Gurel Galip, Sesma Newton, Calamita Marcelo A, Coachman Christian, Morimoto Susana
New York University College of Dentistry, New York, NY, USA.
Int J Periodontics Restorative Dent. 2013 Jan-Feb;33(1):31-9. doi: 10.11607/prd.1488.
The purpose of this study was to evaluate the failure rates of porcelain laminate veneers (PLVs) and the influence of clinical parameters on these rates in a retrospective survey of up to 12 years. Five hundred eighty laminate veneers were bonded in 66 patients. The following parameters were analyzed: type of preparation (depth and margin), crown lengthening, presence of restoration, diastema, crowding, discoloration, abrasion, and attrition. Survival was analyzed using the Kaplan-Meier method. Cox regression modeling was used to determine which factors would predict PLV failure. Forty-two veneers (7.2%) failed in 23 patients, and an overall cumulative survival rate of 86% was observed. A statistically significant association was noted between failure and the limits of the prepared tooth surface (margin and depth). The most frequent failure type was fracture (n = 20). The results revealed no significant influence of crown lengthening apically, presence of restoration, diastema, discoloration, abrasion, or attrition on failure rates. Multivariable analysis (Cox regression model) also showed that PLVs bonded to dentin and teeth with preparation margins in dentin were approximately 10 times more likely to fail than PLVs bonded to enamel. Moreover, coronal crown lengthening increased the risk of PLV failure by 2.3 times. A survival rate of 99% was observed for veneers with preparations confined to enamel and 94% for veneers with enamel only at the margins. Laminate veneers have high survival rates when bonded to enamel and provide a safe and predictable treatment option that preserves tooth structure.
本研究的目的是在一项长达12年的回顾性调查中，评估瓷贴面（PLV）的失败率以及临床参数对这些失败率的影响。在66例患者中粘结了580颗瓷贴面。分析了以下参数：预备类型（深度和边缘）、牙冠延长术、修复体的存在、牙间隙、牙列拥挤、变色、磨损和磨耗。使用Kaplan-Meier方法分析生存率。采用Cox回归模型确定哪些因素可预测PLV失败。23例患者中的42颗贴面（7.2%）失败，观察到总体累积生存率为86%。在失败与预备牙面的界限（边缘和深度）之间发现有统计学意义的关联。最常见的失败类型是折断（n = 20）。结果显示，根尖向牙冠延长术、修复体的存在、牙间隙、变色、磨损或磨耗对失败率没有显著影响。多变量分析（Cox回归模型）还显示，粘结到牙本质以及预备边缘位于牙本质的牙齿上的PLV失败的可能性比粘结到釉质上的PLV大约高10倍。此外，冠向牙冠延长术使PLV失败的风险增加2.3倍。对于预备仅限于釉质的贴面，观察到的生存率为99%，而仅边缘为釉质的贴面生存率为94%。当粘结到釉质上时，瓷贴面具有较高的生存率，并提供了一种安全且可预测的治疗选择，可保留牙齿结构。
