基牙颜色与粘接剂类型对超薄瓷贴面修复体颜色的影响

目的:研究基牙颜色和粘接剂类型对超薄瓷贴面修复体颜色的影响。方法:使用2类6种粘接剂进行研究,酸蚀-冲洗型3种:Ivoclar Syntac? heliobond(SH)、3M Adper^TM Single Bond 2(SB2)、Bisco One-Step Plus(OSP);通用型3种:Ivoclar Tetric? N Bond Universal(TN)、3M Single Bond Universal(SBU)、Bisco ALL-Bond Univeral(ABU)。制备厚度分别为0.3 mm、0.1mm、和2 mm的瓷贴面、水门汀和基牙代型薄片,利用薄片制作超薄瓷贴面修复体试件,模拟临床超薄瓷贴面修复的复合体。树脂代型选择IPS Natural die,颜色为ND1~ND4以模拟不同颜色基牙。使用Vita Easy Shade分光光度计测定各组超薄瓷贴面修复体的颜色并计算色差值。结果:粘接剂种类、基牙代型颜色以及它们的交互作用对超薄瓷贴面修复体颜色变化的ΔE值有显著性影响(P<0.001)。当基牙颜色相同时,OSP与ABU间色差不显著,其余4组间的色差有统计学意义:TN>SH,SBU>SB2(P<0.05);当粘接剂种类相同时,TN组和SBU组不同基牙代型颜色的超薄瓷贴面修复体色差间有显著性差异:TN组:ND2>ND3>ND1>ND4(P<0.05);SBU组:ND1>ND2>ND3>ND4(P<0.05)。结论:粘接剂种类和基牙颜色对超薄瓷贴面修复体的颜色有影响,临床工作中进行超薄瓷贴面修复时,应根据基牙颜色选择适宜的粘接剂进行粘接修复。     

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。     

Retrospective clinical evaluation of a no-prep porcelain veneer protocol

Statement of problemPorcelain laminate veneers without tooth preparation (no-prep veneers) might represent a convenient and conservative option for the esthetic rehabilitation of anterior teeth. However, controversy exists about their predictability.PurposeThe purpose of this clinical study was to retrospectively evaluate the performance of no-prep porcelain veneers placed as per the recently proposed “CH no-prep” protocol, which claimed to overcome many of the drawbacks of previous no-prep veneer solutions.Material and methodsOne hundred eight no-prep porcelain laminate veneers based on the CH no-prep protocol were placed in 21 patients between 2015 and 2017. All participants were contacted, and 15 received a recall examination: a total of 78 veneers were evaluated as per the Clinical-Photographic-Micromorphologic coding. Plaque and gingival indexes and any increase in gingival recession were recorded. Pulp vitality was verified. A survival rate based on the count of absolute failures and a success rate summarizing the effect of both absolute and relative failures were calculated.ResultsThe mean observation period was 43.1 months, with an observation interval of 36 to 60 months and a survival rate of 97.4%. From the 5 relative failures (3 minimal fractures or chips and 2 limited marginal discolorations) and the 2 absolute failures (unrepairable fractures), an overall success rate of 91.0% was recorded, with 71 restorations that were judged excellent in terms of clinical acceptance after the recall examination. From the Clinical-Photographic-Micromorphologic evaluation, 5 restorations (6.4%) showed minimal issues for marginal integrity, while a limited porcelain overhang was identified on 2 restorations (2.8%). Micromorphologic analyses confirmed the clinical evaluations. No periodontal recession was observed, and plaque and gingival indexes appeared stable.ConclusionsPorcelain laminate veneers placed as per the CH no-prep protocol demonstrated excellent performances after 36 to 60 months of clinical service. The achieved outcomes, in terms of color match and overall esthetic and anatomic integration, confirmed that a prepless approach may be safely adopted provided that strict rules for patient selection and finish line placement are adopted.     

