Survival and Complication Rates of Feldspathic, Leucite-Reinforced, Lithium Disilicate and Zirconia Ceramic Laminate Veneers: A Systematic Review and Meta-Analysis

Abstract

Objectives: To analyze survival and complication rates for anterior and premolar laminate-veneers out of different ceramic materials (feldspathic, leucite-reinforced glass-ceramic [LRGC], lithium-disilicate [LDS] and zirconia).

Material and methods: A systematic literature search was conducted across multiple databases for clinical studies on ceramic laminate-veneers with a minimum-follow-up of ≥ 1 year. The date of last search was on February 19, 2024. Survival, technical, esthetic and biological events were assessed for different laminate-veneer materials at three observation periods (short- [1-3 years], mid- [4-6 years] and long-term [≥ 7 years]).

Results: Twenty-nine studies were included. Meta-analysis revealed a pooled survival-rate of 96.13% for feldspathic, 93.70% for LRGC and 96.81% for LDS at 10.4 years. No difference was found between materials. Complication rates (technical/esthetic/biological) were as follows: Feldspathic: 41.48%/19.64%/6.51%; LRGC: 29.87%/17.89%/4.4%; LDS: 6.1%/1.9%/0.45% at 10.4 years. Zirconia showed a 100% survival-rate with no complications at 2.6 years. No long-term data was available for zirconia.

Conclusions: Feldspathic, LRGC and LDS laminate-veneers showed high survival-rates at long-term observation. LDS slightly outperforms feldspathic and LRGC laminate-veneers with lower long-term complication rates. More studies providing long-term data on zirconia laminate-veneers are needed.

Clinical significance: Ceramic laminate-veneers are a reliable treatment option. LDS may be preferred as a restorative material for long-term success.

Keywords: ceramic; dental porcelain; dental restoration failure; follow‐up studies; fractures; survival; veneer.

FIGURE 1

Prisma flow chart for article selection [20].

FIGURE 2

Risk of bias assessment summary according the Revised Cochrane risk‐of‐bias tool for randomized trials (Rob2) [30].

FIGURE 3

Risk of bias assessment summary according to the methodological index for non‐randomized studies (MINORS) [29].

FIGURE 4

Forrest plot on the outcome of short‐term survival (1–3 years). (Random Effects model: DerSimonian‐Laird method. Heterogeneity: τ² = 0.002, I² = 72.027%, H² = 3.575).

FIGURE 5

Forrest plot on the outcome of mid‐term survival (4–6 years). (Random Effects model: DerSimonian‐Laird method. Heterogeneity: τ² = 0.005, I² = 81.691%, H² = 5.462).

FIGURE 6

Forrest plot on the outcome of long‐term survival (> 7 years). (Random Effects model: DerSimonian‐Laird method. Heterogeneity: τ² = 0.004, I² = 69.077%, H² = 3.234).