.3 times greater than that removed should evaluate changes in shape, color, and the lack of harmony
for a porcelain laminate veneer (with facial surface preparation between teeth. Smile analysis helps whether determine if crown
only) and 2.4 times greater than that removed for a more extensive lengthening should be performed in the incisal or upward gingival
porcelain laminate veneer [8]. upward direction. In the majority of clinical cases, tooth volume
Some authors found better results with incisal covering [21], was re-established by repositioning the incisal edges in the incisal
while others did not [9,12]. The use of incisal ceramic coverage direction up to the point that aesthetics and function allowed.
with veneers has been suggested to enhance restoration survival, Therefore, in many instances, no additional tooth reduction
incisal-edge esthetics and adequate seating of the restoration. In occurred in this area when the mock-up and tooth preparation
addition, incisal coverage can diminish the occurrence of crack by means of the aesthetic pre-evaluative temporary method (APT)
lines and fractures on the palatal side, because it provides the allowed for an increase in the incisal edge on the mock-up, thus
restoration with a stronger bulk of porcelain [3,6,18,19,21]. On the resulting in a more conservative preparation [5,11,12].
other hand, incisal edge preparation was considered unnecessary As regards incisal coverage, no systematic review, up to now,
to ensure or improve restoration strength, as this thin palatal has determined its influence on the survival and failure rates of
extension tended to show more cracks. This occurred because the teeth restored with ceramic veneers. In previous systematic
fracture lines propagated due to repeated heavy mechanical reviews about ceramic veneers [4,24,25], only one systematic
loading, that eventually led to a large porcelain fracture in this review [22] included laboratory studies and addressed the
region [9,16,18]. However, there was no consensus about the most question of the most indicated preparation design. One literature
indicated preparation design, with or without incisal coverage, and review [20] attempted to explore the survival rates of veneers
the type of palatal design (butt joint or palatal chamfer) [2,3,5– based on different incisal preparation designs from both clinical
7,9,10,12,14–16,18–21]. At present, more conservative preparations and non-clinical studies.
should be advocated; however, covering the incisal third seemed to In this systematic review, the chance of failure (OR) was 1.25
be the approach most frequently used, in spite of not being the times higher for the veneers with incisal coverage; however, there
most conservative. In this review, seven studies (N = 1186 veneers) was no statistically significant difference between groups (95% CI:
were included and opted for incisal coverage preparation. Only two 0.33–4.73; I2 = 65.3%; p = 0.0562), and the variability could be
studies (N = 188 veneers) were chosen because they did not cover attributed to variations among the studies. Smales and Etemadi
the incisal edge (Fig. 2–A, Fig. 2–B). [21] considered incisal coverage a protective factor; on the other
It may seem nonsensical, but this occurred because when the hand, Granell-Ruiz et al. [9] and Gürel et al. [12] reported incisal
dentist considered the other clinical parameters, they had to coverage to be a risk factor for failures. Gürel et al. [12] affirmed
choose a method of incisal coverage although this was a less that the incisal coverage increased the chance of ceramic laminate
conservative approach. Therefore, dentists should try to determine veneer failure by 2.3 times.
the best decision-making, based on scientific evidence, according The survival rate was 88% for the group with incisal coverage
to the following clinical questions: 1) In cases in which it would be and 91% for the group without incisal coverage. There was no
possible to choose between two preparation designs, what would statistically significant difference between these groups. Thus, the
be the best option- to cover or not cover the incisal edge? and 2) If null hypothesis was confirmed.
incisal coverage is necessary, which clinical parameters are needed These data indicated that the preparation may not be the most
to lenghthen this incisal edge, and what would be the best type of important factor for the survival of veneers; therefore, if there are
palatal termination? no statistically significant differences, it is best not to overlap the
6 R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7

incisal edge whenever possible, because this is a more conservative 5. Conclusions


approach.
Certain conditions may interfere with the survival rate and Irrespective of the preparation designs for placing ceramic
predict the appearance of clinical complications. Ceramic laminate laminate veneers with or without incisal coverage, high survival
veneer failures usually occurred either because of fractures or rates were revealed, providing evidence that both preparation
debonding, and these failures can be minimized by careful designs are safe and effective options for the conservative
selection of patients; minimal and homogeneous ceramic thick- treatment of anterior teeth. As regards the implications for future
ness; minimal luting composite thickness; a favorable thickness clinical research studies, it is necessary to conduct randomized
ratio between the porcelain and luting cement; application of a clinical studies to compare preparations with and without incisal
modern adhesive, and satisfactory veneer fabrication. In addition, coverage and to provide clear descriptions of these preparation
careful evaluation of occlusion and articulation are always designs.
necessary; they require frequent monitoring, and an auxiliary
preventive procedure, for example, muscle relaxants and occlusal
Acknowledgement
splints [9,12,18].
