Porcelain veneers: a review of the literature

Transcription

Journal
of
Dentistry
Journal of Dentistry 28 (2000) 163–177
www.elsevier.com/locate/jdent
Review
Porcelain veneers: a review of the literature
M. Peumans*, B. Van Meerbeek, P. Lambrechts, G. Vanherle
Department of Operative Dentistry and Dental Materials, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven,
Kapucijnenvoer 7, B-3000 Leuven, Belgium
Received 15 April 1999; received in revised form 25 June 1999; accepted 10 September 1999
Abstract
Objectives: Porcelain veneers are steadily increasing in popularity among today’s dental practitioners for conservative restoration of
unaesthetic anterior teeth. As with any new procedure, in vitro and in vivo investigations are required to assess the ultimate clinical efficacy
of these restorations. The current literature was therefore reviewed in search for the most important parameters determining the long-term
success of porcelain veneers.
Data sources: Laboratory studies focusing on parameters in prediction of the clinical efficacy of porcelain veneers such as the tooth
preparation for porcelain veneers, the selection and type of the adhesive system, the quality of marginal adaptation, the resistance against
microleakage, the periodontal response, and the aesthetic characteristics of the restorations have been reviewed. The clinical relevance of
these parameters was then determined by reviewing the results of short and medium to long-term in vivo studies involving porcelain veneers
performed during the last 10 years.
Conclusions: The adhesive porcelain veneer complex has been proven to be a very strong complex in vitro and in vivo. An optimal bonded
restoration was achieved especially if the preparation was located completely in enamel, if correct adhesive treatment procedures were
carried out and if a suitable luting composite was selected. The maintenance of aesthetics of porcelain veneers in the medium to long term
was excellent, patient satisfaction was high and porcelain veneers had no adverse effects on gingival health inpatients with an optimal oral
hygiene. Major shortcomings of the porcelain veneer system were described as a relatively large marginal discrepancy, and an insufficient
wear resistance of the luting composite. Although these shortcomings had no direct impact on the clinical success of porcelain veneers in the
medium term, their influence on the overall clinical performance in the long term is still unknown and therefore needs further study. q 2000
Elsevier Science Ltd. All rights reserved.
Keywords: Porcelain veneers; Adhesion; Clinical effectiveness; Laboratory performance; Literature review
Contents
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1. The adhesion complex: tooth/luting composite/porcelain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1.1. Tooth surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1.2. Porcelain veneer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1.3. Luting composite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1.4. The adhesion complex: tooth/luting composite/porcelain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.2. Marginal adaptation of the porcelain veneer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.3. Microleakage at the tooth/luting composite/porcelain interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.4. Periodontal response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.5. Aesthetic characteristics of porcelain veneers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* Corresponding author. Tel.: 132-16-332432; fax: 132-16-332440.
0300-5712/00/$ - see front matter q 2000 Elsevier Science Ltd. All rights reserved.
PII: S0300-571 2(99)00066-4
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M. Peumans et al. / Journal of Dentistry 28 (2000) 163–177
1. Introduction
The patients’ demand for treatment of unaesthetic
anterior teeth is steadily growing. Accordingly, several
treatment options have been proposed to restore the
aesthetic appearance of the dentition. For many years,
the most predictable and durable aesthetic correction of
anterior teeth has been achieved by the preparation of
full crowns. However, this approach is undoubtedly most
invasive with substantial removal of large amounts of
sound tooth substance and possible adverse effects on
adjacent pulp and periodontal tissues. The great progress
in bonding capability to both enamel and dentine made
with the introduction of multi-step total-etch adhesive
systems [1–3], along with the development of highperformance and more universally applicable smallparticle hybrid resin composites has led to more conservative restorative adhesive techniques to deal with
unaesthetic tooth appearance. Resin composite veneers
can be used to mask tooth discolorations and/or to
correct unaesthetic tooth forms and/or positions.
However, such restorations still suffer from a limited
longevity, because resin composites remain susceptible
to discoloration, wear and marginal fractures, reducing
thereby the aesthetic result in the long term [4,5]. In
search for more durable aesthetics, porcelain veneers
have been introduced during the last decade. Glazed
porcelain veneers were proposed to be durable anterior
restorations with superior aesthetics. The idea of porcelain veneers is not a new one. In 1938, Dr Charles
Pincus [6] described a technique in which porcelain
veneers were retained by a denture adhesive during cinematic filming. The fragile restorations had to be
removed after filming because no adhesive system
existed at that time to permanently attach them. Simonsen and Calamia [7] as well as Horn [8] reactivated the
interest in porcelain veneers by introducing special acidetching procedures that substantially improved the longterm porcelain veneer retention. They demonstrated that
the bond strength of an hydrofluoric acid-etched and
silanated veneer to the luting resin composite is routinely greater than the bond strength of the same luting
resin to the etched enamel surface [9]. From the moment
porcelain veneers could be adhesively luted, the clinical
and laboratory techniques have continued to be refined.
As with any new procedure, in vitro studies are required
to analyse the different aspects of this new system, which
are important for clinical functioning. And finally, in vivo
studies are needed to assess the ultimate clinical efficacy of
these restorations. Therefore, laboratory studies focusing on
the most important parameters in prediction of the clinical
efficacy of porcelain veneers have been reviewed. The
clinical relevance of these parameters was then determined
by reviewing the results of short and medium to long-term in
vivo studies involving porcelain veneers performed during
the last 10 years.
1.1. The adhesion complex: tooth/luting composite/
porcelain
The porcelain veneer technique includes the bonding of a
thin porcelain laminate to the tooth surface using adhesive
techniques and a luting composite in order to change the
colour, form and/or position of anterior teeth. The success of
the porcelain veneer is greatly determined by the strength
and durability of the formed bond between the three different components of the bonded veneer complex, as there are
the tooth surface, the luting composite and the porcelain
veneer.
1.1.1. Tooth surface
Concepts regarding the preparation of teeth for porcelain
veneers have changed over the past few years. Although
early concepts suggested minimal or no tooth preparation
[8,10–13], current beliefs support removal of varying
amounts of tooth structure [10,14–19].
Enamel reduction is required to improve the bond
strength of the resin composite to the tooth surface [20–
22]. Doing so, the aprismatic top surface of mature unprepared enamel, which is known to offer only a minor retention capacity, is removed. In addition, care must be taken to
maintain the preparation completely in enamel to realise an
optimal bond with the porcelain veneer [23]. Although the
results of the newest generation dentin adhesive systems are
very promising, the bond strength of porcelain bonded to
enamel is still superior when compared with the bond
strength of porcelain bonded to dentin [24,25].
The vast majority of teeth receiving porcelain laminate
veneers should have some enamel removal, usually approximately 0.5 mm, which allows for the minimal thickness of
porcelain. Christensen [26] states that 0.75 mm is the optimum amount of enamel that should be removed. According
to Ferrari et al. [27], however, the extent and thickness of
enamel in the gingival area of anterior teeth does not permit
a reduction of 0.5 mm without encroaching upon the
dentine. In addition, Natress et al. [28] found that in case
of freehand preparation, the proximal and cervical enamel
was reduced more than 0.5 mm in the vast majority of cases
with exposure of dentine in most teeth.
If dentine is exposed, protection is recommended for the
period between preparation and cementation in order to
prevent post-operative sensitivity and bacterial invasion
[29,30]. The temporary materials (resin composite or acrylic
resin) currently in use only partially seal the surface [31,32].
More effectively, the exposed dentine can be protected by
means of a primer, which is a hydrophilic reactive monomer
in an organic solvent [33,34]. The use of these primers or
desensitisers after preparation seems not to deteriorate adhesion to dentine when the exposed dentine surface is adequately
re-treated at the final appointment prior to the actual cementation [35]. Paul and Schärer [36] even proposed the application
of the dentin bonding agent immediately after completion of
tooth preparation. This new dentin bonding agent application
165
Fig. 1. Field-emission SEM photomicrograph of a GC Cosmotech porcelain surface etched with 9.5% hydrofluoric acid (Porcelain Etch gel, Ultradent) for 60 s
and ultrasonically cleaned. The etched porcelain surface showed an amorphous micro-structure with numerous micro-porosities. (Bar 10 mm;
Magnification 10 000 × ).
technique may prevent the development of bacterial leakage
and dentin sensitivity during the temporary phase, and the
technique is associated with improved bond strength in vitro.