超薄贴面与常规贴面临床对比研究

目的：比较超薄贴面与常规贴面的临床效果,为超薄贴面的临床应用提供依据。方法选取超薄贴面20例与常规贴面修复患者45例,基牙分别为72、120颗,3、6、12、24、36个月后随访,依据改良美国公共卫生署贴面评价分类标准进行临床效果对比研究,统计留存率和成功率。结果经过3年观察,超薄贴面和常规贴面在继发龋、边缘适合性、边缘变色、颜色适合性和结构形态方面均有较好的临床表现,留存率及成功率均大于90%,经连续性校正卡方检验差异均无统计学意义（P>0.05）。结论超薄贴面可以获得与常规贴面相近的临床效果。     

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。     

10-year practice-based evaluation of ceramic and direct composite veneers

ObjectivesThis 10-year practice-based study aimed to compare survival and success of direct resin composite and ceramic veneers placed in a private dental practice, between January 2008 and March 2014.MethodsData were retrieved from a clinical practice’s records and were anonymized typed into electronic files. All veneer information was recorded, including previous restorations, repairs or failures, materials used, dates, patient, and age.ResultsWe analyzed 1459 veneer restorations, of which 1043 (71.5%) were direct composite, and 416 (28.5%) were ceramic, placed in 341 patients. The mean patients’ age was 47.8 years, and the mean number of restorations per patient was 4.3 restorations. During all follow-up, 957 (65.6%) veneers were successful without any repair, 252 (17.3%) were repaired and still in place, and 250 (17.1%) had a failure that resulted in replacement. Replacements were usually carried out with the same material placed at first. Considering success analysis, annual failure rates (AFR) for veneers in 5 and 10 years were 9.1% and 10% for direct composite and 2.9% and 2.8% for ceramic, respectively. Survival analysis showed AFR of 3.9% and 4.1% for composite and 1.4% and 1.2% for ceramic at the same periods. Cox regression was made for both success and survival outcomes. Composite veneers presented a higher risk of failure than ceramic veneers with higher hazard ratios for survival (HR) [HR 4.00 (2.74–5.83)] and success [HR 5.16 (2.65–10.04)].SignificanceCeramic veneers had superior longevity than direct composite veneers in both success and survival analysis.     

全瓷贴面的临床应用分析

目的观察全瓷贴面在前牙的临床修复效果。方法收集67颗全瓷贴面修复的患牙,12～24个月定期复诊,详细记录患者对颜色的满意度、边缘的适合性及修复体着色情况,并分析其原因。结果67颗全瓷贴面牙,失败5颗,成功率为92.53%。结论全瓷贴面对四环素牙、氟斑牙、釉质发育不全、牙齿钙化不全、牙列稀疏（间隙小于3mm）、轻度错位牙、覆在正常范围内的轻度上颌前突牙等具有较好的临床修复效果。     

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.     

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。     

Porcelain laminate veneer restorations bonded with a three-liquid silane bonding agent and a dual-activated luting composite

This clinical report describes the fabrication and bonding of porcelain laminate veneer restorations in a patient with anterior open spaces. Laminate veneer restorations made of feldspathic porcelain were etched with 5% hydrofluoric acid, rinsed under tap water, ultrasonically cleaned with methanol, and primed with a chemically activated three-liquid silane bonding agent (Clearfil Porcelain Bond). The enamel surfaces were etched with 40% phosphoric acid, rinsed with water, and primed with a two-liquid bonding agent (Clearfil New Bond) that contained a hydrophobic phosphate (10-methacryloyloxydecyl dihydrogen phosphate; MDP). The restorations were bonded with a dual-activated luting composite (Clapearl DC). The veneers have been functioning satisfactorily for an observation period of one year. Combined use of the Clearfil bonding agents and Clapearl DC luting composite is an alternative to conventional materials for seating porcelain laminate veneer restorations, although the system is inapplicable to dentin bonding.     

Clinical evaluation of 546 tetracycline-stained teeth treated with porcelain laminate veneers

OBJECTIVE: The purpose of this study was to evaluate the clinical result of 546 tetracycline-stained teeth restored with a porcelain laminate veneer system (Cerinate, Den-Mat, USA) for aesthetic reasons. METHODS: Tetracycline-stained teeth (546) were restored with a porcelain veneer system, and bonded with Ultra Bond resin cement. The restorations were recalled after 0.5, 1.5 and 2.5 years, respectively. Modified Ryge criteria were used to evaluate the veneers marginal adaptation, interfacial staining, secondary caries, postoperative sensitivity and the patients' satisfaction of the colour of the restorations. RESULTS: This study found that 99% veneers had excellent marginal adaptations; and less than 1% veneers required rebonding in the first 6 months; the colour of the veneers was stable and no evident staining was found. Almost all patients were satisfied with the colour match of their restorations 1 year after placement. CONCLUSIONS: The research indicated that the porcelain veneer restoration system under investigation provided a reliable and highly satisfactory choice for the aesthetic restoration of tetracycline-stained teeth.     

