546例四环素牙烤瓷贴面修复的临床观察

目的 通过546颗前牙瓷贴面修复效果的临床观察，评价该项技术刘四环素变色牙的修复效果。方法 546颗四环素变色牙用Cerinate瓷贴面修复系统进行修复，用改良Ryge评价方法，观察经0.5年、1.5年和2.5年临床使用后贴面的边缘适合性、颜色稳定性及患者对颜色的满意程度。结果 临床调查结果表明，99%的瓷贴面具有优良的边缘适合性，整体脱落率低于1%；瓷贴面颜色稳定；患者对该项修复的长期效果非常满意。结论 研究表明，Cerinate瓷贴面修复系统是一种可靠的、理想的四环素前牙修复方式。     

Cerinate瓷贴面在牙齿美容修复中的临床应用

目的：通过对58例患者382颗瓷贴面修复效果的临床观察,评价该技术在牙科美容中的作用.方法：门诊选择382颗需要美容修复的前牙和前磨牙,使用Cerinate瓷贴面修复系统进行修复,于修复后1周、6个月、1年、2年、3年和5年复诊,对患者满意度、贴面脱落、折裂、边缘适合性、修复体颜色及牙龈健康情况等进行评价.结果：临床调查结果显示,1年内100%的瓷贴面具有良好的边缘适合性及牙龈健康状况,修复体色泽稳定,有2个修复体折裂重新制作,3个脱落并再行粘结,1颗牙出现加重的敏感症状而行根管治疗术.所有患者对修复效果均非常满意.结论：Cerinate瓷贴面修复系统是一种可靠的、理想的前牙美容修复方法.     

Six months clinical evaluation of prefabricated veneer restorations after partial enamel removal

Thirty-three preformed plastic laminate veneers were placed in maxillary anterior teeth of twenty-one subjects. The indications for veneer placement were intrinsic staining of large conventional composite restorations or discolouration caused by previous endodontic therapy. The veneer restorations were evaluated clinically over a 6-month period for retention, colour match, surface texture, marginal integrity and gingival response. Twenty-nine restorations were available for evaluation at 6 months. Three restorations exhibited bonding failure during the study period, giving an overall retention rate of about 91%. Deep brown discolouration in two teeth could not be adequately matched with the opaquer and shader pastes supplied with the kit. Only one patient exhibited any change in veneer surface texture during the study period. Slight, but clinically inconsequential deterioration of marginal integrity was also noted in several restorations. The gingival response to the veneer restorations was uniformly excellent. It was concluded that restoration with preformed veneers, using the enamel reduction and heat adaptation techniques, provided an aesthetic, conservative and functional alternative to fixed prosthodontic therapy in selected cases.     

Porcelain veneers: a review of the literature

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.     

Clinical performance of porcelain laminate veneers without incisal overlapping: 3-year results

The aim of this clinical trial was to evaluate the performance of 135 porcelain laminate veneers placed on anterior teeth without incisal preparation. Only 0.3–0.5 mm of the facial enamel was removed using a tapered round-ended diamond bur. The veneers were fabricated from a sintered feldspathic porcelain, etched and silanized and then bonded with a light-cured composite lute. The veneers were yearly examined clinically for debonding, chipping, marginal integrity and staining. After 3 years of service all veneers were retained. Incisal chipping occurred in seven veneered teeth. Wear and staining were negligible. It was concluded that this minimal porcelain veneer restoration with no incisal overlapping was conservative, predictable and successful.     

IPS Empress铸瓷贴面修复上颌年轻恒切牙冠折的临床观察

目的:评价IPSEmpress铸瓷贴面修复上颌年轻恒切牙冠折的临床效果。方法:对冠折未露髓的上颌年轻恒切牙采用IPSEmpress铸瓷贴面修复后的临床效果观察2～3年。结果:31例患者共35颗牙齿瓷贴面修复,在观察期间瓷贴面完整无缺损,无边缘及表面着色,无继发龋,2颗与邻牙颜色有轻度颜色不调,3颗轻中度的牙龈炎症,其余与邻牙颜色协调,边缘适合性好,没有继发牙髓炎症。结论:用IPSEmpress铸瓷贴面修复年轻恒切牙冠折,可以快速恢复其外形和美观,最大可能地保护了牙体牙髓组织,不需待成年后二次修复。     