If temporary resin veneers must be placed because of aesthetic
and/or phonetic reasons, it is indicated to use an eugenol
free temporary cement in order to maintain the original bond
strength [37]. Alternatively temporary veneers may be
constructed in composite, held in place by a small area of
etched enamel [14,17].
Regarding the incisal preparation, three basic types of
preparation have been described namely, the window or
intra-enamel preparation, the overlapped incisal edge
preparation and the feathered incisal preparation. Several
authors favoured the overlapped incisal preparation
[16,17,26]. With this type of incisal preparation, the
dental technician has more control on the aesthetic characteristics of the incisal part of the porcelain veneer. In
addition, this preparation will make the restoration more
resistant to incisal fractures. Highton et al. [38]
confirmed this latter statement in vitro using a twodimensional photo-elastic stress analysis. This type of
preparation distributed the occlusal load over a wider
surface area and, consequently, reduced stress concentration within the veneer. On the contrary, an in vitro
study by Hui et al. [39] and Gilde et al. [40] demonstrated that an overlap porcelain veneer design will
transmit maximum stress on the veneer and increases
the risk of cohesive fracture. A window design prepared
entirely into enamel withstood axial stress most favourably in this investigation. They concluded that where
strength is an important requisite, the most conservative
type of veneer, namely the window preparation, was the
design of choice. However, in the clinical study of
Meijering et al. [41] no relation was seen between
survival and incisal preparation design (no incisal overlap versus incisal overlap) for both indirect resin
composite and porcelain veneers after 2.5 years of clinical functioning. Further in vivo studies have to point
out if a similar result would be noticed in the long
term.
1.1.2. Porcelain veneer
Veneers are mainly fabricated from conventional low
fusing feldspathic porcelain. Two methods for fabrication
of these porcelain veneers have been described: the platinum foil technique [8,11,14,42] and the refractory die technique [14]. At present, the refractory die technique is
preferred to the platinum foil technique in most laboratories
[43].
By etching the inner side of the porcelain veneer with
hydrofluoric acid and subsequently silanizing the etched
surface, the bond strength of a luting composite to the
etched porcelain surface has been measured to be higher
than the bond strength of a luting composite to etched
enamel and even exceeding the cohesive strength of the
porcelain itself [9,22,44–47]. Etching the inner side of the
porcelain veneer with hydrofluoric acid creates a retentive
etch pattern. SEM of the etched porcelain surface showed an
amorphous micro-structure with numerous porosities
[44,47–50] (Fig. 1). These micro-porosities increase the
surface area for bonding and lead to a micro-mechanical
interlocking of the resin composite. Several factors like
the etching time, concentration of the etching liquid, fabrication method of the porcelain restoration [7,44], and type
of porcelain [51,52] determine the micro-morphology of the
etch pattern and consequently the bond strength of the resin
composite to the etched porcelain.
In addition to micro-porosities, micro-cracks were
observed that grow when the etching time increases [49].
These cracks can act as sources of crack initiation and
slightly, although not significantly, decrease the flexural
strength of the etched porcelain. Weakening of the
166
Fig. 2. The interface tooth/luting composite/porcelain of a bonded to tooth porcelain veneer shows the interdigitation of the luting composite into the etchedand-silanized porcelain surface and the etched enamel surface. (Bar 25 mm; Magnification 625 × ) Center: Magnification of the luting composite (Opal
Luting Composite, 3M). At the luting composite/porcelain interface, the luting composite is diluted with unfilled resin (u) (Scotchbond Multi-Purpose, 3M).
The undiluted luting composite contains densely packed rounded filler particles of different sizes. (Bar 1 mm; Magnification 5000 × ).
porcelain by etching was also noted in other in vitro studies
[53,54].
Ultrasonic cleaning of etched porcelain in 95% alcohol,
acetone or distilled water is indicated to remove all residual
acid and dissolved debris from the surface. Inadequate
rinsing after etching the porcelain surface may leave remineralised salts, which can be recognised as a white residue or deposit [55]. Some authors [50,56] studied the etch
patterns of hydrofluoric acid on feldspathic porcelain with
SEM and concluded that the best surface, in terms of penetrability, was obtained by immersion of the etched porcelain
in an ultrasonic bath. Aida et al. [57], however, observed no
significant differences in surface morphology and bond
strength between etched (5% GC Hydrofluoric Acid, GC
Corp., Tokyo, Japan) feldspathic porcelain with and without
ultrasonic cleaning.
Silanization of etched porcelain with a bi-functional
coupling agent provides a chemical link between the luting
resin composite and porcelain. A silane group at one end
chemically bonds to the hydrolysed silicon dioxide at the
ceramic surface, and a methacrylate group at the other end
copolymerises with the adhesive resin. Single-component
systems contain silane in alcohol or acetone and require
prior acidification of the ceramic surface with hydrofluoric
acid to activate the chemical reaction. With two-component
silane solutions, the silane is mixed with an aqueous acid
solution to hydrolyse the silane, so that it can react directly
with the ceramic surface. If not used within several hours,
silane will polymerise to an unreactive polysiloxane [58].
Several authors reported differences in bond strength dependent on the silane treatment used [45,46,51,56]. In addition,
heating of the silane-coated porcelain to 1008C resulted in a
bond strength twice as high than if no heating was used [52].
The bond strength of resin composite to a pre-treated
ceramic restoration has been described to be negatively
influenced by external factors like water sorption [52], thermocycling [22,59], and fatigue [60]. Contamination of the
pre-treated surface with die stone [61], latex gloves [62],
saliva [46,59], silicone-based fit-checker paste [63,64], and
try-in paste [65] will also lower the bond strength. Several
cleaning methods were proposed to restore the original bond
strength. In case of contamination with saliva, re-etching the
inner side of the porcelain with 37% phosphoric acid
restored the bond strength [46,66]. Acetone cleaning, after
removal of the try-in paste, produced a marked reduction in bond strength [61,65]. This cleaned surface had
to be silanated again to restore the original bond
strength [65]. A decreased bond strength due to contamination with fit-checker paste was restored by re-etching
and silanizing the porcelain surface [64], whereas Sheth
et al. [63] reported that the original bond strength could
not be restored due to chemical contamination of the
porcelain surface.
