Clinical observations of porcelain veneers: a three-year report.

One hundred and sixty-five Cerinate porcelain veneers were placed by 11 private practice clinicians from diverse locations throughout the USA. The veneers were evaluated over a 3-year service period using Kodachrome photographs and grading of clinical characteristics by evaluators. The following factors were evaluated: (1) esthetics; (2) margin fit; (3) margin discoloration; (4) breakage; (5) gingival irritation; (6) patient acceptance; and (7) caries. Specific characteristics and their evaluations over three years were: (1) Esthetics started out excellent and remained that way; (2) Margin fit was acceptable at the beginning of the study and was actually perceived to improve, perhaps related to cement at the margins wearing and smoothing; (3) Margin discoloration started very low and became slightly worse; (4) Breakage was present during each of the 3 years, and 13 percent of veneers had some breakage after 3 years. Changes in clinical procedures are suggested in this paper to diminish this problem; (5) Gingival irritation was minimal throughout the study; (6) Patient acceptance was excellent at the beginning of the study and improved; and (7) Dental caries involvement was minimal, with only one veneered tooth showing caries involvement. Over the 3-year period, the veneers provided excellent service overall.     

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.     

310个烤瓷贴面远期临床效果的回顾性分析

目的 评价完成修复1～8年的310个长石质烤瓷贴面的远期临床效果,以期为临床提供参考.方法 对完成修复1～8年的310个前牙或前磨牙长石质烤瓷贴而进行复查,参照改良美国公共健康协会(United States Public Health Service,USPHS)评价标准对烤瓷贴面的修复体完整度、修复体磨耗、颜色满意度、边缘染色、边缘适合性、继发龋、牙本质敏感症状及牙龈指数(gingival index,GI)8项指标进行评估,寿命表法统计烤瓷贴面1～8年存留率.结果 烤瓷贴面1～8年存留率分别为98.7%、98.0%、93.8%、93.2%、89.7%、81.8%、76.3%、76.3%.结论 烤瓷贴面修复技术的远期临床效果良好.     

A Prospective Ten-Year Clinical Trial of Porcelain Veneers

Objective: The purpose of this prospective clinical study was to evaluate the performance of porcelain veneers after 5 and 10 years of clinical service. Materials and Methods: A single experienced clinician placed 87 porcelain veneers in 25 patients in 1990 and 1991. The teeth included maxillary central incisors to first premolars. As described in the 5‐year report of this study, preparations included a chamfer margin, 0.3 to 0.7 mm labial enamel reduction, and incisal edge coverage. A single laboratory technician fabricated the veneers using feldspathic porcelain on refractory dies. Internal surfaces were etched with 5% hydrofluoric acid and silanated. Teeth were isolated with a rubber dam prior to veneer placement. All veneers were bonded with a light‐activated resin cement. Patients were recalled at 5 to 6 years and at 10 years after initial veneer placement. Two evaluators examined each veneer for retention, fractures, color match, surface roughness, marginal adaptation, leakage, recurrent caries, pulp vitality, and patient satisfaction. Marginal adaptation was assessed further using scanning electron microscopy to examine epoxy replicas. Results: Five years after placement, all 87 veneers remained in place and had “perfect” color match and surface smoothness. Four veneers had fractures, but only one of those required repair. Ninety‐nine percent of the veneers had clinically acceptable marginal adaptation, although just 14% of the veneers had “perfect” marginal adaptation at all margins. One had clinically unacceptable staining from leakage. Recurrent caries was present at the proximal margin of two veneers. At the 10‐year evaluation, which had a 93% recall rate, color match and surface roughness remained optimal. Thirteen of 22 patients were very satisfied with the esthetic result, whereas 7 complained of minor esthetic problems. The fracture rate increased substantially, to 34% at the 10‐year recall. However, only 11% of the fractures were clinically unacceptable. None of the veneers had debonded, but the percentage of veneers with “perfect” marginal adaptation had declined to only 4%. Leakage was now evident around two‐thirds of the veneers, and eight restorations had recurrent caries. Conclusion: Porcelain veneers are a reliable and effective means for conservative esthetic treatment of anterior teeth in the long term. After 10 years of clinical service, esthetic results remained good, patient satisfaction was high, and the retention rate was excellent. The number of irreparable fractures was low. Appropriate preparation design, occlusion, and use of adhesive materials contribute to the ultimate outcome.     