小瓷贴面在上前牙切角缺损修复中的应用

目的:采用小瓷贴面修复上前牙切角的小面积牙体缺损,对其治疗效果进行评估。方法:上切牙切角小面积牙体缺损患者9例,涉及患牙9颗,其中上中切牙8颗,上侧切牙1颗,根据个体牙体缺损的大小进行牙体预备,要求牙体预备的范围达缺损区域以外约2mm,常规制作IPS-EmpressII小瓷贴面,常规粘结。修复治疗完成后进行了12-24个月的临床追踪观察,检查基牙与贴面边缘密合度、边缘着色、修复体颜色、解剖形态、有无修复体周围龋及修复体有无折裂。结果:在12-24个月的观察期中,全部修复体各项检查指标都未发现异常,修复效果良好。结论:在严格选择适应证的前提下,小瓷贴面可以做为上切牙小面积切角缺损的有效治疗方法。     

Clinical and scanning electron microscopic assessments of porcelain and ceromer resin veneers.

PURPOSE: Recently available Ceromer resin materials are promising for fabrication of esthetic anterior laminates and provices an alternative, cost effective treament modality to porcelain laminates for discolored anterior anterior teeth. It was proposed to study the esthetic quality and surface finish of veneers fbricated from ceromer resin and compare it with the standard porcelain veneers, both clinically as well as by scanning electron microscope (SEM) at baseline and at 12 months. If found comparable, ceromer resin veneer could provide an alternative to porcelain veneers which is an expensive technique for a developing country like India. MATERIALS AND METHODS: Seventy-two veneers, 36 porcelain and 36 ceromer were placed in 12 subjects who were studied at 0, 6 and 12 months for clinical acceptability, and at 0 and 12 months for SEM assessment. The restorations were luted with Opal luting composite and Scotchbond multipurpose system; polyvinyl siloxane was used as the impression material. The clinical assessment was made using modified United Public Health Services criteria, whereas the SEM assessment was made by quantitative analysis of the marginal fit and surface characteristics of the two veneering materials. RESULTS: Ceromer exhibited good anatomical form during the study period, but depicted changes in color, surface appearance, marginal adaptation, increased marginal discoloration, and tissue response. Inability to achieve a good finish with high gloss was a major drawback of the ceromer. Porcelain exhibited better esthetics, marginal adaptation, finish qualities, and tissue response. The SEM showed good to excellent marginal fit at baselinne in ceromer and porcelain veneers, but loss of luting resin at the margins was evident in both the materials after 12 months, leading to visible gaps in a number of veneer restorations. Ceromer veneers exhibited poor surface characteristics in several restorations, which further degraded in an oral conditions over 12 months. CONCLUSION: Veneering is an effective mode of treating discolored teeth. Ceromer veneers exhibited deterioration of surface finish and increased marginal discolouration over a period of 12 months. Clinically ceromer veneers were less acceptable to the patients than porcelain veneers. Porcelain out-scored ceromer as a permanent mode of treatment for discolored teeth, as over a period of 12 months it yielded good clinical results in comparison to ceromer.     

In vitro microleakage at the gingival margin of porcelain and resin veneers.

This in vitro study investigated the effect of dental surface treatments on the seal of porcelain and resin laminate veneers to tooth structure. Nine groups of 20 teeth were prepared for labial veneers--six groups with the apical margin of the veneer in dentin, two groups with the veneer wholly bordered by enamel, and one group with the apical margin coincident with the apical margin of a previously placed glass ionomer restoration. The teeth were treated with a variety of dentin-bonding agents prior to restoration of eight groups with porcelain veneers and one group with Visio-Gem microfilled resin veneers. After placement, the veneers were stored in water for 4 days, then subjected to thermocycling before silver staining and sectioning. Results showed no leakage around the margins of the veneers wholly bordered by enamel. Complete leakage was found around the glass ionomer restorations, and nearly total leakage was found along the resin-dentin interface of the resin veneers. The porcelain veneers that extended onto dentin showed variable but limited leakage for four of five of the dentin-bonding treatments.     