1.1.3. Luting composite
For cementation of porcelain veneers a light-curing luting
composite is preferred [55]. A major advantage of lightcuring is that it allows for a longer working time compared
with dual cure or chemically curing materials. This makes it
easier for the dentist to remove excess composite prior to
curing, and greatly shorten the finishing time required for
these restorations. In addition, their colour stability is superior compared with the dual-cured or chemical-cured
systems. Nevertheless, it is important that there is enough
light transmittance throughout the porcelain veneer to polymerise the light-curing luting composite. The porcelain
veneer absorbs between 40–50% of the emitted light. The
thickness of the porcelain veneer is the primary factor
Table 1
Descriptive statistics of clinical trials involving porcelain veneers (evaluation criteria*: color (1), surface texture (2), wear (3), marginal adaptation (4), marginal discoloration (5), caries (6), fracture (7), retention
(8), post-operative sensitivity (9), gingiva response (10), patient satisfaction (11))
Number of veneers
Number of patients
Porcelain/adhesive-system
Type of preparation
Observation-period
Evaluation criteria*
Clyde and Gilmoure [42]
200
Not specified
Chameleon(Terec)/Duo-cure
(Terec)
Feathered incisal edge
Incisal bevel
Palatal overlap
1–30 months
1,7,8,9,10
Calamia [89]
115
17
Chameleon (Terec)/
Comspan 1 Ultrabond
(Den-Mat)
No preparation
Slight incisal overlap
2–3 y
4,5,6,7,8,10
(USPHS criteria)
Jordan et al. [90]
80
12
Not specified/dual cure
(not specified)
Conventional
(no incisal overlap)
4y
1,2,3,4,6,8,9,10
(modified Ryge criteria)
Rucker et al. [84]
44
16
Vitadur-N(Vita)/
Heliolink 1 Dual cement
(Vivadent)
Incisal bevel
2y
1,4,7,8,10,11
163
45
Feathered incisal edge
Feathered incisal egde
3y
1,4,5,6,7,10,11
135
41
3y
3,4,5,7,8
80
25
Cerinate (Den-Mat)/
Ultrabond (Den-Mat)
Ceramco (Ceramco Inc.)/
Porcelite LC (Kerr)
Mirage/Mirage
FLC 1 Mirage Bond (FA
Mirage)
1–7 y
4(SEM),5,6,7,10,11
Strassler and Nathanson [83]
291
60
Cerinate (Den-Mat)/
Ultrabond (Den-Mat)
No preparation
Conventional
Strassler and Weiner [92]
115
21
Cerinate (Den-Mat)/
Ultrabond (Den-Mat)
No preparation
Conventional
7–10 y
1,4,5,6,7,8
(modified USPHS criteria)
Walls [93]
54
12
Special preparation for
worn teeth
5y
5,7,8,10
Meijering [41]
56
Not specified
Fiber reinforced porcelain
(not specified)/Heliolink
(Vivadent) 1 Gluma (Bayer)
Flexo-ceram (Elephant
Ceramics)/not specified
2.5 y
1,4,5,6,7,8,9,10,11
Peumans et al. [87]
87
25
Conventional
Palatal overlap
Palatal overlap
5–6 y
1,2,4,5,6,7,8,10,11
Kihn et al. [88]
59
12
Conventional (no
incisal overlap)
Palatal overlap
48 months
1,4,5,6,9,10
Christensen and Christensen
[91]
Nordbq et al. [85]
Jäger et al. [86]
GC Cosmotech Porcelain/GC
Cosmotech Bonding Set
(GC) 1 Scotchbond 2 (3M)
Ceramco Colorlogic/
Ceramco Colorlogic Bonding
System
Conventional
Palatal overlap
(10 veneers .4 y)
18–42 months
1,4,5,7,8
Author
167
168
Author
Retention 1 Fracture rate (%)
Excellent margins (%)
Microleakage (%)
Clyde and Gilmoure [42]
Calamia [89]
Jordan et al. [90]
Rucker et al. [84]
Christensen and Christensen
[91]
Nordbq et al. [85]
Jäger et al. [86]
Strassler and Nathanson [83]
Strassler and Weiner [92]
Walls [93]
Meijering et al. [41]
Peumans et al. [87]
Kihn et al. [88]
1
3
3
0
13
–
93
83
100
65
–
17
–
–
8
5
1
1.7
7
14
Not specified
1
0
Not specified
55
96
88
Not specified
98
14
85
Negligible
1
0
14
28
22
25
2
Caries (%)
Periodontal health
Maintenance of aesthetics (%)
Patient satisfaction
–
1
0
–
1
Excellent (not specified)
Acceptable
Excellent
Excellent (not specified)
Slight gingival irritation
–
100
100
100
100
–
–
–
100% excellent
87% excellent
–
1
0
1
–
0
2
0–1
–
Excellent
–
–
Excellent
Excellent
Slight gingival irritation
No gingival response
100
–
100
100
–
100
100
100
–
84% excellent
–
–
–
93% excellent
80% excellent
/
Table 2
Results of clinical trials involving porcelain veneers
determining the light transmittance available for polymerisation [67–73]. The colour and the opacity of the porcelain
would have less influence on the amount of absorbed light
[69,72,73]. Linden et al. [72] reported that the opacity of
porcelain became more important for facings with a thickness of 0.7 mm or more. Consequently, the presence of a
porcelain veneer increases the setting time of the resin
composite used beneath the veneer [69–72]. O’Keefe et al.
[73] argued that it was necessary to double the recommended exposure time.
In case of porcelain with a thickness of more than 0.7 mm
[72], light-cured resin composites do not reach their maximum hardness. A dual-cured luting composite, which
contains the initiation systems for both chemically and
light-cured composites, is advisable in these situations.
With these latter luting agents a stronger bond can be
obtained with the porcelain [68]. Also higher values of hardness were reported for the dual-cure resin cements than for
the light-cured luting composites because of their higher
degree of polymerisation [72,74].
Regarding the classification of luting composites, Albers
[55] ranked these luting composites following the classification of resin composites for restorative purposes proposed
by Lutz and Phillips [75]. According to Inokoshi et al. [76],
it is difficult to classify the luting composites following
these criteria because their high content of small particles
requires that many of them would be classified as hybrid
resins or heavily filled resins. A classification of 14 dualcure luting composites was made according to their maximum filler size. This maximum filler size varied extremely
from less than 1 to 250 mm. The predominant filler size for
all products was much smaller than the maximum filler size.
The filler weight varied from 36 to 77%. No correlation was
observed between filler loading, maximum filler size and
consistency of these dual-cured luting composites, whereas
a strong correlation was found between the consistency and
the film thickness of the luting agents. This relation was
supported by the temperature dependence of the film thickness reported for these dual-cure luting composites [77].
The great diversity in the currently available products
makes clear specification for luting composites urgently
needed.
1.1.4. The adhesion complex: tooth/luting composite/
porcelain
The adhesion complex porcelain/luting composite/tooth
was studied by Stacey [22]. He reported that a very strong
complex was obtained in vitro by luting the porcelain
veneer. The strength of the combined porcelain/luting
composite/enamel bond (63 MPa) was significantly higher
than the separate composite/etched enamel (31 MPa) and
luting composite/etched-and-silanized porcelain (33 MPa)
bond strengths. This assumes that a close apposition of the
enamel and the porcelain surface synergistically influences
the bond strength of the luting composite/enamel and luting
composite/porcelain bonds. In addition, Andreasen et al.
169
[78] and Stokes and Hood [79] noted that extracted incisors
restored with porcelain veneers were recovered to their
original strength. A laboratory investigation analysing
ultra-morphologically the adhesive interface of porcelain
veneers bonded to tooth structure confirmed the high retention of bonded porcelain veneers [50]: FE-SEM photographs showed a strong micro-mechanical interlocking of
the luting composite in the micro-retentive pits of the acidetched tooth surface at one side and in the etch pits of the
acid-etched porcelain surface at the other side (Fig. 2).
Magne and Douglas [80] also demonstrated that porcelain
veneers restore the mechanical behaviour and microstructure of the intact tooth in vitro even when they are bonded to
an extensive dentin surface using an optimised application
mode of dentine adhesives. Nevertheless, significant cyclic
temperature changes can induce the development of flaws in
porcelain veneers. A sufficient and even thickness of ceramic combined with a minimal thickness of luting composite
will provide the restoration with a favourable configuration
with regard to crack propensity, namely, a ceramic and
luting composite thickness ratio above 3 [81]. This ratio
also appears to have a relevant influence on the stress distribution in porcelain laminates. Restorations that are too thin,
combined with poor internal fit, resulted in higher stresses at
both the surface and interface of the restoration [82].
Ultimately, the clinical relevance of these in vitro results
must be determined in vivo. A review of clinical trials involving porcelain veneers, that were conducted during the last
10 years, is summarised in Table 1 with their respective
descriptive statistics (Table 1) and results (Table 2). These
in vivo results confirmed the strong bond between a porcelain veneer and the underlying tooth tissue as most short and
medium-term clinical studies reported a very low failure
rate (0–5%) due to loss of bonding and fracture [42,83–
88]. Somewhat higher failure rates were noted by Christensen and Christensen [91], 13% after three years and by
Strassler and Weiner [92], 7% after 7–10 years. Walls
[93] also observed a high number of fractures and/or loss
of porcelain veneers (14%) after five years of clinical functioning. Unfavourable occlusion and articulation seemed to
have been a determining factor for the high failure rate of
porcelain veneers as the latter restorations were placed
for aesthetic and functional reconstruction of fractured
and worn anterior teeth in patients with a history of
bruxism. The large exposed dentine surfaces to be
bonded in these fractured and worn teeth (using a
third generation dentin adhesive) may also have contributed to the high failure rate.
Some authors [94,95] reported higher failure rates in vivo
when porcelain veneers were partly bonded to underlying
composite restorations. This bonding is based on delayed
resin-to-resin bonding, which may decrease the bond
strength of the porcelain veneer–tooth complex.
As a conclusion, in vitro and in vivo studies indicated that
porcelain veneers are strong and durable restorations in the
medium to long term when enough intact tooth tissue is left
170
Fig. 3. SEM photomicrograph of the cervical margin of a 5-year old porcelain veneer (P) showing a small marginal defect and a border of roughened porcelain
(arrows). (G, gingiva; C, luting composite) (Bar 250 mm; Magnification 52 × ).
to bond the porcelain veneer and when occlusion and articulation are not pathological.