Ceramic veneers with overlap (incisal/palatal butt-joint mar-
This work was granted by Ibirapuera University in São Paulo,
gin) and full veneers (palatal rounded shoulder margin) were
Brazil.
considered reliable treatment options for anterior teeth with
extensive deficits, and showed similar survival rates [10]. Da Costa
et al. [22] in their systematic review, that included only laboratory References
studies, reported that the butt joint was the preparation that least
affected the strength of the teeth, and the chamfer preparation was [1] O. Addison, G.J. Fleming, P.M. Marquis, The effect of thermocycling on the
strength of porcelain laminate veneer (PLV) materials, Dent. Mater. 19 (4)
more susceptible to ceramic fractures. (2003) 291–297.
This review could not determine what influence the type of [2] G.A. Aristidis, B. Dimitra, Five-year clinical performance of porcelain laminate
preparation (incisal bevel/butt joint or palatal chamfer) had on the veneers, Quintessence Int. 33 (3) (2002) 185–189.
[3] Y. Chaiyabutr, K.M. Phillips, P.S. Ma, K. Chitswe, Comparison of load-fatigue
Group with incisal coverage, as the preparation was not always testing of ceramic veneers with two different preparation designs, Int. J.
well described and standardized. Incisal bevel was not recom- Prosthodont. 22 (6) (2009) 573–575.
mended due to the a high number of clinical failures found [6] and [4] J.H. Chen, C.X. Shi, M. Wang, S.J. Zhao, H. Wang, Clinical evaluation of 546
tetracycline-stained teeth treated with porcelain laminate veneers, J. Dent. 33
this could be explained based on the fact that insufficient tooth (1) (2005) 3–8.
preparation to create space for the porcelain laminate veneer [5] C. Coachman, G. Gurel, M. Calamita, S. Morimoto, B. Paolucci, N. Sesma, The
buildup could lead to fractures [12]. However, other study [23] influence of tooth color on preparation design for laminate veneers from a
minimally invasive perspective: case report, Int. J. Periodont. Restor. Dent. 34
concluded that incisal bevel and incisal overlap (palatal chamfer)
(4) (2014) 453–459.
preparation designs exhibited survival rates of 94% and 85.7%, [6] H.S. Cötert, M. Dündar, B. Oztürk, The effect of various preparation designs on
respectively, but this difference was not statistically significant. the survival of porcelain laminate veneers, J. Adhes. Dent. 11 (5) (2009) 405–
411.
The risk of bias analysis of this study aimed to investigate the
[7] M. Fradeani, M. Redemagni, M. Corrado, Porcelain laminate veneers: 6- to 12-
level of quality for later data interpretation and a better year clinical evaluation—a retrospective study, Int. J. Periodont. Restor. Dent.
understanding of these studies. Moreover, the outcomes may 25 (1) (2005) 9–17.
have varied among studies selected. This variable must be taken [8] D. Edelhoff, J.A. Sorensen, Tooth structure removal associated with various
preparation designs for anterior teeth, J. Prosthet. Dent. 87 (5) (2002) 503–509.
into consideration when the results of this meta-analysis were [9] M. Granell-Ruiz, A. Fons-Font, C. Labaig-Rueda, A. Martínez-González, J.L.
interpreted. The methodological quality of the studies included, Román-Rodríguez, M.F. Solá-Ruiz, A clinical longitudinal study 323 porcelain
assessed by NOS, demonstrated that 1 study had high risk of bias laminate veneers: period of study from 3 to 11 years, Med. Oral Patol. Oral Cir.
Bucal 15 (3) (2010) e531–7.
[7]. Otherwise, 7 studies had relatively high quality. The studies [10] P.C. Guess, C.F. Selz, A. Voulgarakis, S. Stampf, C.F. Stappert, Prospective clinical
that had high quality contributed to assessment of a total of 1.772 study of press-ceramic overlap and full veneer restorations: 7-year results, Int.
veneers, when compared with the low quality studies, with 182 J. Prosthodont. 27 (4) (2014) 355–358.
[11] G. Gurel, S. Morimoto, M.A. Calamita, C. Coachman, N. Sesma, Clinical
veneers. The risk of bias (Table 1) and analysis of the study designs performance of porcelain laminate veneers: outcomes of the aesthetic pre-
(Table 2) may help to understand the differences among studies. evaluative temporary (APT) technique, Int. J. Periodont. Restor. Dent. 32 (6)
In the area of Prosthodontics, randomized clinical studies are (2012) 625–635.