烤瓷贴面和计算机辅助设计与计算机辅助制作瓷贴面的应用效果比较

目的通过对烤瓷贴面和计算机辅助设计（computer aided design，CAD）与计算机辅助制作（computer aided manufacture，CAM）瓷贴面修复3年后的临床观察和比较，评价CAD—CAM瓷贴面的临床效果。方法选取23例患者制作CAD—CAM瓷贴面65个，25例患者制作烤瓷贴面105个。修复3年后采用改良加利弗尼亚牙科协会一瑞格标准对两种贴面的各项临床指标、存留率及患者满意度进行比较分析。结果烤瓷贴面和CAD—CAM瓷贴面3年存留率分别为96．2％和93．8％；患者满意度分别为92．4％和90．8％。两种贴面在颜色匹配、边缘着色、边缘适合性方面差异无统计学意义。CAD—CAM瓷贴面表面质地优于烤瓷贴面。结论CAD—CAM瓷贴面是一种成功的修复方式。     

Fracture behavior of human mandibular incisors following endodontic treatment and porcelain veneer restoration

PURPOSE: Because of existing controversy, the present study investigated the individual and combined effects of endodontic treatment and porcelain veneer restoration on the fracture behavior of human mandibular incisors. MATERIALS AND METHODS: Forty extracted intact human mandibular incisors were assigned to four groups of ten with a similar range of labiolingual widths at the cementoenamel junctions. Group A consisted of intact teeth; group B consisted of endodontically treated teeth; group C teeth were restored with labial porcelain veneers; and those of group D were endodontically treated and had labial porcelain veneers. All teeth were subjected to a slow continuous loading test at 30 degrees to the long axis of the teeth and 1 mm below the incisal edge on the labial side. RESULTS: Fracture forces were 415 +/- 220 N, 370 +/- 89 N, 420 +/- 128 N, and 448 +/- 156 N for groups A, B, C, and D, respectively. Root fracture was the most common mode of failure. There were no statistically significant differences between the groups in terms of fracture forces and modes of failure. CONCLUSION: Human mandibular incisors with endodontic treatment and/or porcelain veneer restorations were able to withstand the same magnitude of oblique loading as intact teeth. Endodontic treatment and/or porcelain veneer restoration did not affect the mode of failure of mandibular incisors.     

IPS-Empress瓷贴面在前牙美容修复中的临床应用

目的:评价IPS-Empress瓷贴面在前牙美容修复中的临床效果。方法:收集29例52颗全瓷贴面修复的前牙,定期随访2年。详细记录颜色匹配、表面质地、边缘着色和边缘完整性。结果:52颗瓷贴面,失败3颗,(1个折裂,1个脱落,1个贴面颜色偏差较大)。成功率为94.23%。结论:瓷贴面对四环素牙、氟斑牙、釉质发育不全、牙列稀疏(间隙小于3 mm)、轻度错位牙等具有较好的临床修复效果。     

超薄瓷贴面前牙美学修复的临床效果评价

目的：评价超薄瓷贴面在前牙美学修复中的临床效果。方法对64例要求前牙美学修复患者的112颗前牙进行超薄瓷贴面修复,追踪24个月,采用改良加利福尼亚牙科协会-瑞格（Ryge）标准,对修复效果进行评价。结果在12个月复查时有2颗贴面发现切端折裂。在24个月复查时有1颗贴面发现远中切角部分折裂;另有1颗贴面边缘可探及间隙;5颗贴面边缘有较明显着色。所有复诊病例均未出现牙敏感及牙龈炎。结论超薄瓷贴面牙体预备量少,修复强度高,不易脱落折裂,具有良好的临床修复效果。     

Porcelain laminate veneers. A retrospective evaluation after 1 to 10 years of service: Part I--Clinical procedure

PURPOSE: Currently available clinical studies on porcelain laminate veneers seem to support their use as a standard treatment method in modern restorative dentistry. The purpose of this study, which comprises 3 parts, was to evaluate the clinical applicability and the survival probability of porcelain laminate veneers for an observation period of up to 10 years. This first part of the study describes the step-by-step clinical procedure. MATERIALS AND METHODS: The reasons for provision of porcelain laminate veneers were mainly for the treatment of worn anterior teeth, surface enamel defects, intrinsic discolorations, and hypoplasia. As the treatment time for try-in, cementation, and finishing of veneers differs significantly from that needed for conventional restorations, the total time required for veneer treatment was evaluated. RESULTS: A total of 205 porcelain laminate veneers, 117 in the maxilla and 88 in the mandible, was placed in 72 patients (43 females and 29 males). Mean cementation time was 38.7 minutes, which increased significantly to 43.9 minutes if single discolored teeth were being restored. Clinical experience and a familiarity with the strict step-by-step procedure followed throughout the study reduced the mean treatment time from 40.8 minutes during the first 5 years to 36.7 minutes in the following years. CONCLUSION: The porcelain laminate veneer concept provides excellent esthetic and conservative restorations, but it should be stated that the cementation and finishing procedure is highly time consuming.     

