A Prospective Ten-Year Clinical Trial of Porcelain Veneers: swift

Abstract

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.