Cochrane · intervention · CD004347

Direct versus indirect veneer restorations for intrinsic dental stains

Cochrane Database of Systematic Reviews · 2004 · Cochrane Library

Oral Health Dental caries Esthetic dentistry Implants and prosthodontics2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 4 · 44.4%Ungraded 5 · 55.6%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Patients with permanent anterior teeth suitable (i.e. with intrinsic staining) for restorations using laminate veneers	112 patients (180 restorations) with permanent maxillary anterior teeth requiring 1 to 6 veneers (maximum 2 included per patient); mean age 30 years (range 14 to 74); recruited via general practitioners and the Dental School, University of Nijmegen, The Netherlands
Intervention	Direct laminate veneer techniques (different composite materials)	Direct resin composite (microfine; Silux Plus) (n=69 restorations); Indirect resin composite (microfine; Dentacolor) (n=54); Porcelain (fine crystalline; Flexo-ceram) (n=56)
Comparison	Indirect laminate veneer techniques (indirect restorations composite or porcelain)	Not reported (three-arm trial; comparator arms not separately defined)
Outcomes	Restoration failure (primary; debond, fracture, delamination or significant leakage requiring replacement); Aesthetic achievement (colour match); Patient satisfaction (e.g. visual analogue scale); Pain following treatment; Cost of treatment; Adverse reactions	Absolute failure (n=180 restorations); Relative failure (n=180); Survival of original restoration (n=180); Functional survival (n=180); Overall survival (n=180); Patient satisfaction (n=112 patients)
Study designs	Randomised controlled trials (RCTs); quasi-randomised trials eligible (sensitivity analysis)	1 RCT (Meijering 1998; three publications; 2.5-year interim analysis; The Netherlands)
Timing	Not specified	Baseline (~4 weeks post-placement); ~1 year (0.9 to 1.3 years); 2 years (1.9 to 2.5 years)

Search date: 2003-11. Databases: The Cochrane Oral Health Group's Trials Register; CENTRAL (The Cochrane Library 2003, Issue 4); MEDLINE (1980 to November 2003); EMBASE (1980 to November 2003)

Questions and results

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Direct resin composite veneer vs Indirect resin composite veneer

Population: Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations

6 questions

Outcome	Effect	Evidence	Status / GRADE
Pain following treatment same question in other reviews	Planned outcome; pain following treatment was not reported by the included trial (earlier trial publications reported treatment times, not pain).	0 studies	No studies
Patient satisfaction 2 years same question in other reviews	Meijering 1998 (Table 4): patients satisfied at 2 years - direct resin composite 67%, indirect resin composite 82%. No statistical comparison performed.	1 study	Ungraded
Cost of treatment same question in other reviews	Planned outcome; cost of treatment was not reported by the included trial.	0 studies	No studies
Adverse reactions same question in other reviews	Planned outcome; no adverse-reaction data were reported by the included trial.	0 studies	No studies
Restoration failure (longevity) 2 years same question in other reviews	Meijering 1998 (data by restoration, not pooled; no statistical analysis possible). Failures over 2-year follow-up: direct resin composite (n=69) 4 absolute and 14 relative failures; indirect resin composite (n=54) 7…	1 study · 123 participants	Ungraded
Colour match (aesthetic achievement) same question in other reviews	Planned outcome; colour match was not reported by the single included trial (Meijering 1998).	0 studies	No studies

Direct resin composite veneer vs Porcelain (indirect) veneer

Population: Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations

2 questions

Outcome	Effect	Evidence	Status / GRADE
Patient satisfaction 2 years same question in other reviews	Meijering 1998 (Table 4): patients satisfied at 2 years - direct resin composite 67%, porcelain 93%. No statistical comparison performed.	1 study	Ungraded
Restoration failure (longevity) 2 years same question in other reviews	Meijering 1998 (data by restoration, not pooled; no statistical analysis possible). Failures over 2-year follow-up: direct resin composite (n=69) 4 absolute and 14 relative failures; porcelain (n=56) 0 absolute and 3…	1 study · 125 participants	Ungraded

Indirect veneer with no incisal edge reduction vs Indirect veneer with incisal edge reduction (1.5 mm plus short palatal bevel)

Population: Patients receiving indirect laminate veneer restorations on permanent anterior teeth

1 question

Outcome	Effect	Evidence	Status / GRADE
Restoration survival (longevity) 2 years same question in other reviews	Meijering 1998 (Table 3): survival percentages by preparation type at 2 years (original/functional/overall) - no incisal edge reduction 98/97/95; incisal reduction 95/90/87. No statistical comparison performed.	1 study	Ungraded