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Survival of ceramic veneers made of different
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Article in European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry,
The · June 2012
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Greece. Department of Fixed Prosthesis and Implant Prosthodontics. E-mail: Lpetridi@dent. Greece Alkisti Zekeridou. DDS. Department of Fixed Prosthesis and Implant Prosthodontics. 54124. DDS. Department of Fixed Prosthesis and Implant Prosthodontics. School of Dentistry. School of Dentistry.. Greece Dimitrios Tortopidis.gr 138 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. CLINICAL RESEARCH Survival of Ceramic Veneers Made of Different Materials After a Minimum Follow-up Period of Five Years: A Systematic Review and Meta- Analysis Haralampos P. DDS Dentist. Thessaloniki. Department of Fixed Prosthesis and Implant Prosthodontics.#&3t46. PhD Assistant Professor. School of Dentistry. Aristotle University of Thessaloniki. Aristotle University of Thessaloniki. Aristotle University of Thessaloniki. DDS Dentist. Tel/Fax: +30-231-099-9575. Petridis. Thessaloniki. Aristotle University of Thessaloniki.&3 . Thessaloniki. Greece Maria Malliari. Mob: +30-694-425-0459. School of Dentistry. MSc. Thessaloniki.&t/6. Department of Fixed Prosthesis and Implant Prosthodontics. School of Dentistry. Greece Petros Koidis. MSc.auth. Thessaloniki. DDS. Greece Correspondence to: Haralampos P. School of Dentistry. Thessaloniki. Aristotle University of Thessaloniki. Department of Fixed Prosthesis and Implant Prosthodontics. PhD Professor and Chair. PhD Assistant Professor. Petridis Assistant Professor. Aristotle University of Thessaloniki.

tion reported was marginal discoloration up time of at least 5 years. Four of the included studies complication rates of ceramic veneers reported on the survival of ceramic ven- produced with different techniques and eers made out of feldspathic ceramics. No study directly compared the in- cidence of complications between cer- Purpose: The purpose of this systematic amic veneers fabricated from different review was to compare the survival and materials. marginal integrity. Results: Nine studies were selected for final analysis over an initial yield of 409 (Eur J Esthet Dent 2012. was calculated for at least 5 years of clinical service. tion rates were low.. Event rates were cal.&3 . ture.#&3t46. materials after a minimum follow-up time four studies were on glass-ceramic ven- of 5 years. The mean search was conducted. the 5-year complica- and journal researching. fabricated from feldspathic or glass-cer- groups of different materials. relevant references. The most frequent complica- niques and materials with a mean follow. Summary Conclusion: The results of this systemat- estimates.&t/6. no statistically significant difference in culated for the following complications the event rates between the subgroups associated with ceramic veneers: frac.7:138–152) 139 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. There was to October 2010. for clinical stud. PETRIDIS ET AL Abstract titles. with very low complication rates. with the exception of ies reporting on the survival of ceramic studies reporting on extended ceramic veneers fabricated with different tech. as well as amics have an adequate clinical survival statistical significance. of different materials (feldspathic vs.7% at 5 years).9–7. and caries. and 5-year event rates were ic review showed that ceramic veneers reported. eers and one study included veneers Materials and methods: A literature fabricated from both materials. The search (9% at 5 years). Overall. followed by marginal in- period spanned from January 1980 up tegrity (3. glass-ceramic). using electronic observation time ranged between 5 and databases. using a mixed effects model. debonding. citations 10 years. veneers. Comparison between sub. marginal discoloration.