[12] G. Gurel, N. Sesma, M.A. Calamita, C. Coachman, S. Morimoto, Influence of
still scarce, and consequently, when the systematic reviews that enamel preservation on failure rates of porcelain laminate veneers, Int. J.
preceded the present review [4,24,25] reported that the exclusion Periodont. Restor. Dent. 33 (1) (2013) 31–39.
criteria had become very strict, the researchers found the data [13] D. Layton, T. Walton, An up to 16-year prospective study of 304 porcelain
veneers, Int. J. Prosthodont. 20 (4) (2007) 389–396.
were unable to gather strong evidence about the subject. When the
[14] D.M. Layton, T.R. Walton, The up to 21-year clinical outcome and survival of
authors of the present study assessed the foregoing considerations, feldspathic porcelain veneers: accounting for clustering, Int. J. Prosthodont. 25
they resolved to seek elucidation in RCTs, prospective studies, and (6) (2012) 604–612.
retrospective studies, about numerous factors and trends that [15] P. Magne, R. Perroud, J.S. Hodges, U.C. Belser, Clinical performance of novel-
design porcelain veneers for the recovery of coronal volume and length, Int. J.
needed to be investigated with regard to two preparation designs, Periodont. Restor. Dent. 20 (5) (2000) 440–457.
with or without incisal coverage, which could guide new primary [16] A.C. Meijering, N.H. Creugers, F.J. Roeters, J. Mulder, Survival of three types of
studies. veneer restorations in a clinical trial: a 2.5-year interim evaluation, J. Dent. 26
(7) (1998) 563–568.
In spite of the authors seeking studies without any restrictions [17] M. Peumans, B. Van Meerbeek, P. Lambrechts, M. Vuylsteke-Wauters, G.
on language or types of study, the limitation of this study was that Vanherle, Five-year clinical performance of porcelain veneers, Quintessence
few clinical studies, prospective clinical trials, or retrospective Int. 29 (4) (1998) 211–221.
[18] M. Peumans, J. De Munck, S. Fieuws, P. Lambrechts, G. Vanherle, B. Van
clinical trials analyzed the effects of different preparation designs Meerbeek, A prospective ten-year clinical trial of porcelain veneers, J. Adhes.
on the clinical outcomes and complications of laminate veneers. Dent. 6 (1) (2004) 65–76.
Furthermore, the type of preparation was not always well [19] K.K. Schmidt, Y. Chiayabutr, K.M. Phillips, J.C. Kois, Influence of preparation
design and existing condition of tooth structure on load to failure of ceramic
described and standardized, and the results of this and other laminate veneers, J. Prosthet. Dent. 105 (6) (2011) 374–382.
studies reported in the literature, have pointed out the importance [20] A. Shetty, A. Kaiwar, N. Shubhashini, P. Ashwini, D. Naveen, M. Adarsha, et al.,
of planning and preparation techniques for the successful Survival rates of porcelain laminate restoration based on different incisal
preparation designs: an analysis, J Conserv. Dent. 14 (1) (2011) 10–15.
placement of ceramic laminate veneers [12].
R.B. Albanesi et al. / Journal of Dentistry 52 (2016) 1–7 7

[21] R.J. Smales, S. Etemadi, Long-term survival of porcelain laminate veneers using [26] S. Morimoto, R.B. Albanesi, N. Sesma, C.M. Agra, M.M. Braga, Main clinical
two preparation designs: a retrospective study, Int. J. Prosthodont. 17 (3) outcomes of feldspathic porcelain and glass-Ceramic laminate veneers: a
(2004) 323–326. systematic review and meta-Analysis of survival and complication rates, Int. J.
[22] D.C. da Costa, M. Coutinho, A.S. de Sousa, J.P. Ennes, A meta-analysis of the Prosthodont. 29 (1) (2016) 38–49.
most indicated preparation design for porcelain laminate veneers, J. Adhes. [27] D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, P. Group, Preferred reporting
Dent. 15 (3) (2013) 215–220. items for systematic reviews and meta-analyses: the PRISMA statement, J.
[23] E. Ozturk, S. Bolay, Survival of porcelain laminate veneers with different Clin. Epidemiol. 62 (10) (2009) 1006–1012.
degrees of dentin exposure: 2-year clinical results, J. Adhes. Dent. 16 (5) (2014) [28] R.T. Du, Y. Li, D.N. Fan, A retrospective study on the long-term clinical outcomes
481–489. of 310 porcelain laminate veneers, Zhonghua Kou Qiang Yi Xue Za Zhi. 44 (6)
[24] C.M. Kreulen, N.H. Creugers, A.C. Meijering, Meta-analysis of anterior veneer (2009) 343–346.
restorations in clinical studies, J. Dent. 26 (4) (1998) 345–353. [29] G. Wells, B. Shea, D. O’connell, J. Peterson, V. Welch, M. Losos, et al., The
[25] E.A. McLaren, Y.Y. Whiteman, Ceramics rationale for material selection, Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised
Compend. Contin. Educ. Dent. 31 (9) (2010) 666–668 (70, 72 passim; quiz 80, studies in meta-analyses (2000).
700). [30] J.P. Higgins, S.G. Thompson, Quantifying heterogeneity in a meta-analysis, Stat.
Med. 21 (11) (2002) 1539–1558.

Вам также может понравиться