Bonding porcelain laminate veneer provisional restorations: An experimental study.

STATEMENT OF PROBLEM: Minimal tooth preparation is required for porcelain laminate veneers, but an interim restoration is anticipated by patients to protect their teeth against thermal insult, chemical irritation, and to provide esthetics. Cement remaining after the removal of the provisional restoration can impair the etching quality of the tooth surface and the fit and final bonding of the porcelain laminate veneer. PURPOSE: This in vitro study inspected the tooth surface for remaining debris from cement after removal of a provisional restoration. MATERIAL AND METHODS: Seventy-two extracted natural anterior teeth were prepared for porcelain laminate veneers. For half of the teeth, the smear layer was removed before luting provisional restorations. Veneer provisional restorations were fabricated and luted to teeth with 3 bonding methods: temporary eugenol-free cement, spot etching combined with dual-curing luting cement, and polyurethane adhesive combined with dual-curing luting cement. After removal of provisional restorations 1 week later, the tooth surface was examined for residual luting material with an SEM. RESULTS: Traces of cement debris were found on provisionally prepared teeth for all 3 material methods. CONCLUSION: The use of polyurethane adhesive combined with the dual-curing cement revealed significantly less teeth with debris than the other methods. This difference was less distinct when the smear layer was removed.     

Composite laminate veneers: a clinical study

A 2-year clinical trial of a composite laminate veneer system for masking discoloration or hypoplasia on the anterior teeth of patients has been undertaken. Three hundred and twenty restorations were placed in seventy-nine patients, of these 273 restorations in sixty-eight patients have been followed over a 2-year period. The technique produced an acceptable improvement in the aesthetics of the patients in the trial. However, the veneers were susceptible to chipping (52% of lateral incisor veneers and 79% of central incisor and canine veneers showed some evidence of material loss after 2 years) and marginal staining (75% of veneers showed some evidence of marginal staining after 2 years) during function. The veneer restorations had a deleterious affect upon the gingival health of the teeth on which they were placed.     

前牙超薄瓷贴面美学修复临床效果评价

目的    评价超薄瓷贴面用于前牙美学修复的临床效果。方法    对2012年2月至2013年2月于南京市口腔医院口腔修复科就诊的54例要求改善前牙美观患者的126颗前牙,采用IPS e.max Press热压铸二硅酸锂玻璃陶瓷系统高半透性HT色系瓷块制作超薄瓷贴面,口内试戴满意后用光固化树脂黏结剂黏固。修复完成后第1、6个月及第1、2、3、4、5年复诊,参照改良美国公共卫生署（USPHS）评价标准,从继发龋、边缘适合性、外形、颜色匹配和破裂等方面对临床效果进行评价。结果    本研究共制作了126颗超薄瓷贴面进行前牙修复。修复完成后1个月复诊,2颗贴面（1.6%）颜色匹配为B级,其余指标均达A级。修复完成后6个月、1年和2年复诊,所有修复体各项指标均达A级。修复完成后3年复诊,2颗贴面（1.6%）边缘可探及间隙,边缘适合性评为B级。修复完成后4年复诊,2颗贴面（1.6%）切端折裂1 mm,破裂指标为C级。修复完成5年复诊,1颗贴面（0.8%）失访;1颗贴面（0.8%）远中切角部分折裂,破裂指标为C级;5颗贴面（4.0%）边缘有较明显的轻度着色,颜色匹配为B级。所有患牙修复后均无牙髓敏感症状、未见继发龋和牙龈炎。结论    超薄瓷贴面的透光性极佳,颜色自然协调,边缘适合性非常好,临床效果令医患满意,是一种理想的前牙美学修复方法。     