&3 . over feldspathic ceramics for the fabri- terior teeth. parafunctional habits. but The marginal adaptation achieved for none of the existing systems are that flex- ceramic veneers fabricated by using ei.17-19 On the manufacturing (CAD/CAM) systems to contrary. ible. the latter being form of teeth. have demonstrated the superior mech- face treatment during the 1980s. Cementation techniques seem to be ials. presented as the weakest material.&t/6.13 Mechanical fractory die or a platinum foil using con. servative esthetic rehabilitation of worn. The third technique. possible mechanical challenges. necessarily predict clinical outcomes of ond involves the use of heat-pressable. prostheses. Glass-ceramic materials are proposed fractured or anatomically malformed an. Artificial ceramic veneers are de- ence important aspects and properties signed to reproduce the depth of the of ceramic veneers.1 based ceramics. introduced in a critical factor for the survival of etch- the last decade.4. compared to leucite- Ceramic veneers can be utilized to alter reinforced ceramics and conventional and improve the alignment. ceramics.21 was essentially the same as those pro.2 the presence of dentin substructure or The first involves the use of either a re.#&3t46. and have been described in the literature. fabrication. such terials for fabricating ceramic veneers as extended veneer preparations. amic systems do not require any spe- strength ceramics. Studies22. properties of materials though do not ventional feldspathic porcelain. as con. cific cementation procedure. such as marginal color. esthetics. The sec.4 chroma and value) and translucency. and their marginal adaptation preparation.21 Feldspathic and glass-ceramic ther the platinum foil technique or the materials exhibit increased translucency refractory die technique was reported compared to alumina or zirconia-based to be superior to that of castable glass. alumina or zirconia-based cer- fabricate ceramic veneers utilizing high. relevant literature up to the year 2000 140 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. cation of veneers in clinical situations of Three techniques and families of ma. mechanical strength. They also permit the con. require increased thickness of material tive in generating high quality ceramic and therefore a less conservative tooth veneers. mode teeth. CLINICAL RESEARCH Introduction The various ceramic materials also differ as far as mechanical properties Ceramic veneers became popular with are concerned. The latter are useful for mask- ceramics.9 found that ing underlining discolorations but also CAD/CAM systems were quite effec.20 cation techniques and materials influ. translucency and texture of natural adaptation.23 that have reviewed the duced by conventional methods. shape and feldspathic ceramics. able feldspathic and leucite-reinforced er-aided design and computer-aided glass-ceramic materials. An ideal ceramic material would of cementation. Laboratory studies10–12 the advent of ceramic etching and sur. and ease of allow control of substrate color (hue. anical properties of zirconia or alumina- servative restorations for anterior teeth.5-7 Two studies8..14-16 leucite-reinforced glass-ceramic mater.3 The different fabri. is the use of comput.

pendently using the following inclusion porting on the survival of ceramic veneers criteria: fabricated by different techniques and „Statement of the method and state- materials. the search was augmented.” as well as the references solved by discussion amongst the and citations from different studies were reviewers and the third reviewer used to identify relevant articles.” The option of “re. The screening the past decade. amongst the reviewers or by consulting amic veneers has been published within the third reviewer (HP). laboratory studies. The full text of all studies of possible Materials and methods relevance was obtained. according to the “Journal of Prosthetic Dentistry. Any disagreement was re- lated articles. At this point. fabrication of the ceramic veneers The search terms that were used alone „Mean follow-up time of at least or in conjunction were “ceramic ve. and materials after a minimum follow-up time publications appearing in English. and neers. The majority of clinical studies The review process consisted of two have investigated various veneer types. PETRIDIS ET AL have demonstrated a survival of ceramic Selection of studies veneers of over 90% after 3 to 5 years follow-up. searching of the references of the se- Search strategy lected studies and hand searching of the selected journals was also imple- A literature search was conducted by mented. into four categor- “Journal of Esthetic Dentistry. (HP).” cess were classified.#&3t46. 5 years. two reviewers (AZ. During the first phase. during the first phase was performed The purpose of this systematic re. The search period spanned ment of the materials used for the from January 1980 up to October 2010. according to the following inclusion cri- view was to compare the survival and teria: prospective and retrospective clin- complication rates of ceramic veneers ical studies reporting on the survival and fabricated by different techniques and complications of ceramic veneers. phases. ly.&3 . utilizing hand searching (time period: 01/1980– The final included studies that passed 10/2010) of the following journals: “In.” and strength of evidence.. the second phase in the review pro- ternational Journal of Prosthodontics. reports.” ies.&t/6. Scopus. abstracts were screened for relevance fluence of the material and technique by the two reviewers together. nique.” “porcelain veneers.” “survival. according to Jökstad et al:24 141 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. screened by the two reviewers inde- Cochrane library) for clinical studies re. titles and without taking into consideration the in. MM) using three The selected full texts were further electronic databases (Medline.” „Utilization of proper clinical tech- and “complications. Any dis- used to fabricate ceramic veneers. No agreement was resolved by discussion review on the clinical behavior of cer. technical articles and reviews were excluded. Case of 5 years. Final.

etc). The „C. the relationship between event rate and 142 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. Pois- that interval was used to measure the son distribution was considered for the total exposure time of the restorations.&t/6. along with sum- to time. Common titles in the same Databases Hits Titles selected or in the other databases Pubmed 207 99 108 Scopus 181 137 44 Cochrane 21 20 1 Total 409 256 153 „A1. Statistical analysis tient randomization (RCT) „A2. spective. In studies where only the min. Event rates/100 prosthesis above was finally calculated in relation years were reported. controlled clinical trial with split.#&3t46. controlled clinical trial with pa. Data of the final studies was tabulated The mean follow-up was directly extract- for the following complications associ. The exposure time (denominator) was calculated by multiplying the mean fol- Data extraction low-up time by the number of ceramic veneers available for statistical analysis. available for the analysis were defined debonding. ed from the articles. The inci. based on a random effects model. Complication rates for ceramic veneers mouth randomization (split-mouth were calculated by dividing the total RCT) number of events (complications) in the „# QSPTQFDUJWFDPOUSPMMFEUSJBMXJUIPVU numerator. clinical studies with different de. as all the prostheses from which informa- marginal integrity.&3 . mary estimates size and 95% intervals imum follow-up time was mentioned. In number of events per variable under cases of multiple publications following examination. relative to the issues dence of each complication mentioned considered. extracted directly from the publication. total number of events (numerator) was TJHOTUIBODBUFHPSJFT"BOE# SFUSP. the study tions (with the corresponding 95% con- with the longest follow-up was taken into fidence interval) were calculated via account.. tion was available. CLINICAL RESEARCH Table 1 Results of electronic search. by the total veneer exposure randomization (CCT) time in years in the denominator. and caries. Five-year survival propor- the same cohort of patients. marginal discoloration. Ceramic veneers ated with ceramic veneers: fracture. case series.