Midterm results of a 5-year prospective clinical investigation of extended ceramic veneers.

OBJECTIVES: Midterm-evaluation of a prospective 5-year clinical study on long-term performance and success rate of pressed-ceramic veneers with two extended preparation designs. METHODS: Anterior teeth of 25 patients were restored with 66 extended veneers. Forty-two overlap veneers (OV) (incisal-edge-reduction 0.5-1.5mm, butt-joint) and 24 full veneers (FV) were inserted. Both veneer designs were similar in buccal (0.5mm) and proximal (0.5-0.7mm) chamfer preparation, but differed in palatal extension. Ceramic veneers were fabricated with IPS Empress* and adhesively luted with dual-polymerizing composite Variolink II* (*Ivoclar Vivadent). Clinical reevaluations were performed 6, 12, 25, 39, 45, and 62 months after insertion of the veneers according to the modified USPHS-criteria. Absolute failures were recorded as survival-rate, relative failures demonstrated by Kaplan-Meier success-rate. RESULTS: After an observation time up to 5 years, survival-rate of full veneers was 100%, of overlap veneers 97.5% due to one severe fracture. Kaplan-Meier-analysis of relative failures resulted in a success-rate of 85% for FV and 72% for OV. Reasons for relative failures were cracks, ceramic-cohesive-fractures, and loss-of-adhesion. No significant differences were found between the two veneer groups. Secondary caries and endodontic complications did not occur. Increased clinical service time resulted in enhanced marginal discoloration and decrease of marginal adaptation. SIGNIFICANCE: Extended pressed-ceramic veneers (both OV and FV) proved to be reliable procedures to restore larger deficits in anterior teeth. Pronounced palatal extension of full veneers was not linked to a higher failure probability. Reliable adhesive bonding, as well as ceramic fatigue and fracture resistance are considered key factors for long-term success of extended-veneer restorations.     

Clinical evaluation of etched porcelain onlays: a 4-year report

Etched porcelain-bonded-to-enamel restorations (porcelain veneers) have demonstrated a low incidence of debonding, fracture, microleakage, and discoloration. In addition, laboratory and short-term clinical studies have shown satisfactory results with posterior etched porcelain-bonded restorations. This study evaluated the 4-year clinical performance of posterior all-ceramic onlays and overlays bonded with a dual-cure luting resin and a self-cure acetone-based dentinal adhesive. Twenty-one posterior porcelain overlay restorations were fabricated from a high-leucite-content porcelain and bonded to the teeth of 12 adults using a dual-cure luting resin and an acetone-based self-cure N(P-tolyl) glycine-glycdyl methacrylate (NTG-GMA), pyromellitic acid dianhydride and 2-hydroxyethyl methacrylate (PMDM) dentinal adhesive. Restorations were examined for retention, marginal caries, marginal microleakage, sensitivity, discoloration, restorative fracture, and patient satisfaction. Data collected at 4 years revealed 100% retention of the restorations with no marginal discoloration, marginal ditching, caries, or sensitivity. A small gap (Ryge UPHS rating of Bravo) was detected at the facial margin of one restoration but was not sufficient enough to require repair or replacement. Each patient reported a very high level of satisfaction with the restorations. This study demonstrates that porcelain overlays with supragingival margins entirely on enamel that rely primarily or entirely on bonding for their retention can provide excellent esthetics, good function, and perhaps long-term durability if properly designed, fabricated, and bonded. Porcelain overlays fabricated from high-leucite-content porcelain bonded to sound enamel and dentin with a dual-cure luting resin and a fourth generation dentinal adhesive provide satisfactory clinical results and high patient satisfaction.     

