Direct versus indirect veneer restorations for intrinsic dental stains.

Department of Biomaterials Science, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK, M15 6FH.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2004; DOI: 10.1002/14651858.CD004347.pub2
Source: PubMed

ABSTRACT Patients with discoloured teeth frequently present to the dentist requesting restorations designed to improve their appearance. For teeth that are sound, this might include the use of a veneer restoration. The veneer acts as a thin layer of a material covering the labial surface of a tooth and can be applied directly to the tooth, or by using indirect methods.
To examine the effectiveness of direct versus indirect laminate veneer restorations.
The following electronic databases were searched: The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library Issue 3, 2002), MEDLINE (1980 to 19/11/2002) and EMBASE (1980 to 19/11/2002). There was no restriction on language.
All randomised controlled trials (RCTs) of participants with permanent anterior teeth suitable for restorations using laminate veneers, comparing direct (different composite materials) and indirect techniques for making dental veneers. The indirect restorations may be either composite or porcelain. The primary outcome was restoration failure.
Assessment of relevance and validity and data extraction were conducted in triplicate. Authors of the primary studies were contacted to provide additional information as necessary.
Six full publications were screened as being potentially relevant to the review, only one trial was found to meet the review's inclusion criteria. Although the trial met the review's inclusion criteria with regard to participant characteristics, interventions and outcomes assessed, problems with the reporting of the data prevented any statistical analysis of the results.
There is no reliable evidence to show a benefit of one type of veneer restoration (direct or indirect) over the other with regard to the longevity of the restoration.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study investigated toothbrush abrasion and in vitro aging on ceramic (indirect technique) and composite veneers (direct technique). Identical composite and individual human incisors were restored with industrially preformed composite veneers, indirectly produced ceramic veneers, and direct composite restorations. Surface roughness was determined before and after tooth brushing. A 5-year period of oral service was simulated by thermal cycling and mechanical loading (TCML). After TCML, all specimens were examined with microscopy and scanning electron microscopy. Specimens without failures during TCML were loaded until failure. Statistics: analysis of variance; Bonferroni's post hoc analysis, Kaplan-Meier-Log Rank test (α = 0.05). Tooth brushing yielded a non-significant increase (p = 0.560) in roughness in all materials (industrial veneer, 0.12+/-0.07 μm, direct restoration, 0.18+/-0.14 μm, ceramic, 0.35+/-0.16 μm). No significant differences in roughness could be determined between the materials, neither before nor after testing (p < 0.001). After TCML of artificial teeth, direct and preformed composite veneers on composite teeth showed no failures or damages. Two ceramic veneers showed cracking in the labial area. After TCML of human teeth, transmission microscopy indicated a facial crack in a ceramic veneer and chipping in the cervical area of a preformed veneer. Two direct composite veneers lost retention. No significantly different survival rates were found between the three veneer groups. Fracture force on human teeth varied between 527.8+/-132.4 N (ceramic), 478.3+/-165.4 N (preformed composite), and 605.0+/-263.5 N (direct composite). All materials revealed comparable wear resistance. Indirect ceramic, direct restorative composite, and preformed composite veneers showed comparable failure rates and satisfying longevity. The results indicate similar longevity of the chosen materials for veneer restorations.
    Clinical Oral Investigations 02/2014; 19(1). DOI:10.1007/s00784-014-1209-2 · 2.29 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Various methods are used for closure of head and neck incisions but not all of them have adhesive property. Hence aim of this study is to evaluate the efficacy of Iso-Amyl 2 cyanoacrylate as a wound closure material. A total of 16 cases were selected for the study. The length of incisions varied from 2.0 to 13.5cms. Closure was done by cyanoacrylate tissue adhesive after approximating with subcutaneous Vicryl/Catgut or intermittent holding sutures. The wound was evaluated on the first, third, and seventh postoperative day for gaping, infection and necrosis of tissue edges and any other complications. The results of the study showed 15 cases of excellent clinical outcomes in which healing occurred by primary intention.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective:The aim of this study was to test the null hypothesis that different surface conditioning (etch and rinse and self-etch) and curing techniques (light cure/dual cure) had no effect on the shear bond strength of direct and indirect composite inlays.Materials and Methods:A total of 112 extracted human molar teeth were horizontally sectioned and randomly divided into two groups according to restoration technique (direct and indirect restorations). Each group was further subdivided into seven subgroups (n = 8) according to bonding agent (etch and rinse adhesives Scotchbond multi-purpose plus, All-Bond 3, Adper Single Bond and Prime Bond NT; and self-etch adhesives Clearfil Liner Bond, Futurabond DC and G bond). Indirect composites were cemented to dentin surfaces using dual-curing luting cement. Shear bond strength of specimens was tested using a Universal Testing Machine. Two samples from each subgroup were evaluated under Scanning electron microscopy to see the failing modes. Data was analyzed using independent sample t-tests and Tukey's tests.Results:Surface conditioning and curing of bonding agents were all found to have significant effects on shear bond strength (P < 0.05) of both direct and indirect composite inlays. With direct restoration, etch and rinse systems and dual-cured bonding agents yielded higher bond strengths than indirect restoration, self-etch systems and light-cured bonding agents.Conclusions:The results of the present study indicated that direct restoration to be a more reliable method than indirect restoration. Although etch and rinse bonding systems showed higher shear bond strength to dentin than self-etch systems, both systems can be safely used for the adhesion of direct as well as indirect restorations.
    European journal of dentistry 10/2013; 7(4):436-41. DOI:10.4103/1305-7456.120679