Coelho-de-Souza Fábio Herrmann, Gonçalves Daiana Silveira, Sales Michele Peres, Erhardt Maria Carolina Guilherme, Corrêa Marcos Britto, Opdam Niek J M, Demarco Flávio Fernando
Department of Conservative Dentistry, Federal University of Rio Grande do Sul, RS, Brazil.
Private Practitioner, Porto Alegre, RS, Brazil.
J Dent. 2015 Nov;43(11):1330-6. doi: 10.1016/j.jdent.2015.08.011. Epub 2015 Aug 28.
This retrospective, longitudinal clinical study investigated the performance of direct veneers using different composites (microfilled×universal) in vital or non-vital anterior teeth.
Records from 86 patients were retrieved from a Dental School clinic, comprising 196 direct veneers to be evaluated. The FDI criteria were used to assess the clinical evaluation. The survival analysis was done using Kaplan-Meier method and Log-Rank test. The multivariate Cox regression with shared frailty was used to investigate the factors associated with failure.
A total of 196 veneers were evaluated, with 39 failures. The mean time of service for the veneers was 3.5 years, with a general survival rate of 80.1%. In the qualitative evaluation of the restorations, microfilled composite showed slighty better esthetics. The annual failure rates (AFR) were 4.9% for veneers in vital teeth and 9.8% for non-vital teeth with statistical significance (p=0.009). For microfilled and universal veneers the respective AFRs were 6.0% and 6.2% (p>0.05). Veneers made in non-vital teeth had a higher risk of failure over time compared to those made in vital teeth (HR 2.78; 95% CI 1.02-7.56), but the type of material was not a significant factor (p=0.991). The main reason for failure was fracture of the veneer.
Direct composite veneers showed a satisfactory clinical performance. Veneers performed in vital teeth showed a better performance than those placed in non-vital teeth. No difference in the survival rate for different composites was found, although microfilled composites showed a slightly better esthetic appearance.
Direct composite veneers show good results in esthetic dentistry nowadays. Composite veneers in vital teeth have a lower risk of failure than those in non-vital teeth.
本回顾性纵向临床研究调查了使用不同复合材料（微填料×通用型）制作的直接贴面在活髓或无髓前牙中的性能。
从一所牙科学院诊所检索了86例患者的记录，其中包括196个待评估的直接贴面。采用FDI标准进行临床评估。使用Kaplan-Meier方法和对数秩检验进行生存分析。采用具有共享脆弱性的多变量Cox回归来研究与失败相关的因素。
共评估了196个贴面，其中39个失败。贴面的平均使用时间为3.5年，总生存率为80.1%。在修复体的定性评估中，微填料复合材料的美学效果略好。活髓牙贴面的年失败率（AFR）为4.9%，无髓牙贴面的年失败率为9.8%，具有统计学意义（p=0.009）。微填料贴面和通用型贴面的年失败率分别为6.0%和6.2%（p>0.05）。与活髓牙制作的贴面相比，无髓牙制作的贴面随着时间推移失败风险更高（风险比2.78；95%置信区间1.02-7.56），但材料类型不是一个显著因素（p=0.991）。失败的主要原因是贴面折断。
直接复合树脂贴面显示出令人满意的临床性能。活髓牙上制作的贴面比无髓牙上制作的贴面性能更好。尽管微填料复合材料的美学外观略好，但未发现不同复合材料的生存率有差异。
如今直接复合树脂贴面在美容牙科中显示出良好的效果。活髓牙的复合树脂贴面失败风险低于无髓牙的复合树脂贴面。