1.2. Marginal adaptation of the porcelain veneer
For any cemented restoration the weak link is at the
restoration-cement–tooth interface. In porcelain veneers
the composite luting agent is the weak link in the system.
When used as a luting agent, the bulk of composite resin is
greatly reduced. However, there is still polymerisation
volumetric shrinkage in the amount of 2.6–5.7% [96],
which may create a marginal opening or loss of the
marginal seal. The thermal expansion coefficient (TEC) is
also different from the tooth tissues and the porcelain.
Finally, composite resins may wear and the wear will be
greater in case of larger gap widths compared to smaller
ones [97]. In addition, in vitro studies have demonstrated
a dissolution of the resin matrix of composite resin in oral
fluids [98–100]. Therefore it is desirable to minimise the
composite component and maximise the porcelain component by having as close an adaptation of the porcelain
veneer as possible.
Sorensen et al. [101] compared in vitro the marginal fit of
porcelain veneers fabricated by the two procedures
described above: the platinum foil technique and the refractory die technique. They reported that the mean vertical
marginal discrepancy (for all positions combined) for platinum foil veneers (187 mm) was significantly less than that
for veneers made with the refractory die technique
(242 mm). The same observation was done by Sim and
Ibbetson [102] (60 versus 290 mm) and Wall et al. [103]
(74 versus 132 mm), although they reported smaller
marginal gap widths. This finding seems however incongruous, considering that the platinum foil occupies 25 mm. Lim
and Ironside [104] reported that divesting with aluminium
oxide abrasive may account for inadvertent abrasion of the
delicate inner porcelain surface and causes larger marginal
discrepancies (114 mm with sandblasting versus 97 mm
without sandblasting).
With the refractory die technique, the importance of
matching the thermal expansion coefficient between the
refractory die and the ceramic must be emphasised in
order to fabricate restorations with a significantly improved
marginal accuracy [105]. Intermixing of individual ceramic
and refractory products seems to be commonplace in many
laboratories with some combinations having different
thermal expansion coefficients [43].
For both fabrication techniques, the marginal openings at
the gingivo-proximal corners were two to four times larger
than at the mid-labial position [101,102,106]. This is probably the result of the shrinkage of porcelain towards the
region of greatest bulk (the centre) and the geometry of
the margins. Clinically this poorer fit at the gingivoproximal corners of the veneers would be further
compounded by the difficulty in access for finishing of the
luted veneers in these regions.
When luting porcelain veneers it is important that the
marginal discrepancies are completely filled with the luting
composite, in order to polish the cement layer to a smooth
margin. Harasani et al. [106] observed after finishing of the
veneers still a considerable amount of excess luting agent at
the veneer margins. Also Coyne and Wilson [107] reported
that only a small proportion of the margins of each porcelain
veneer was found to have an ideal marginal adaptation
microscopically. Hannig et al. [108] noted that especially
the cervical region seems to be a problematic area to achieve
perfect marginal adaptation.
Tay et al. [109] advised to remove the excess of nonpolymerised composite cement with a brush moistened
with bonding resin. This will reduce the dragging out
tendency of the resin out of the marginal gap and ensure a
smoother margin that is polishable.
171
Fig. 4. Field-emission SEM photomicrograph of the luting composite/etched enamel interface of a bonded to tooth porcelain veneer. At the most cervical
enamel area, the luting composite is bonded to aprismatic enamel. Atypically shaped prisms are present. (C, Luting composite; E, Enamel, u, unfilled resin)
(Bar 2 mm; Magnification 5000 × ).
Finishing of the veneer margins corrects the inherent
marginal defects but results in removal of the glaze from
the porcelain [87] (Fig. 3). This will cause increased plaque
retention and gingival reaction on the one hand and wear of
the antagonistic elements on the other hand, unless the
porcelain can be polished to a smooth surface.
Some authors showed that polishing procedures can
produce a polished surface, which is equal to a glazed
porcelain surface [110–112]. While these polishing instruments perform satisfactorily on flat accessible surfaces at
high speeds, none of them are well suited for finishing
crucial gingival or interproximal regions of a bonded
veneer. Haywood et al. [113] evaluated finishing and
polishing in these crucial areas in vitro. According to
these authors, a finish equal or superior in smoothness to
glazed porcelain was achieved through the use of a series of
finishing grit diamonds (Micron Finishing System) followed
by a 30-fluted carbide bur and diamond polishing paste.
Other finishing combinations produced surface textures,
which were not as smooth as glazed porcelain. Polishing
under waterspray produced also a smoother surface for a
given diamond sequence than did dry polishing [114].
However, the effect of all these finishing procedures at
the cervical margins of the veneer with their difficult
accessibility for polishing instruments, must be evaluated
in vivo.
Regarding the marginal adaptation of porcelain veneers
after several years of clinical functioning, most in vivo
Fig. 5. Field-emission SEM photomicrograph of the luting composite/etched enamel interface of a bonded to tooth porcelain veneer at the area of prismatic
enamel. The enamel prismata are longitudinally sectioned. The perifery of the enamel prisms is preferentially dissolved forming macro-tags with a depth of
approximately 5 mm (large arrows). Micro-tags are present between the hydroxyapatite crystals (small arrows). The macro-tags and micro-tags contribute to an
enormous increase in surface area for bonding. (C, Luting composite; E, Enamel) (Bar 2 mm; Magnification 5000 × ).
172
Fig. 6. Field-emission SEM photomicrograph of the luting composite/etched dentine interface at the cervical third of a bonded to tooth porcelain veneer. The
dentine tubules (arrows) are longitudinally sectioned. The dark area represents the hybrid layer and the layer of unfilled adhesive resin (H). No loss of bonding
is observed in this area using a modern total etch dentine adhesive system (Scotchbond Multi-Purpose, 3M). (C, Luting composite; D, dentine) (Bar 10 mm;
Magnification 1000 × ).
studies reported a relatively high number of restorations
with an excellent marginal adaptation (65–98%)
[41,83,84,88–92], while only few clinical studies reported
that small marginal defects were frequently observed along
the entire outline of the porcelain veneer after five years of
functioning [86,87] (Table 2). SEM examination showed
that these small marginal defects were due to the wearing
out of the composite luting agent and loss of bonding
[86,87]. A similar phenomenon was reported as submargination in several in vivo studies of porcelain inlays [115–117].
Further research should be directed towards improvement of marginal adaptation of the porcelain veneers.
Attention must be given to the laboratory procedure to
reduce the marginal gap width and to the finishing
procedure to diminish the excess of resin composite at the
margins. Finally more wear-resistant luting composites
should be developed.
1.3. Microleakage at the tooth/luting composite/porcelain
interface
The polymerisation shrinkage of the luting composite and
the difference in thermal expansion coefficient between the
luting composite and both the tooth and the porcelain veneer
causes stress at the tooth/luting composite/porcelain interface. According to the theories by Feilzer et al. [118], there
is only a limited potential for relaxation of polymerisation
stress due to flow because the luting composite is bonded at
all sides in a narrow “gap” with only a limited area of
unbonded surface. Consequently, Feilzer et al. [119] found
that when the thickness of the resin composite is thinned
down, as in the case of a luting agent, the wall-to-wall
polymerisation shrinkage might be three times the normal
linear contraction of bulk resin composite. Residual polymerisation stress could then be expected to be even greater
Fig. 7. The oblique sectioned dentine tubules at the luting composite/etched dentine interface are filled with resin tags (arrow). No loss of bonding is observed
in this area using a modern total etch dentine adhesive system (Scotchbond Multi-Purpose, 3M). (C, Luting composite; D, dentine; H, hybrid layer and layer of
unfilled adhesive resin) (Bar 5 mm; Magnification 2000 × ).
than that reported for resin composite restorations. Due to
this contraction stress there exists a competition between the
adhesive forces of the two bonded interfaces: the porcelain/
luting composite interface and the luting composite/tooth
interface. The interface with the lowest adhesive forces
will fail namely the luting composite/tooth interface. Microleakage will occur at this interface and may then lead to
staining, post-operative sensitivity and recurrent caries.