微创超薄贴面修复畸形前牙的效果研究

目的:研究超薄贴面修复变异前牙的临床效果。方法:选择要求对先天性牙体形态发育异常(锥形牙及过小牙)的前牙进行美学修复的患者41例共67颗变异前牙,确认患牙牙髓、牙周健康后行不备牙或少备牙(0.3~0.5 mm)超薄贴面修复,根据改良的美国公共卫生署评价标准(USPHS),由2位医师分别评价修复后0.5、1、2、3、4年的美学修复效果。结果:在0.5、1、2、3、4年的追踪研究中,分别有0(0)、1(1)、3(6)、7(12)、11(18)例患者(贴面)失访,患者满意度分别为100%、100%、98%、96%、91%。修复体完整性、颜色、边缘美学效果(密合度及是否着色)、贴面形态、半透明度、牙龈指数、牙齿敏感性、继发龋、患者满意度等方面,经4年的追踪检查,均取得了满意的效果。结论:在严重控制适应症和告知患者注意事项及使用方法的情况下,微创超薄贴面修复变异前牙可取得良好的修复效果,值得临床推广应用。     

Clinical evaluation of etched porcelain veneers

This study evaluated 115 etched porcelain laminate veneers placed by a single operator at New York University Dental Center between 1982 and 1985. The restorations were divided into two groups. Group I consisted of 43 restorations placed without any tooth preparation; Group II consisted of 72 restorations placed using a chamfer preparation. The U.S.P.H.S. criteria was used to record cavosurface marginal discoloration, marginal integrity, and presence of caries. A clinical examination also revealed the number of debonds and/or the number of fractures of porcelain. A periodontal evaluation included the use of baseline and recall stone replicas of restored teeth to measure the height of the free gingival margin taken mid-facial to the incisal edge of the restoration. Any changes in gingival contour were also noted. Plaque and gingival indices were also recorded. The low fracture and debond rate found in the study combined with no incidence of caries seem to indicate that these restorations are functioning satisfactorily and with minimal negative periodontal response.     

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.     

EverStick高强纤维树脂贴面用于四环素牙美容修复的临床评价

目的 探讨everStick高强纤维树脂贴面修复四环素染色牙的优势。方法 选取四环素染色牙患者20例（共80颗患牙），随机分为实验组（10例）和对照组（10例），按照树脂贴面修复的牙备要求对患者上颌4颗切牙进行牙体预备，实验组和对照组分别采用everStick高强纤维树脂材料（NET型）及3M光固化复合树脂材料制作成树脂贴面，利用Kerr全酸蚀粘接系统进行粘接。贴面完成后进行6~30个月、每次间隔6个月的临床随访，采用改良Ryge贴面复查标准及牙龈指数（GI）、龈沟出血指数（SBI）、菌斑指数（PLI）作为临床检查指标，观察贴面色彩稳定性、边缘适合性、邻接边缘变色情况、继发龋及牙周组织健康状况等，评价2种材料制成贴面的上述指标之间的差异是否具有统计学意义（P<0.05）。结果 在6~30个月、每次间隔6个月的临床随访中，实验组的修复体无松动脱落，无继发龋，边缘无明显染色，色泽稳定；对照组有5只贴面出现脱落，2只出现折裂，2组差别有统计学意义（P<0.05）；2组的牙龈指数（GI）、龈沟出血指数（SBI）、菌斑指数（PLI）结果中，实验组均低于对照组，差异有统计学意义（P<0.05）。结论 相比3M复合树脂材料，everStick高强纤维树脂材料用于四环素染色牙的贴面修复具有较好的机械强度，色泽稳定，对牙龈刺激小，有利于牙周组织健康。     

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.     

