Schuitemaker, J. (Julia) (2018) Overleving en klinische evaluatie van keramische schildjes, een prospectief cohortonderzoek tot 10 jaar: Overleving van keramische schildjes gehecht aan tanden met en zonder bestaande composiet restauraties, met en zonder toepassing van IDS en met en zonder wortelkanaalbehandeling. Klinische evaluatie op basis van USPHS-score. thesis, Dentistry.
Full text available on request.Abstract
Introduction: Laminate veneers are a minimally invasive treatment. They can’t rely on a macro-mechanic preparation. Therefore they rely completely on adhesive retention. Several factors can be of influence on this. Research objective: The objective of this prospective observational cohort study give the practitioner guidelines for durable treatment using laminate veneers. Research questions: What is the survival rate of laminate veneers up to 10 years? Are existing restorations, IDS or existing root canal treatment of influence on the survival? Is there a relation between smoking and marginal discoloration and between color match and root canal treatment? Materials and methods: A database consisting of 444 veneers placed in a 118 patients in the period of 07/2007 to 09/2017 was formed. All patients were asked for evaluation between 06/2016 and 10/2017. Beforehand all tooth preparations were accessed for the presence of existing composite restorations and dentine exposure, using photos taken at the time of preparation. During the evaluations photos were taken and the veneers were accessed by one independent examination using the modified USPHS for adaptation, color match, margin discoloration, fracture of restoration, fracture of tooth, wear of restoration, wear of antagonist, caries, surrounding tissues and post-operative sensitivity. Veneers that had to be replaced were considered absolute failures. Success was rated based on the previously mentioned criteria on veneers that didn’t fail. The cumulative survival was determined using Kaplan-Meier analysis and compared with the Log Rank test. Quality of the veneers was determined using Fisher’s exact test. Results: 384 veneers with 104 patients were included for analysis. The mean observation time was 45 months with a maximum of a 120 months. In total n=19 absolute failures were observed, fracture (n=15) being the most observed, followed by debonding (n=3) and extraction of a tooth (n=1). Cumulative survival was 92,0% at 7.5 years. The presence of existing composite restorations did not lead to a significantly lower survival rate (p=0,923). When IDS was used a significant increase in survival was seen, when a lot of dentin was exposed in preparation (p=0.025). Root canal treatments did not lead to a significantly lower survival rate (p=0.102). Minor marginal discoloration occurred more often in patients who smoked (p<0,001). Root canal treatment has a negative influence on color match (p<0,001) Interpretation: Laminate veneers are a durable and reliable treatment option. Conclusion: Within the limitations of this study the following can be concluded; Existing composite restoration can be covered using a laminate veneer, when proper surface conditioning is applied. When there is 50% dentin exposure or more, IDS can significantly improve the survival of laminate veneers. Root canal treatment doesn’t cause a lower survival rate. Smoking has a negative influence on marginal discoloration and the presence of a root canal treatment have a negative influence on color match.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Gresnigt, dr. M.M.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 Nov 2021 12:47 |
| Last Modified: | 23 Nov 2021 12:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2828 |
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