Microleakage at the luting composite/porcelain interface
was negligible [101,120,121]. At the interface luting
composite/tooth the microleakage was minimal when the
preparation margins were located completely in enamel
[101,120–123]. Only at the cervical margin, microleakage
was more pronounced. This would be due to the presence of
aprismatic enamel in the cervical region [50,124] (Figs. 4
and 5). Porcelain veneer preparations generally end in this
region of aprismatic enamel, which therefore may be largely
responsible for the poor marginal sealing reported at the
cervical margins of porcelain veneers in vitro [101,120–
123]. When the cervical preparation margin was located in
dentine, significantly greater microleakage was recorded at
the luting composite/tooth interface [125]. The use of a third
generation dentine bonding agent can reduce the occurrence
of microleakage according to several authors [120,125] in
contrast with the results obtained by Sim et al. [123],
who reported that none of the tested (third generation)
dentine bonding agents significantly reduced microleakage at the dentine margins. Dietschi et al. [126]
reported an obvious reduction in marginal leakage of
ceramic inlays when bonded to dentin using two
modern dentine adhesives, although the integrity of
the adhesive interface did not yet appear optimal in
dentine bonded ceramic restorations because bonding
failures occurred mainly between the hybrid layer and
the overlaying resin. In another in vitro study debonding
was never noticed along the luting composite/dentin
interface when a modern multi-step total-etch dentin
adhesive system was used [50] (Figs. 6 and 7). Magne
and Douglas [80] noticed in vitro that the method of
dentin adhesive application during placement of the
porcelain veneer had an influence on the quality of
the luting composite dentin/interface. Their scanning
electron microscope observations demonstrated that the
traditional application of a multi-step total etch dentin
adhesive (dentin adhesive applied when proceeding to
luting the veneer) was associated with bonding failures
between the hybrid layer and the overlaying resin,
whereas unbroken and continuous interfaces were
obtained with a new method using the same dentin
adhesive (dentin adhesive applied to dentin and cured
before taking the impression of the veneer). However,
none of the modern adhesive systems appears yet to be
able to guarantee hermetically sealed restorations with
margins free of discoloration for a long time [25].
Another effective method to reduce microleakage is by
post-finishing sealing the margins of the veneer with a
173
bonding resin [125]. Further research is necessary to evaluate the retention of the sealer.
In addition to the location of the preparation margins, the
type of luting composite determines the occurrence of
microleakage as the thermal expansion coefficient and the
amount of polymerisation shrinkage vary among the type of
resin composite. A high filler loading reduces the thermal
expansion coefficient and polymerisation shrinkage.
Because of these reasons, a luting composite with an optimal filler loading is preferred to lute the porcelain veneers
[101,121,122,123]. However, the viscosity of such cements
is high and hence the positioning of the veneer during the
luting procedure may be delicate. The luting procedure with
these highly filled luting composites can be simplified by
using an ultrasonic insertion technique [127]. Clinical
confirmation of this method is however required.
Light-cured and dual-cured luting composites show a
similar leakage pattern at the luting composite/tooth interface according to Zaimoglu et al. [122], whereas Jankowski
et al. [128] observed less microleakage when using dualcured luting composites.
In clinical studies, microleakage was more frequently
observed when dentine was exposed during preparation
for porcelain veneers [89], even when a third generation
dentine adhesive system was used [87,93]. In other clinical
studies of porcelain veneers with complete intra-enamel
preparations, microleakage was reported less frequently
[83,85,88,91,92]. Finally, microleakage was rarely associated with the presence of caries in vivo [41,83,86–92].
As a conclusion, microleakage can be minimised by
locating the preparation margins of the veneer in enamel
and by selecting a highly filled luting composite.
1.4. Periodontal response
Porcelain is considered as the most aesthetic and biocompatible material in dentistry with the ability to imitate sound
enamel. Several studies showed that porcelain retains
plaque less than other restorative materials or enamel
[129–132], that the plaque is removed more rapidly from
porcelain surfaces and/or that the bacterial plaque vitality on
these surfaces was smaller [133]. The low surface roughness
of the glazed porcelain may to a large part be responsible for
this phenomenon [134]. Based on these observations one
would expect no or even a positive reaction of the marginal
gingival tissues towards porcelain veneers.
Several short-term [89,135] and medium-term
[88,93,136] clinical studies of porcelain veneers confirmed
this expectation. They reported no increase of even a
decrease in plaque accumulation on these restorations.
Kourkata et al. [135] even described a significant lower
bacterial plaque vitality immediately after placement of
the porcelain veneers. Peumans, however, observed a slight
increase in plaque retention at the cervical margins of 5-year
old porcelain veneers [137]. This slight increase was
explained by the increased surface roughness at the cervical
174
border of the restoration caused by removal of the glaze of
the porcelain during finishing with microfine finishing
diamonds (Fig. 3). In addition to this roughened cervical
border, the presence of small cervical marginal defects
can lead to an increased plaque retention [87].
Concerning the gingival response, most clinical studies
observed no change in gingival health at the restored teeth
[41,42,84,86,88–90,93,136] (Table 2). Only a few clinical
studies reported a slight gingival inflammation at the
restored teeth [91], especially in patients with a moderate
or bad oral hygiene [137].
According to Pippin et al. [136], the location of the cervical extension of the restoration in location to the gingival
margin also plays an important role in the reaction of the
gingival tissues. They reported that the gingival reaction
increased as the extension was located closer to or below
the gingival margin, however, the gingival reaction for
porcelain veneers was at the same location lower than for
the metal ceramic restorations.
In conclusion, no or a minimal periodontal response can
be expected at teeth restored with porcelain veneers. An
optimal oral hygiene of the patient and smoothly finished
margins are important factors to maintain an optimal periodontal health around the restored teeth.
1.5. Aesthetic characteristics of porcelain veneers
There is a general agreement among the practitioners that
porcelain veneers will continue to play a vital role in elective dental aesthetics. This places high demands on predictability, especially with colour matching and masking
methods. The final shade of the veneers depends not only
on the colour, opacity and thickness of the porcelain but also
on the colour of the underlying tooth and the colour and
thickness of the luting composite [138–143].
Colour matching of one discoloured tooth with a porcelain veneer to the surrounding natural teeth must be considered as most difficult. It is impossible to mask a strong
discoloration by a thin layer of porcelain (0.3–0.7 mm)
without making the restoration opaque and lifeless. Consequently, the restored tooth will never have the same translucency as the surrounding natural teeth. [14,15,42,55,87].
Regarding the aesthetics (colour stability and surface
smoothness) of porcelain veneers after several years of clinical functioning, all clinical studies confirmed the maintenance of aesthetics of porcelain veneers in the short term
and in the medium to long term (Table 2). In addition,
patient acceptance of porcelain veneers in these clinical
studies was high. The percentage of patients that were
completely satisfied with the porcelain veneers varied
from 80 to 100% (Table 2). Some studies even reported
an increase in patient satisfaction after several years
[91,144]. This increase was explained by the habituation
of the patients to the aesthetic improvement of their dentition with porcelain veneers.
2. Conclusion
The adhesive porcelain veneer complex appeared to be a
very strong complex in vitro and in vivo. An optimal bond
was obtained if the preparation was located completely in
enamel, if correct surface treatment procedures were carried
out and if a suitable composite luting agent was selected.
However, from an aesthetic and periodontal point of view a
complete intra-enamel preparation cannot always be
realised. The quality of the restoration was inferior if
dentine was exposed to a large extent, as the current dentin
bonding agents are not yet able to prevent microleakage at
the dentin margins in the long term.
The periodontal response to porcelain veneers varied
from clinically acceptable to excellent. Regarding the
aesthetic properties of the porcelain veneers, these restorations maintained their aesthetic characteristics in the
medium to long term and patient satisfaction was high.
The major shortcoming of porcelain veneers was the relatively wide marginal discrepancy. At these marginal openings the luting composite was exposed to the oral
environment and the wear resistance of the composite luting
agents was not yet optimal.
Nevertheless, these shortcomings had no direct impact on
the success of porcelain veneers in the medium term,
however, their influence on the overall clinical performance
in the long term is still unknown.
References
[1] Nakabayashi N, Kojima K, Masuhara E. The promotion of adhesion
by infiltration of monomers into tooth substrates. Journal of Biomedical Materials Research 1982;16:265–73.
[2] Van Meerbeek B, Vanherle G, Lambrechts P, et al. Dentin- and
enamel-bonding agents. Current Opinion in Dentistry 1992;2:117–
27.
[3] Pashley DH, Ciucchi B, Sano H, et al. Permeability of dentin to
adhesive agents. Quintessence International 1993;24:618–31.
