Survival of Ceramic Veneers: Impact of Dentin Exposure and Tooth Vitality After 1 to 15 Years of Follow-Up

Abstract

Objective: This retrospective clinical study aimed to evaluate the survival rates of ceramic laminate veneers in relation to dentin exposure, endodontic treatment, preparation design, and the type of dual-cure resin cement used.

Materials and methods: A total of 672 veneers were placed in 189 patients and followed for 1 to 15 years. Veneer supporting teeth were categorized after etching based on the degree of dentin exposure into three groups: GA1 (enamel only), GA2 (< 30% dentin), and GA3 (> 30% dentin). Additional variables included endodontic treatment, preparation design, and the resin cement system used. Kaplan-Meier survival analysis, Log-Rank tests (α = 0.05), and Odds Ratios (ORs) were computed. All procedures were performed by a single clinician, veneers were fabricated by a single ceramist, and the study was performed by a different, single examiner.

Results: The cumulative 15-year estimated survival rate was 96%, mean survival 5.98 years. Veneers in the GA1 group showed an estimated survival rate of 96.7%, compared to 95.3% in GA2 and 93.9% in GA3. A statistically significant difference was found between GA1 and GA3 (p = 0.033). Endodontically treated teeth and those with dentin exposure exhibited higher risks of failure (OR = 1.68 and 3.47, respectively). Endodontic treatment, preparation design, and resin cement type did not significantly affect survival (p > 0.05).

Conclusions: The extent of dentin exposure significantly impacts the survival of bonded ceramic veneers after 1 to 15 years of follow-up. Preservation of enamel is critical for optimizing outcomes.

Clinical significance: These findings suggest that meticulous patient selection, preparation techniques, optimal bonding protocols, and bonding exclusively to enamel, whenever possible, are essential for ensuring the clinical success of CLV bonded with dual-cured resin.

Keywords: Kaplan–Meier survival; ceramic veneers; dentin exposure; dual‐cure resin cements; enamel preservation; retrospective study.