Ultrathin Ceramic Veneers in the Aesthetic Zone: A 36-month Retrospective Case Series.

PURPOSE To evaluate the incidence of ultrathin ceramic veneer fracture over a period of 36 months and the possible relationship with local- and patient-related factors. MATERIALS AND METHODS Adult patients who received ceramic veneers for improvement in smile esthetics were selected from a private practice pool. Veneers were grouped as conventional ceramic veneers (prep) or ultrathin following either a minimal preparation (min-prep) or no tooth preparation (no-prep) protocol. After veneer bonding, all patients were followed up at intervals of 6 months up to 36 months. A panel of clinical outcomes was recorded. Patient satisfaction was assessed at 36 months. RESULTS The study sample was formed by 49 patients who received a total of 194 veneers. Twelve veneers were prep, 125 were min-prep, and 57 were no-prep. Total fracture occurrence was 9.8% in 13 participants. No fractures were observed in prep veneers, while 16 out of 125 min-prep and 3 out of 57 no-prep veneers had fractures. Most fractures (13 out of 19) occurred early, within the first 12 months after bonding. Out of 194 veneers, only 1 had a catastrophic failure (0.5%), 3 had large (≥ 1 mm) chippings (1.5%), and 15 had minor (< 1 mm) chippings (7.7%). A generalized estimating equation model revealed that the odds of veneer fracture were significantly higher in men (odds ratio [OR] = 11.29), in patients who exhibited tooth wear at baseline (OR = 5.54), and in central (OR = 13.56) and lateral (OR = 10.43) incisors compared to canines and premolars. All participants indicated that they would not change to a different restorative protocol in order to have a thicker restoration and possibly less risk of fracture. CONCLUSION Ultrathin ceramic veneers are a viable cosmetic dentistry treatment option that involves minimal or no tooth preparation. However, a tendency for increased early fractures was observed in the min-prep group.