前牙超薄瓷贴面美学修复32例临床疗效观察

目的：评价超薄瓷贴面前牙美容修复的临床效果。方法：因四环素牙、氟斑牙、牙釉质发育不全、牙间隙过大、牙齿缺损、增龄性变黄等原因需行前牙美容修复的患者32例,108颗牙,用超薄热压铸瓷贴面进行修复。术后1、6、12、24、36个月,按照美国公共健康协会的修正标准（USPHS）进行评估。结果：经过3年的临床观察,108颗瓷贴面中有2颗折裂,修复体成功率98．1％。吸烟患者的边缘着色率明显高于不吸烟患者。结论：超薄热压铸造瓷贴面具有磨除牙体组织少、瓷贴面修复体强度高等特点,具有良好的临床修复效果。     

Retrospective study on the performance of porcelain laminate veneers delivered by undergraduate dental students

The aim of this study was to retrospectively evaluate the clinical performance of porcelain laminate veneer restorations delivered by undergraduate students at the Department of Restorative Dentistry, University Dental School and Hospital Cork and to analyze the factors that influence their prognosis and their effect on periodontal health. Patients who had veneers fitted over a period of 5 yrs. were recalled for evaluation. The recall protocol took the form of a questionnaire and a full clinical examination of the teeth involved and contra lateral control teeth. In all, 29 patients with 62 porcelain veneers were examined, only 2 of which were in the mandible. 77% of patients had veneers fitted due to discolouration, 13% in order to alter the shape or size of teeth and 10% due to palatal erosion. On the date of recall 89% of veneers had never debonded or fractured, 6% had to be rebonded since the date of insertion and 5% presented with a fracture. From this study it appears that porcelain laminate veneers are successful in the treatment of discoloured and irregular configured anterior teeth. It shows that undergraduate students can deliver satisfactory veneer restorations.     

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.     

Effect of immediate dentin sealing on load-bearing capacity under accelerated fatigue of thin occlusal veneers made of CAD-CAM glass-ceramic and resin composite material

ObjectiveThe objective of this study was to assess the influence of immediate dentin sealing (IDS) on the fatigue behavior of laminate occlusal veneers fabricated with CAD/CAM lithium disilicate ceramic and resin composite.MethodsForty sound human molars were prepared and randomly divided into 4 groups (n = 10): RC–IDS+ (IDS and resin composite occlusal laminate veneer); RC–IDS- (resin composite occlusal laminate veneer without IDS); LD–IDS+ (IDS and lithium disilicate laminate veneer); LD–IDS- (lithium disilicate occlusal laminate veneer without IDS). The restorations were obtained using a digital workflow. After surface conditioning and bonding, thermocycling and accelerated fatigue tests (20 Hz, 5000 cycles with an initial load of 300 N, step-size of 100 N for 10,000 cycles, up to 1000 N, and then a step-size of 50 N until failure) were conducted. Fatigue data were recorded for both outcomes (crack or fracture) and statistically analyzed. Fractographic and adhesive interface analysis were conducted.ResultsThe indirect resin composite groups showed better fatigue behavior compared to lithium disilicate. IDS only had a positive effect for the survival of resin composite restorations for the ‘fracture’ outcome. Evident presence of micro-gaps at the adhesive interface in the LD–IDS- group could be noted.SignificanceImmediate dentin sealing improved fatigue resistance behavior of resin composite occlusal veneers. However, this effect was not observed in lithium disilicate veneers.     

