Retrospective evaluation of the clinical performance and longevity of porcelain laminate veneers 7 to 14 years after cementation

Abstract

Statement of problem: Studies on the long-term clinical assessment and longevity of porcelain laminate veneers (PLVs) are lacking.

Purpose: The purpose of this clinical study was to assess the clinical performance and longevity of PLVs after 7 to 14 years of clinical service.

Material and methods: Patients with PLVs placed 7 to 14 years earlier were recalled for clinical evaluation. At the recall visit, clinical parameters such as margin integrity, margin discoloration, porcelain surface, anatomic form, and secondary caries were evaluated according to the Ryge criteria. Standardized photographs of veneers were made for each participant. Data were tabulated for all descriptive criteria and analyzed statistically. The Cohen Kappa assessment was carried out to determine interrater agreement, the Kaplan-Meier survival analysis for survival probability, and the Cox regression for significance between the arches.

Results: One hundred and fourteen veneers (83 maxillary and 31 mandibular) were evaluated in 26 participants, including 19 women restored with 87 veneers and 7 men restored with 27 veneers. Distribution of the veneers included 37 central incisors, 41 laterals, and 36 canines. The Alfa ratings for the veneers were as follows: porcelain surface (85%), anatomic form (87%), and secondary caries (96%). For margin integrity, 37% rated Alfa, 60% Bravo, and 3% Charlie. For margin discoloration, 56% rated Alfa and 44% Bravo. The overall Cohen Kappa interrater agreement was 0.7023 with an agreement rate of 88.3%. Clinical deficiencies included fracture rate of 4.35% (n=5); porcelain chipping 5.26% (n=6); caries 4% (n=4); debonding 2% (n=2); crack/craze lines 5.26% (n=6); loss of vitality 2% (n=2); and replaced veneers 4.38% (n=5). The main reason for failure was porcelain fracture. The survival rate for the veneers was 98%. The Kaplan-Meier success probability was 0.976 at 7 years and 0.882 at 14 years.

Conclusions: Within the limitations of this clinical study, PLVs exhibited an estimated survival probability of 0.976 over 7 years and 0.882 over 14 years, a high survival rate of 98%, and a low failure rate of 4.38%.