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??Objective    To evaluate the clinical aesthetic efficacy of ultra-thin veneers for anterior teeth. Methods    Totally 126 anterior teeth of 54 patients were chosen and restored in Department of Prosthodontics??Nanjing Stomatological Hospital between February 2012 and February 2013. Ultra-thin ceramic veneers were made from IPS e.max Press HT ??high translucency?? lithium disilicate glass ceramic ingots??and cemented with light-cured resin cement. Patients were interviewed and examined at 1 month??6 months??1 year??2 years??3 years??4 years and 5 years respectively. The clinical evaluation of ultra-thin ceramic veneers was carried out with reference to the criteria of USPHS from the aspects of secondary caries??marginal suitability??appearance??color match and integrity. Results    Totally 126 anterior teeth were restored with ultra-thin ceramic veneers made of IPS e.max Press. After 1 month??2 veneers ??1.6%?? were B class in color match??and the other indicators were A class. At 6 months??1year and 2 years after restoration??all veneers achieved A class in each evaluation indicator. After 3 years??gap was detected at the margin of 2 veneers ??1.6%????which were B class in marginal suitability. After 4 years??2 veneers ??1.6%?? were C class in integrity with 1mm incisal fracture. At 5 years after restoration??1 veneer ??0.8%?? was C class in integrity with disto-incisal fracture; slight discoloration was observed in 5 veneers ??4.0%????which were B class in color match??and one veneer was lost in follow-up. All the veneers were clinically effective with no sensitivity symptoms??no secondary caries or gingivitis. Conclusion    Ultra-thin ceramic veneers have the advantages of excellent translucency??natural appearance and acceptable marginal suitability??and have been an ideal choice for anterior aesthetic restoration.     

Clinical evaluation on porcelain laminate veneers bonded with light-cured composite: results up to 7?years

The purpose of this study was to evaluate the clinical performance of laminate porcelain veneers bonded with a light-cured composite. Thirty patients were restored with 119 porcelain laminate veneers. The veneers were studied for an observation time of 7 years. Marginal adaptation, marginal discoloration, secondary caries, color match, and anatomic form were clinically examined following modified United States Public Health Service (USPHS) criteria. Each restoration was also examined for cracks, fractures, and debonding. Pulp vitality was verified. In addition, plaque and gingival indexes and increase in gingival recession were recorded. Survival rate evaluating absolute failures and success rate describing relative failures were statistically determined, using both restoration and patient-related analyses. On the basis of the criteria used, most of the veneers rated Alfa. After 7 years, the results of the clinical investigation regarding marginal adaptation and marginal discoloration revealed only 2.5% and 4.2% Bravo ratings, respectively, among the 119 initially placed veneers. Using the restoration as the statistical unit, the survival rate was 97.5%, with a high estimated success probability of 0.843 after 7 years. Using the patient as the statistical unit, the survival rate was 90.0% and the estimated success probability after 7 years was 0.824. Gingival response to the veneers was all in the satisfactory range. Porcelain laminate veneers offer a predictable and successful treatment modality giving a maximum preservation of sound tooth. The preparation, cementation, and finishing procedures adopted are considered key factors for the long-term success and aesthetical result of the veneer restorations.     

An in vitro assessment of the strength of porcelain veneers dependent on tooth preparation

The treatment of teeth using veneer restorations combines aesthetic and functional improvements with a low destructive technique. Different kinds of tooth preparation techniques are described in the literature for this kind of restoration. This in vitro study aimed to examine the influence of the incisal preparation on the loadability of teeth restored with porcelain laminate veneers. Thirty-six selected mandibular incisors were randomly assigned to three groups with 12 teeth per group. In the first group, only the facial surface was prepared. In the second group, the preparation included a rounded incisal edge and a distinct chamfer lingually. The third group served as an unprepared control. Empress(R) veneers were then fabricated and cemented with a low viscous luting composite material. After 120 days storage in Ringer's solution, the specimens were loaded incisally to the point of failure. Statistical analysis of the results showed significant differences between the series (P=0.0103). Group 2 (with preparation of the incisal edge) exhibited the lowest fracture resistance (466+/-99 N) (N, mean forces). When prepared only facially, the teeth restored with Empress veneers reached the strength of unprepared teeth. Compared with the biting force described for incisors in the literature, the in vitro loadability reached in this investigation seems to jusitify the clinical use of both preparation designs tested.