Five-year clinical evaluation of Dyract in small Class I cavities

PURPOSE: To evaluate the 5-year clinical performance of Dyract in small Class I cavities in non stress-bearing areas. METHODS: On 36 patients, 87 restorations needing small cavity preparations were performed. The lesions were diagnosed macroscopically with a probe. They involved shallow fissures, and had reached dentin but the lateral spread was limited and localized in dentin. Cavities were designed to be on non stress bearing areas. Cavities' average facio-lingual width were prepared to be 1/3 or less than the intercuspal width. At baseline, 1-, 2-, 3-, 4- and 5-year recalls, the restorations were evaluated according to the modified Ryge criteria by two calibrated, experienced examiners. RESULTS: None of the restorations was lost and retention rate was 100% at the end of 1 year. After 2 years, one restoration (1.2%) had to be replaced due to caries lesion adjacent to its margin and the rate of retention was 98.8%. At the 3-year recall, four restorations, at the 4-year, one restoration and at the 5-year, one restoration had caries lesions adjacent to their margins and the cumulative retention rates were 94.2%, 92.9% and 91.5% respectively. Significant differences were detected between all of the evaluation periods in regard to color match rate (P = 0.00001), with the exception of rate between the baseline and 1 year evaluations. In regard to the marginal discoloration rates, there were statistically significant differences (P = 0.00001) between all of the evaluation periods with the exception of rates between the baseline and 1-year, 3- and 4-year, and 4- and 5-year results. Except for the failed restoration, no other restoration was clinically unacceptable in regard to color match, wear or loss of anatomic form, marginal discoloration, caries, marginal adaptation and surface texture.     

Clinical performance of a packable resin composite for a period of 3 years.

OBJECTIVE: The purpose of this clinical study was to evaluate SureFil packable resin composite for posterior restoration of permanent teeth for a period of 3 years. METHOD AND MATERIALS: Fifty-five resin composite restorations were placed in 36 patients (16 Class I and 39 Class II restorations). After cavity preparation, the enamel was etched with 34% phosphoric acid. Prime & Bond NT was applied 20 seconds to dentin and etched enamel and cured for 20 seconds. The teeth were restored in 3- to 5-mm increments. The restorations were assessed after placement, at 6 months, 1 year, 2 years, and 3 years for color stability, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form, and postoperative sensitivity according to Ryge's criteria. The changes in the parameters were assessed with Friedman test analysis with a Bonferroni correction at a significance level of .05. RESULTS: Forty of the monitored 47 restorations were classified as excellent after 3 years. Thirty-one restorations were graded Bravo at baseline for color match. At the 3-year assessment (n = 47) the color of the 31 restorations had not changed. Two restorations (same patient) were lost after 1 month and were scored as Charlie until the end of the study. After 3 years there were five Bravos and one Charlie with marginal discoloration, five Bravos with marginal adaptation, and three Bravos with anatomic form (P < .05). CONCLUSION: After 3 years of clinical service, SureFil packable resin composite, with a failure rate of 6%, was considered to be successful in Class I and II restorations.     

前牙唇侧齐龈边缘肩台EMAX铸造陶瓷全冠的临床效果评价

目的 评价唇侧齐龈边缘肩台在前牙EMAX铸造陶瓷全冠修复中的临床应用效果.方法 对120颗前牙预备唇侧齐龈肩台,EMAX铸造陶瓷全冠修复.修复后1周、6个月、1年、2年复诊,从EMAX铸造陶瓷全冠的颜色、边缘着色、有无继发龋以及形态和边缘密合度等方面评价修复效果.结果 120颗患牙修复后1周、6个月、1年及2年比较,修复体颜色、边缘着色、继发龋发生率、修复体形态和边缘密合度变化的差异无统计学意义(P＞0.05).修复后2年,120颗铸造陶瓷全冠修复体,114颗修复体颜色、明暗度、透光度与邻牙协调一致,5颗与邻牙不完全一致,但在正常范围内,1颗与邻牙不一致;118颗修复体边缘线上无可见的边缘着色,1颗修复体边缘线上可见边缘着色但着色未向牙髓方向渗透,1颗边缘着色且着色向牙髓方向渗透;117颗修复体与基牙外形延续一致或稍凹陷,3颗修复体与基牙外形表面相比凹陷明显,但牙本质未暴露;120颗患牙均未发现继发龋,修复体边缘密合度良好.结论 唇侧齐龈边缘肩台的EMAX铸造陶瓷全冠修复体在临床上可获得理想的美学效果和边缘适应性.     