[4] Peumans M, Van Meerbeek B, Lambrechts P, et al. The five-year
clinical performance of direct composite additions to correct tooth
form and position. Part I: aesthetic qualities. Clinical Oral Investigations 1997;1:12–18.
[5] Peumans M, Van Meerbeek B, Lambrechts P, et al. The five-year
clinical performance of direct composite additions to correct tooth
form and position. Part II: marginal qualities. Clinical Oral Investigations 1997;1:19–26.
[6] Pincus CR. Building mouth personality. Journal of South California
Dental Association 1938;14:125–9.
[7] Simonsen RJ, Calamia JR. Tensile bond strength of etched porcelain. Journal of Dental Research 1983;62:297 Abstract 1154.
[8] Horn RH. Porcelain laminate veneers bonded to etched enamel.
Dental Clinics of North America 1983;27:671–84.
[9] Calamia JR, Simonsen RJ. Effect of coupling agents on bond
strength of etched porcelain. Journal of Dental Research
1984;63:179 Abstract 79.
[10] Calamia JR. Etched porcelain veneers: the current state of the art.
Quintessence International 1985;1:5–12.
[11] Plant CG, Thomas GD. Porcelain facings: a simple clinical and
laboratory method. British Dental Journal 1987;163:231–4.
[12] McLaughlin G, Morrison JE. Porcelain fused to tooth: the state of the
art. Restorative Dentistry 1988;4:90–4.
[13] Reid JS, Murray MC, Power SM. Porcelain veneers—a four year
follow-up. Restorative Dentistry 1988;5:42–55.
[14] Garber DA, Goldstein RE, Feinman RA. Porcelain laminate veneers,
Lombourg: Quintessence Publishing Co, 1987.
[15] McComb D. Porcelain veneer technique: a promising new method
for restoring strength and esthetics to damaged or discolored teeth.
Ontario Dentist 1988;65:25–32.
[16] Weinberg LA. Tooth preparation for porcelain laminates. New York
State Dental Journal 1989;5:25–8.
[17] Nixon RL. Porcelain veneers: an esthetic therapeutic alternative. In:
Rufenacht CR, editor. Fundamentals of esthetics, Lombourg: Quintessence Publishing Co, 1990. p. 329–68.
[18] Garber DA. Porcelain laminate veneers: to prepare or not to
prepare?. Compendium of Continuing Education in Dentistry
1991;XII:178–82.
[19] Friedman MJ. Augmenting restorative dentistry with porcelain
veneers. Journal of the American Dental Association 1991;122:29–34.
[20] Schneider PM, Messer LB, Douglas WH. The effect of enamel
surface reduction in vitro on the bonding of composite resin to
permanent human enamel. Journal of Dental Research
1981;60:895–900.
[21] Black JB. Esthetic restoration of tetracycline-stained teeth. Journal
of the American Dental Association 1982;104:846–51.
[22] Stacey GD. A shear stress analysis of the bonding of porcelain
veneers to enamel. The Journal of Prosthetic Dentistry
1993;70:395–402.
[23] Troedson M, Dérand T. Shear stresses in the adhesive layer under
porcelain veneers. A finite element method study. Acta Odontologica Scandinavica 1998;56:257–62.
[24] Van Meerbeek B, Peumans M, Gladys S, et al. Three-year clinical
effectiveness of four total-etch dentinal adhesive systems in cervical
lesions. Quintessence International 1996;27:775–84.
[25] Van Meerbeek B, Perdigao J, Lambrechts P, et al. The clinical
performance of adhesives. Journal of Dentistry 1998;26:1–20.
[26] Christensen GJ. Have porcelain veneers arrived? Journal of the
American Dental Association 1991;122:81.
[27] Ferrari M, Patroni S, Balleri P. Measurement of enamel thickness in
relation to reduction for etched laminate veneers. The International
Journal of Periodontics and Restorative Dentistry 1992;23:407–13.
[28] Nattress BR, Youngson CC, Patterson JW, et al. An in vitro assessment of tooth preparation for porcelain veneer restorations. Journal
of Dentistry 1995;23:165–70.
[29] Olgart L, Brännstrom M, Johnson G. Invasion of bacteria into dentinal tubules; experiments in vivo and in vitro. Acta Odontologica
Scandinavica 1974;32:61–70.
[30] Brännström M. Etiology of dentin hypersensitivity. Proceedings of
the Finnish Dental Society 1992;88(Suppl. 1):7–13.
[31] Ellege DA, Schorr BI. A provisional restoration technique for laminate veneer preparation. The Journal of Prosthetic Dentistry
1989;62:139–42.
[32] Rada RE, Jankowski BJ. Provisional laminate veneer provisionalization using visible light-curing acrylic resin. Quintessence International 1991;22:291–3.
[33] Nikaido T, Burrow MF, Tagami J, et al. Effect of pulpal pressure on
adhesion of resin composite to dentin: bovine serum versus saline.
Quintessence International 1995;26:221–6.
[34] Cagidiaco MC, Ferrari M, Garberoglio R, et al. Dentin contamination protection after mechanical preparation for veneering. American Journal of Dentistry 1996;9:57–60.
[35] Cobb DS, Reinhardt JW, Vargas MA. Effect of HEMA-containing
dentin desensitizers on shear bond strength of a resin cement. American Journal of Dentistry 1997;10:62–5.
[36] Paul SJ, Schärer P. The dual bonding technique: a modified method
to improve adhesive luting procedures. International Journal of Periodontics & Restorative Dentistry 1997;17:537–45.
175
[37] Kelsey WP, Latta AM, Blankenau RJ. Effect of provisional restorations on dentin bond strength of resin cements. American Journal of
Dentistry 1998;11:67–70.
[38] Highton R, Caputo AA, Matyas J. A photoelastic study of stresses on
porcelain laminate preparations. The Journal of Prosthetic Dentistry
1987;58:157–61.
[39] Hui KKK, Williams B, Davis EH, et al. A comparative assessment
on the strengths of porcelain veneers for incisor teeth dependent on
their design characteristics. British Dental Journal 1991;171:51–5.
[40] Gilde H, Lenz P, Furst U. Untersuchungen zur belastbarkeit von
Keramikfacetten. Deutsche Zahnärtzliche Zeitschrift 1989;44:869–
71.
[41] Meijering AC, Creughers NHJ, Roeters FJM, et al. Survival of three
types of veneer restorations in a clinical trial: a 2.5-year interim
evaluation. Journal of Dentistry 1998;26:563–8.
[42] Clyde JS, Gilmoure A. Porcelain veneers: a preliminary review.
British Dental Journal 1988;164:9–14.
[43] Wildgoose DG, Winstanley RB, van Noort R. The laboratory
construction and teaching of ceramic veneers: a survey. Journal of
Dentistry 1997;25:119–23.
[44] Stangel I, Nathanson D, Hsu CS. Shear strength of the composite
bond to etched porcelain. Journal of Dental Research 1987;66:
1460–5.
[45] Lacy AM, Laluz J, Watanabe LG, et al. Effect of porcelain surface
treatment on the bond to composite. The Journal of Prosthetic
Dentistry 1988;60:288–91.
[46] Nicholls JI. Tensile bond of resin cements to porcelain veneers. The
Journal of Prosthetic Dentistry 1988;60:443–7.
[47] Lu R, Harcourt JK, Tyas MJ, et al. An investigation of the composite
resin/porcelain interface. Australian Dental Journal 1992;37:12–19.
[48] Schäffer H, Dumfahrt H, Gausch K. Öberflächenstruktur und
substanzverlust beim ätzen keramischer materialien. Schweizerische
Monatsschrift Zahnmedicin 1989;90:530–43.
[49] Yen TW, Blackmann RB, Baez RJ. Effect of acid etching on the
flexural strength of a feldspathic porcelain and a castable glass ceramic. The Journal of Prosthetic Dentistry 1993;70:224–33.
[50] Peumans M, Van Meerbeek B, Yoshida Y, et al. Porcelain veneers
bonded to tooth structure: an ultra-morphological FE-SEM examination of the adhesive interface. Dental Materials 1999.
[51] Calamia JR, Vaidyanathan J, Vaidyanathan TK, et al. Shear bond
strength of etched porcelains. Journal of Dental Research
1985;64:828 Abstract 1096.
[52] Roulet JF, Söderholm KJM, Longmate J. Effects of treatment and
storage conditions on ceramic/composite bond strength. Journal of
Dental Research 1995;74:381–7.
