ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title There Is No Conclusive Evidence That Porcelain Veneers Placed On Anterior Teeth Greatly Increase The Risk Of Developing Gingivitis
Clinical Question Is a 28 year old male with porcelain veneers on teeth 7 through 10 at a greater risk of developing localized gingivitis than he would without veneers?
Clinical Bottom Line There is no conclusive evidence that porcelain veneers placed on anterior teeth greatly increase the chances of developing gingivitis. Unfortunately, the most recent studies identified were of low-level evidence. What did seem apparent was that excellent oral hygiene and supra-gingival veneer margins help keep the respective gingival tissues in good health.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 1812967Reid/1991 6 dental students, 5 male and 1 female Case Control
Key resultsIf the veneer is placed supra-gingivally and the patient exhibits good oral hygiene, there were no adverse effects to the gingiva when examined using the plaque index, gingival indexes and gingival crevicular fluid volume over a 50-day period. The effect of less than good oral hygiene combined with veneers was not evaluated.
#2) 7499649Pippin/199530 patients with two laminate porcelain veneers (13 men and 17 women, ages 18-77 years)Case Control
Key resultsPeriodontal health was measured using gingival crevicular fluid flow, pocket depth, gingival bleeding index, and the Quigley, Hein, and Turesky plaque index. The differences in tissue health between the porcelain veneer on the labial surface and the non-veneered lingual were considered insignificant. Porcelain veneers were named the anterior restoration of choice because of the tendency to keep veneer margins at or above the gingiva.
Evidence Search ("Dental Veneers"[Mesh]) AND "Gingivitis"[Mesh]
Comments on
The Evidence
The Reid et. al., study was very small and only done over a short period of time (only 50 days and the veneers were removed afterwards.) The teeth receiving the veneers were also not prepped. In the Pippin et. al., study, porcelain veneers were sub-grouped by how long they had been placed, ranging from 0 to 60 months. The group was larger and much more diverse. Also, both studies were case controls that rank fairly low on the hierarchy of evidence.
Applicability Although no particular findings were seen, both studies seem to suggest that porcelain veneers minimize gingival harm because of the tendency to place them at or above the gingiva. Additionally, oral hygiene is of utmost importance to keep gingivitis from developing. New studies are greatly needed to expand upon this further.
Specialty/Discipline (Periodontics) (Restorative Dentistry)
Keywords Porcelain veneer, gingivitis
ID# 2410
Date of submission: 02/28/2013spacer
E-mail pfeifera@livemail.uthscsa.edu
Author Adam Pfeifer
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie Jones, DDS
Faculty mentor/Co-author e-mail JonesA@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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