An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: Influence of occlusal splint in patients with bruxism.

OBJECTIVES: The aim of this study was to perform a 8-year prospective clinical investigation on the survival rate of feldspathic ceramic veneers, as well as analyse the influence of the occlusal splint in patients with parafunctional bruxism. METHODS: Three hundred and sixty-four veneers fabricated using conventional feldspathic ceramic were provided in 64 patients. The patient sample included 40 individuals with bruxism. During the follow-up period, the effect of wearing the occlusal splint on the incidence of failure (fracture and/or debonding) in patients with bruxism was also assessed. The survival rate of veneers was determined using the Kaplan-Meier estimator. Statistical significance was set at p < 0.05 with a confidence interval of 95%. RESULTS: The occurrence of fracture for the feldspathic veneers tested in this study was 7.7%, while only 1.9% of the total number of veneers debonded. The overall survival rate was 93.7% after 3 years, 91% after 5 years, and 87.1% after 8 years. Patients with bruxism using an occlusal splint showed a survival rate of 89.1% after 7 years, while the survival rate in patients with bruxism using no occlusal splint was 63.9% (p < 0.05). CONCLUSION: This study confirmed that feldspathic veneers may represent a suitable clinical solution for indirect aesthetic restorations. Such a treatment may be an option also for those patients affected by bruxism, as long as they regularly wear an occlusal splint. However, patients with bruxism using no occlusal splint may still present a potential high-risk of failure and/or debonding.

Severe tetracycline dental discoloration: Restoration with conventional feldspathic ceramic veneers. A clinical report.

The treatment of severe tetracycline discoloration is a challenge for the dentist. There are several treatment options and one of the most effective is the use of feldspathic veneers. The aim of this clinical case was to carry out the replacement with conventional feldspathic ceramic veneers on a patient with highly stained teeth (grade IV tetracycline) by a minimally invasive approach. Clinical examination revealed gingival retraction, color change of the veneers, ceramic cracked of 1.1 and 1.3 and incisal wear in lower anterior teeth. The decision was to retreat with feldspathic ceramic veneers from 1.6 to 2.6. Premolars and first molars were included because its dark color intensifies the width buccal corridors. Also, the restoration with veneers from 3.3 to 4.3 was considered. Firstly, the veneers were removed and the color was selected by the Vitapan 3D Master guide (Vita Zahnfabrick, Bad Säckingen, Germany). Mock-up was made to evaluate aesthetic, phonetic and functional parameters. Then, teeth were prepared through the mock-up in order to reduce the minimal amount of dental tissue possible. Opaque dentine mass of microhybrid composite (Esthet-X A2O, Dentsply Sirona, Konstanz, Germany) was placed to mask the most intense stains. The definitive impressions were taken with silicone (Aquasil Ultra XLV, Dentsply Sirona, Konstanz, Germany) were taken to fabricate conventional feldsphatic ceramic veneers (Noritake kisai Co, Ltd. Japan) by the parallel stratification masking technique. For cementing, an opaque cement was selected from the try-in tests (Calibra, Dentsply Sirona, Konstanz, Germany) and the composite was silicatized with an air-abrasion device. A favorable and minimally invasive result was achieved to treat grade IV tetracycline stains, surpassing the patient's aesthetic expectations and functional needs. Key words:Porcelain veneer, tetracycline teeth, minimally invasive, masking, opaque composite.