[53] Hussain MA, Bradford EW, Charlton G. Effect of etching on the
strength of aluminious porcelain jacket crowns. British Dental Journal 1979;147:89–90.
[54] Jones DW. The strength and strengthening mechanisms of dental
ceramics. In: McLean JW, editor. Dental ceramics, Proceedings of
the First International Symposium on Ceramics, Chicago: Quintessence Publishing Co, 1983. p. 83–136.
[55] Albers HF. Bonded tooth colored restoratives: indirect bonded
restorations, Santa Rosa: Alto Books, 1989. p. 1–42 Supplement.
[56] Jones GE, Boksman L, McConnell RL. Effect of etching technique
on the clinical performance of porcelain veneers. Quintessence of
Dental Technology 1986;10:635–7.
[57] Aida M, Hayakawa T, Mizukawa K. Adhesion of composite to
porcelain with various surface conditions. The Journal of Prosthetic
Dentistry 1995;73:464–70.
[58] Suh BI. All Bond—Fourth generation dentin bonding system. Journal of Esthetic Dentistry 1991;3:139–46.
[59] Müller G. Ätzen und silaniseren dentaler keramiken. Deutsche
Zahnärtzliche Zeitschrift 1988;43:438–41.
[60] Williamson RT, Mitchell RJ, Breeding LC. The effect of fatigue on
the shear bond strength of resin bonded porcelain. Journal of
Prosthodontics 1993;2:115–9.
176
[61] Swift B, Walls AWG, McCabe JF. Porcelain veneers: the effect of
contaminants and cleaning regimens on the bond strength of porcelain to composite. British Dental Journal 1995;179:203–8.
[62] Holtan JR, Lua MJ, Belvedere P, et al. Evaluating the effect of glove
coating on the shear bond strength of porcelain laminate veneers.
Journal of the American Dental Association 1995;126:611–6.
[63] Sheth J, Jensen M, Tolliver D. Effect of surface treatment on etched
porcelain bond strength to enamel. Dental Materials 1988;4:328–37.
[64] Tjan AHL, Dunn JR, Grant BE. Effect of fitting paste on bond
strength of composite/porcelain. Journal of Dental Research
1989;68:270 Abstract 714.
[65] Della Bona A, Northeast SE. Shear bond strength of resin bonded
ceramic after different try-in procedures. Journal of Dentistry
1994;22:103–7.
[66] Aboush YE. Removing saliva contamination from porcelain veneers
before bonding. The Journal of Prosthetic Dentistry 1998;80:649–
53.
[67] Brodbelt RHW, O’Brien WJ, Fan PL. Translucency of dental porcelains. Journal of Dentistry 1980;59:70–75.
[68] Nathanson D, Hassan F. Effect of etched porcelain thickness on
resin–porcelain bond strength. Journal of Dental Research
1987;66:245 Special Issue, Abstract 1107.
[69] Strang R, McCrosson J, Muirhead GM, et al. The setting of visible
light-cured resins beneath etched porcelain veneers. British Dental
Journal 1987;163:149–51.
[70] Chan KC, Boyer DB. Curing light-activated composite cement
through porcelain. Journal of Dental Research 1989;68:476–80.
[71] Blackman R, Barghi N, Duke E. Influence of ceramic thickness on
the polymerization of light-cured resin cement. The Journal of Prosthetic Dentistry 1990;63:295–300.
[72] Linden JJ, Swift EJ, Boyer DB, et al. Photo-activation of resin
cements through porcelain veneers. Journal of Dental Research
1991;70:154–7.
[73] O’Keefe KL, Pease PL, Herrin HK. Variables affecting the spectral
transmittance of porcelain through porcelain veneer samples. The
[74] Cardash HS, Baharav H, Pilo R, et al. The effect of porcelain color
on the hardness of luting composite resin cement. The Journal of
Prosthetic Dentistry 1993;69:620–3.
[75] Lutz F, Phillips RW. A classification and evaluation of composite
resin systems. The Journal of Prosthetic Dentistry 1983;50:480–8.
[76] Inokoshi S, Willems G, Van Meerbeek B, et al. Dual-cure luting
composites. Part I: filler particle distribution. Journal of Oral Rehabilitation 1993;20:133–46.
[77] Van Meerbeek B, Inokoshi S, Davidson CL, et al. Dual cure luting
composites—Part II: Clinically related properties. Journal of Oral
Rehabilitation 1994;21:57–66.
[78] Andreasen FM, Flügge E, Daugaard-Jensen J, et al. Treatment of
crown fractured incisors with laminate veneer restorations: an
experimental study. Endodontics and Dental Traumatology
1992;8:30–5.
[79] Stokes AN, Hood JAA. Impact fracture characteristics of intact
crown human central incisors. Journal of Oral Rehabilitation
1993;20:89–95.
[80] Magne P, Douglas WH. Porcelain veneers: dentin bonding
optimization and biomimetic recovery of the crown. The International Journal of Prosthodontics 1999;12:111–21.
[81] Magne P, Kwon KR, Belser UC, et al. Crack propensity of porcelain
laminate veneers: a simulated operatory evaluation. Journal of Prosthetic Dentistry 1999;81:327–34.
[82] Magne P, Versluis A, Douglas WH. Effect of luting composite
shrinkage and thermal loads on the stress distribution in porcelain
laminate veneers. Journal of Prosthetic Dentistry 1999;81:335–44.
[83] Strassler HE, Nathanson D. Clinical evaluation of etched porcelain
veneers over a period of 18 to 42 months. Journal of Esthetic
Dentistry 1989;1:21–8.
[84] Rucker ML, Richter W, MacEntee M, et al. Porcelain and resin
[85]
[86]
[87]
[88]
[89]
[90]
[91]
[92]
[93]
[94]
[95]
[96]
[97]
[98]
[99]
[100]
[101]
[102]
[103]
[104]
[105]
[106]
[107]
veneers clinically evaluated: 2-year results. Journal of the American
Dental Association 1990;121:594–6.
Nordbq H, Rygh-Thoresen N, Henaug T. Clinical performance of
porcelain laminate veneers without incisal overlapping: 3-year
results. Journal of Dentistry 1994;22:342–5.
Jäger K, Stern M, Wirz J. Laminates-reif fur die Präxis? Quintessenz
1995;46:1221–30.
Peumans M, Van Meerbeek B, Lambrechts P, et al. Five-year clinical performance of porcelain veneers. Quintessence International
1998;29:211–21.
Kihn PW, Barnes DM. The clinical evaluation of porcelain veneers:
a 48-month clinical evaluation. Journal of the American Dental
Association 1998;129:747–52.
Calamia JR. Clinical evaluation of etched porcelain veneers. American Journal of Dentistry 1989;2:9–15.
Jordan RE, Suzuki M, Senda A. Clinical evaluation of porcelain
laminate veneers: a four-year recall report. Journal of Esthetic
Dentistry 1989;1:126–37.
Christensen GJ, Christensen RP. Clinical observations of porcelain
veneers: a three year report. Journal of Esthetic Dentistry
1991;3:174–9.
Strassler HE, Weiner S. Seven to ten year clinical evaluation of
etched porcelain veneers. Journal of Dental Research 1995;74:176
Abstract 1316.
Walls AWG. The use of adhesively retained all-porcelain veneers
during the management of fractured and worn anterior teeth. Part II:
clinical results after 5-years follow-up. British Dental Journal
1995;178:337–9.
Dunne SM, Millar J. A longitudinal study of the clinical performance of porcelain veneers. British Dental Journal 1993;175:317–
21.
Shaini FJ, Shortall ACC, Marquis PM. Clinical performance of
porcelain laminate veneers. A retrospective evaluation over a period
of 6.5 years. Journal Oral Rehabilitation 1997;24:553–9.
Bausch JR, De Lange K, Davidson CL, et al. Clinical significance of
polymerization shrinkage of composite resins. The Journal of Prosthetic Dentistry 1982;48:59–67.
Shinkai K, Suzuki S, Leinfelder KL, et al. Effect of gap dimension
on wear resistance of luting agents. American Journal of Dentistry
1995;8:149–51.
Mc Kinney JE, Wu W. Chemical softening and wear of dental
composites. Journal of Dental Research 1985;64:1326–31.
Roulet JF, Walti C. Influence of oral fluids on composite resin and
glass–ionomer cement. The Journal of Prosthetic Dentistry
1984;52:182–9.
