De Angelis Francesco, D'Arcangelo Camillo, Angelozzi Roberta, Vadini Mirco
Assistant Professor, Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, "G. D'Annunzio" University of Chieti, Chieti, Italy.
Full Professor and Head of the Unit of Restorative Dentistry and Endodontics, Department of Medical, Oral and Biotechnological Science, School of Dentistry, "G. D'Annunzio" University of Chieti, Chieti, Italy.
J Prosthet Dent. 2023 Jan;129(1):40-48. doi: 10.1016/j.prosdent.2021.04.016. Epub 2021 May 28.
Porcelain 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.
The 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.
One 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.
The 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.
Porcelain 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.
无需牙体预备的瓷贴面（无预备贴面）可能是前牙美学修复的一种便捷且保守的选择。然而，其可预测性存在争议。
本临床研究的目的是回顾性评估按照最近提出的“CH无预备”方案放置的无预备瓷贴面的性能，该方案声称克服了以往无预备贴面解决方案的许多缺点。
2015年至2017年期间，在21名患者中放置了108颗基于CH无预备方案的无预备瓷贴面。联系了所有参与者，15人接受了复诊检查：根据临床-摄影-微观形态编码对总共78颗贴面进行了评估。记录菌斑和牙龈指数以及牙龈退缩的任何增加情况。核实牙髓活力。计算基于绝对失败数的生存率以及总结绝对和相对失败影响的成功率。
平均观察期为43.1个月，观察间隔为36至60个月，生存率为97.4%。从5例相对失败（3例轻微骨折或崩瓷和2例有限的边缘变色）和2例绝对失败（无法修复的骨折）中，记录的总体成功率为91.0%，复诊检查后71颗修复体在临床接受度方面被判定为优秀。根据临床-摄影-微观形态评估，5颗修复体（6.4%）显示边缘完整性存在轻微问题，而在2颗修复体（2.8%）上发现了有限的瓷悬突。微观形态分析证实了临床评估结果。未观察到牙周退缩，菌斑和牙龈指数保持稳定。
按照CH无预备方案放置的瓷贴面在临床使用36至60个月后表现出优异的性能。在颜色匹配以及整体美学和解剖学整合方面取得的结果证实，只要采用严格的患者选择和边缘线放置规则，就可以安全地采用无预备方法。