切牙切角缺损大小对其贴面修复后抗折性能的影响

目的 研究切牙切角缺损大小对其贴面修复后抗折性能的影响。方法 收集离体上颌中切牙42颗,随机均分为6组（1A、2A、3A、1B、2B、3B组）,每组7颗,其中1、2、3代表缺损等级, A、B分别代表IPS e.max铸瓷贴面和GC硬质树脂贴面。每组按不同缺损大小预备牙体,并在唇侧缺损边缘制备宽1 mm,深度为0.5 mm浅凹形微创边缘。然后分别按照标准工艺程序完成微创IPS e.max Press铸瓷贴面和GC.GRADIA硬质树脂贴面。各组均用3M RelyX Veneer树脂粘接套装粘固于离体牙上,用万能测力机测试抗折力,体视显微镜观察断裂模式。结果 微创铸瓷贴面修复的抗折力与缺损大小有关。1A组与2A、3A组之间差异有统计学意义（P<0.05）, 2A组与3A组差异无统计学意义（P>0.05）,微创瓷贴面复合体主要的破坏模式为粘接面脱落（占71.43%）;微创树脂贴面修复的抗折力与缺损大小无明显关系,3组间抗折力差异无统计学意义（P>0.05）,微创树脂贴面复合体的破坏模式为树脂贴面崩折（100%）。抗折力2A组 > 2B组、3A组 > 3B组,其差异都有统计学意义（P<0.05）。结论 在本实验条件下,缺损等级越大,微创铸瓷贴面修复后抗折力越大;而缺损等级大小对微创树脂贴面修复抗折力影响较小,在2、3级缺损时微创瓷贴面的抗折力都大于微创树脂贴面,提示当前牙咬力较大,缺损等级增大时,应尽可能选择抗折力较大的微创瓷贴面修复。     

Clinical long-term results with 617 Cerec veneers: a nine-year report

There are no long-term clinical studies concerning the treatment outcome of CAD/CAM generated porcelain laminate veneers. The objective of this study was to conduct a longitudinal evaluation of CAD/CAM fabricated porcelain laminate veneers. A single practitioner placed 715 CAD/CAM generated porcelain laminate veneers produced chairside with the Cerec system on 307 patients between December 1989 and December 1997. 260 patients with 617 veneers were available for recall examination. Forty-seven patients with 98 veneers (13.7%) were unable to be located or return for recall examination. Fourteen restorations had been lost. The Kaplan-Meier survival rate was 94% after up to 9 years (95% confidence interval: 90.7 to 97.8%). Of the surviving restorations, 98% were classified as clinically acceptable after 9 years. 97.3% of the teeth examined tested vital, 96.2% of the veneers were asymptomatic since their production, 98.8% of the veneers were considered successful by the patient. CAD/CAM veneers fabricated with the Cerec System achieved comparable long-term clinical results to those reported for laboratory processed porcelain laminate veneers. The high survival rate and favorable clinical results would support the use of CAD/CAM porcelain laminate veneers in clinical situations similar to those for laboratory processed porcelain veneers. CAD/CAM generated porcelain laminate veneers may provide equally good clinical results and longevity as conventional laboratory-processed porcelain laminate veneers.     

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。     

Removal of Porcelain Veneers Aided by a Fluorescing Luting Cement

Purpose: Porcelain veneers are a safe and effective treatment modality for selected teeth that have poor esthetics. However, removal of porcelain veneers that have failed may be time‐consuming and involve considerable removal of sound tooth structure adjacent to the veneer. The aim of this study was to evaluate a novel method of porcelain laminate veneer removal by incorporating a fluorescent dye into the luting cement that allows the practitioner to visualize the cement on the tooth and remove the veneer without causing residual damage to the adjacent tooth substance. Materials and Methods: Porcelain veneers were luted on extracted teeth with a luting cement modified with a fluorescing agent. Faculty teaching staff and final year dental undergraduates were asked to remove the veneers with the aid of a curing light to render the luting cement visible by fluorescing. They were then asked to compare the removal of comparable veneers without this visual aid and to complete a standard questionnaire. The depth of cure of the conventional and modified cements was measured using a penetrometer. Results: Results of the questionnaire indicated that the operators found removing the veneer cemented with the modified (fluorescing) cement considerably easier than removing the veneer cemented with the conventional cement. Microscopy indicated that more damage was caused to the underlying tooth during removal of conventionally cemented veneers. The incorporation of the dye into the cement reduced the depth of cure from 4.238 mm (SD = 0.025) to 3.761 mm (SD = 0.096). CLINICAL SIGNIFICANCE The fluorescent cement was considered to be superior to conventional cements in its ease of visibility, and as a consequence, veneers cemented with the fluorescing cement are easier to remove. The fluorescing dye significantly reduced the depth of cure, but this may not be clinically significant, because of the small thickness of cement employed when luting adhesive restorations. The use of such fluorescing materials may not be restricted to a luting cement for veneers but may also be incorporated into bases and lining materials so they can be visualized on removal of tooth‐colored restorations, to prevent further tooth destruction.