Vrijhoef MMA, Hendriks FHJ, Letzel H. Loss of substance of dental
composite restorations. Dental Materials 1985;1:101–5.
Sorensen JA, Strutz JM, Avera SP, et al. Marginal fidelity and
microleakage of porcelain veneers made by two techniques. The
Sim C, Ibbetson RJ. Comparison of fit of porcelain veneers fabricated using different techniques. International Journal of Prosthodontics 1993;6:36–42.
Wall JG, Reisbick MH, Espelata KG. Cement luting thickness
beneath porcelain veneers made on platinum foil. The Journal of
Prosthetic Dentistry 1992;68:448–50.
Lim CC, Ironside JG. Grit blasting and the marginal accuracy of two
ceramic veneer systems—a pilot study. The Journal of Prosthetic
Dentistry 1997;77:359–64.
McIntyre MF, Bochiechio RA, Johnson R. Marginal gap width with
a new refractory porcelain system. The Journal of Prosthetic Dentistry 1993;69:564–7.
Harasani MH, Isidor F, Kaaber S. Marginal fit of porcelain and
indirect composite laminate veneers under in vitro conditions. Scandinavian Journal of Dental Research 1991;99:262–8.
Coyne B, Wilson NHF. The marginal adaptation of porcelain laminate veneers. Journal of Dental Research 1987;66:885 Abstract 452.
[108] Hannig M, Jepsen S, Jasper V, et al. Der Randschlub glaskeramischer Veneers mit zervikaler Schmelz-oder Dentinebegrenzung.
Deutsche Zahnärtzliche Zeitschrift 1995;50:227–9.
[109] Tay WM, Lynch E, Auger D. Effects of some finishing techniques on
cervical margins of porcelain laminates. Quintessence International
1987;18:599–602.
[110] Goldstein GR, Barnhard BR, Penugonda B, Profilometer SEM.
Profilometer, SEM, and visual assessment of porcelain polishing
methods. The Journal of Prosthetic Dentistry 1991;65:627–34.
[111] Patterson CJW, McLundie AC, Stirrups DR, et al. Efficacy of porcelain refinishing systems in restoring surface finish after grinding with
fine and extra-fine diamond burs. The Journal of Prosthetic Dentistry
1992;68:402–6.
[112] Ward MT, Tate WH, Powers JM. Surface roughness of opalescent
porcelains after polishing. Operative Dentistry 1995;20:106–10.
[113] Haywood VB, Heymann HO, Kusy RP, et al. Polishing porcelain
veneers: an SEM and specular reflectance analysis. Dental Materials
1988;4:116–21.
[114] Haywood VB, Heymann HO, Scurria MS. Effect of water, speed,
and experimental instrumentation on finishing and polishing porcelain intra-orally. Dental Materials 1989;5:185–8.
[115] Roulet JF. Margin quality: criteria and techniques for assessment. In:
Anusavice Kenneth J, editor. Quality evaluation of dental restorations: criteria for placement and replacement, Lombourg: Quintessence Publishing Co, 1989. p. 223–9.
[116] Suzuki S, Leinfelder K, Shinkai K. Wear resistance of resin cements.
American Journal of Dentistry 1995;8:83–7.
[117] Gladys S, Van Meerbeek B, Inokoshi S, et al. Clinical and semiquantitative marginal analysis of four tooth-coloured inlay systems
at 3 years. Journal of Dentistry 1996;23:329–38.
[118] Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite
resin in relation to configuration of the restoration. Journal of Dental
Research 1987;66:1636–9.
[119] Feilzer AJ, De Gee AJ, Davidson CL. Increased wall-to-wall curing
contraction in thin bonded resin layers. Journal of Dental Research
1988;68:48–50.
[120] Tjan AHL, Dunn JR, Sanderson IR. Microleakage patterns of porcelain and castable ceramic laminate veneers. The Journal of Prosthetic
Dentistry 1989;61:276–82.
[121] Lacy AM, Wada C, Du W, et al. In vitro microleakage at the gingival
margin of porcelain and resin veneers. The Journal of Prosthetic
Dentistry 1992;67:7–10.
[122] Zaimoglu A, Karaaglaçlioglu L, Üçtaçli. Influence of porcelain
material and composite luting resin on microleakage of porcelain
laminate veneers. Journal of Oral Rehabilitation 1992;19:319–27.
[123] Sim C, Neo J, Kiam Chua EK, et al. The effect of dentin bonding
agents on the microleakage of porcelain veneers. Dental Materials
1994;10:278–81 Abstract 215.
[124] Gaspercic D. Micromorphometric analysis of cervical enamel structure of human upper third molars. Archives of Oral Biology
1995;40:453–7.
[125] Zaimoglu A, Karaagaçlioglu L. Microleakage in porcelain laminate
veneers. Journal of Dentistry 1991;19:369–72.
[126] Dietschi D, Magne P, Holz J. Bonded to tooth ceramic restorations:
in vitro evaluation of the efficiency and failure mode of two modern
[127]
[128]
[129]
[130]
[131]
[132]
[133]
[134]
[135]
[136]
[137]
[138]
[139]
[140]
[141]
[142]
[143]
[144]
177
adhesives. Schweizerische Monatsschrift Zahnmedicin 1995;105:
229–305.
Done B. Techniques for placement of porcelain veneers. Journal of
the American Dental Association 1987;114:155–6.
Jankowski JL, Olin PS, Holtan JR. Microleakage of porcelain
veneers bonded with dual cured luting agents and fatigued. Journal
of Dental Research 1993;72:130.
Newcomb GM. The relationship between the location of subgingival
crown margins and gingival inflammation. Journal of Periodontology 1974;45:151–4.
Janenko C, Smales RJ. Anterior crowns and gingival health. Australian Dental Journal 1979;24:225–30.
Chan C, Weber H. Plaque retention on restored teeth with full-ceramic crowns: a comparative study. The Journal of Prosthetic Dentistry 1986;56:666–71.
Olsson J, van der Heijde Y, Holmberg K. Plaque formation in vivo
and bacterial attachment in vitro on permanently hydrophobic and
hydrophilic surfaces. Caries Research 1992;26:428–33.
Hahn R, Weiger R, Netuschil L, et al. Microbial accumulation and
vitality on different restorative materials. Dental Materials
1993;9:312–6.
Quirynen M, Bollen CML. The influence of surface roughness and
surface-free energy on supra- and subgingival plaque formation in
man. A review of the literature. Journal of Clinical Periodontology
1995;22:1–14.
Kourkata S, Walsh TF, Davis LG. The effect of porcelain laminate
veneers on gingival health and bacterial plaque characteristics. Journal of Clinical Periodontology 1994;21:638–40.
Pippin DJ, Mixson JM, Sodan-Els P. Clinical evaluation of restored
maxillary incisors: veneers vs. PFM crowns. Journal of the American Dental Association 1995;126:1523–9.
Peumans M. The clinical performance of veneer restorations and
their influence on the periodontium. Thesis. Katholieke Universiteit
Leuven. 1997.
Davis BK, Aquilino SA, Lund PS, et al. Subjective evaluation of the
effect of porcelain opacity on the resultant color of porcelain
veneers. International Journal of Prosthodontics 1990;3:567–72.
Davis BK, Scott JO, Johnston WM. Effect of porcelain shades on
final shade of porcelain veneers. Journal of Dental Research
1991;70:475 Abstract 1671.
Davis BK, Aquilino SA, Lund PS, et al. Colorimetric evaluation of
the effect of porcelain opacity on the resultant color of porcelain
veneers. International Journal of Prosthodontics 1992;5:130–6.
Mörmann WH, Link C, Lutz F. Color changes in veneer ceramics
caused by bonding composite resins. Acta Med Dent Helv
1996;1:97–102.
Davis BK, Papcum LJ, Johnston WM. Effect of cement shade on
final shade of porcelain veneers. Journal of Dental Research
1991;70:297 Abstract 250.
Davis BK, Johnston WM, Saba RF. Kubelka-Munk reflectance
theory applied to porcelain veneer systems using a colorimeter.
International Journal of Prosthodontics 1994;7:227–33.
Meijering AC, Roeters JM, Mulder J, et al. Patients’ satisfaction
with different types of veneer restorations. Journal of Dentistry
1997;25:493–7.

Porcelain veneers: a review of the literature

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