Porcelain laminate veneers: 6- to 12-year clinical evaluation--a retrospective study

The purpose of this study was to retrospectively evaluate the clinical performance of laminate veneers placed in the anterior segments of the dental arches over a 12-year period at two different private dental practices. Forty-six patients were restored with 182 porcelain laminate veneers. The veneers were studied for a mean observation time of 5.69 years. Color match, porcelain surface, marginal discoloration, and marginal integrity were clinically examined following modified CDA/Ryge criteria. On the basis of the criteria used, most of the veneers rated A. Risk of fracture was determined with a Kaplan-Meier survival analysis. Probability of survival of the 182 veneers was 94.4% at 12 years, with a low clinical failure rate (approximately 5.6%). Porcelain veneers must be bonded with a correct adhesive technique to reach this successful survival rate.     

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.     

Five-year clinical performance of porcelain laminate veneers.

OBJECTIVE: The clinical performance of porcelain laminate veneers was evaluated at 5 years. METHOD AND MATERIALS: One hundred eighty-six porcelain laminate veneers were placed in 61 patients, aged 18 to 70 years, by a single operator following the same clinical procedure. At the 5-year recall, esthetics, marginal integrity, marginal discoloration, fracture rate, and patient satisfaction were recorded. RESULTS: At recall 98.4% of the veneers were satisfactory without intervention. The retention rate was excellent, the fracture rate was very low, and the maintenance of esthetics was superior. Patient satisfaction was very high. CONCLUSION: Porcelain laminate veneers offer a reliable and effective procedure for the conservative and esthetic treatment of anterior teeth.     

Clinical evaluation of different posterior resin composite materials: a 7-year report.

OBJECTIVES: The aim of this study was to investigate the clinical performance of 120 posterior composite restorations placed in 38 patients after a period of 7 years. METHOD AND MATERIALS: Eighty-eight Class I and 32 Class II restorations were made (93 molars and 27 premolars) using three different resin composite materials: Z100, Clearfil Ray-Posterior, and Prisma TPH. The restorations were evaluated using Ryge's criteria for color match, marginal discoloration, marginal adaptation, secondary caries, surface texture, and anatomic form at baseline, 1,2, 5, and 7 years. Photographs and radiographs were taken at each recall period. RESULTS: At 7-year recalls, 70 restorations were available for examination. Four restorations had failed due to secondary caries. Saliva sampling was performed to determine the level of mutans streptococci and lactobacilli for the four failed restorations at the last recall. No statistically significant differences were found among the materials in regard to color match, anatomic form, and secondary caries. Clearfil Ray-Posterior had statistically significantly rougher surface texture than the surrounding enamel compared to the other resin composites. Z100 showed more cavosurface margin discoloration after 5 years than the other two resin composites. All materials had slight marginal adaptation problems at the 7-year recall. There was no apparent relationship between the levels of mutans streptococci and lactobacilli in saliva and the failed restorations. CONCLUSION: The three posterior composites tested had acceptable clinical performance after 7 years.     

A longitudinal clinical study of Procera ceramic-veneered titanium copings.

PURPOSE: The purpose of the present paper was to study the long-term clinical results with ceramic-veneered Procera titanium copings. MATERIALS AND METHODS: A total of 44 titanium copings (fabricated for 22 patients) veneered with a low-fusing ceramic were followed for 60 to 78 months. The clinical examinations were performed by licensed specialists in prosthetic dentistry. The crowns were rated according to the California Dental Association system. In addition, Bleeding Index and Margin Index were also evaluated. RESULTS: In 3 crowns ceramic fractures necessitated their replacement. Two crowns had to be replaced because of caries. The ratings for surface and color had changed markedly, from excellent to acceptable. Regarding anatomic form, with the exception of the 3 fractured ceramic crowns, there were no obvious changes. The margin integrity, aside from the 2 crowned teeth with caries, was recorded as satisfactory (excellent or acceptable) for all other crowns; in fact, a large majority were rated excellent. Regarding Bleeding Index, there were no differences between crowned teeth and control teeth. Changes in Margin Index showed that the gingiva of the crowned teeth had retracted. CONCLUSION: Of the various clinical factors evaluated, only surface and color-related to the low-fusing ceramic used for veneering-showed any obvious change during the follow-up period. Otherwise the veneered titanium copings had, in general, performed well.