. töSTUFMFDUSPOJDTFBSDIUJUMFT UJUMFTXFSF The 95% confidence interval was calcu. DPNNPOJO EBUBCBTF lated with the aid of Poisson regression analysis with a logarithmic link function. tUJUMFTTFMFDUFE BCTUSBDUTPCUBJOFE IBOETFBSDIJOH tBHSFFEPOBCTUSBDUT GVMMUFYUPCUBJOFE Comparison between subgroups of dif. PETRIDIS ET AL the survival function S(t) = exp(-t*event rate). assuming a constant event rate.

24 ing a mean follow-up time of less than and most were implemented in a private five years (Table 2). cluded studies are depicted in Table 3.63 were report the number of patients. 55 full texts were screened for Only one study56 included both felds- the inclusion/exclusion criteria of first pathic and glass-ceramic veneers. from which 29 full texts were obtained. but phase. Eleven studies53-63 clinical setting. of complications between ceramic ven. the category C.61 on glass-ceramic 143 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. The de- finally selected for analysis. ing to the strength of the evidence. and only two as A1 accord- most frequent reason for exclusion be. tGVMMUFYUTUVEJFTNFFUJOHDSJUFSJBPGöSTUQIBTF TUVEJFTFYDMVEFE TJPO #JPTUBU &OHMFXPPE/+ 64"  JOTFDPOEQIBTF töOBMOVNCFSPGTUVEJFTJODMVEFE tTUVEJFTPGTBNFDPIPSUT9 final studies Results Fig 1 Flow diagram of study selection. The publica.SFGFSFODFT TUVEJFT ferent materials. did not make a direct comparison be- viewed during the second review phase. as well as statistical sig- nificance was calculated using a mixed tUPUBMGVMMUFYU TDSFFOFEGPSöSTUQIBTF TUVEJFT effects model.&3 .&t/6. and Figure 1 shows the process of identifying the studies finally included from an initial yield of 409 titles. tween the materials. eers fabricated from different materials.59. four studies53. lished in the past 10 years. Four of the included studies54. The studies included a met the criteria of the second review total of 215 patients with an age range QIBTF#ZFYDMVTJPOPGTUVEJFTPGTBNF of 15 to 73 years. nine studies53-57. No reported on the survival of ceramic ve- study directly compared the incidence neers made out of feldspathic ceramics.60 were pub.#&3t46. Twen- ty-six studies were retrieved from jour- nal hand searching and references and. Statistical analysis was FYDMVEFEEVSJOH UIFöSTUQIBTF performed using appropriate software (Comprehensive Meta-analysis Ver. Initial screening of titles led to 153 titles.59-61.. therefore. Table 1 depicts the results from the ini- tial electronic search of the three data- bases.55.60. One study54 did not cohorts.57. mographics and study design of the in- Seven studies53-57. Twenty-eight studies25-52 were excluded Most of the studies were classified as during the second review phase.59. Thirty-nine studies25-63 were re.63 tion dates ranged from 1995 to 2009.

Strassler & Nathanson198927. The results of one study54 did leucite-reinforced (IPS Empress I. three with veneers. No stud. clinical information of the ceramic ve- neers fabricated from both materials. Meijering follow-up time not stated et al 199836. Nordbø et al 199434 .25 years up to a maximum period complication rates. Pippin et al 199546. Karlsson et al 199232. 5 years). Rucker et al 199029. (3. Murphy et al 200547. Dumfahrt 199938. Ivoclar not differentiate the complication rates Vivadent. and complication rates were estimated. The mean observation time of the included studies.JIO#BSOFT35. Shang & Mu 200251 Flawed clinical/laboratory technique Mean follow up time <5 years Wiedhahn et al 200552 Use 108 veneers as repairs without separating results veneers and one study56 included ve. CLINICAL RESEARCH Table 2 Studies excluded during the second phase and reason for exclusion. Ivoclar Vivadent.#&3t46. All included studies reporting on glass. These studies ranged between 5 and 10 years.7% at 5 years). The mainly included extended ceramic ven- 144 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. Friedman 199844 Reid et al 198845. Magne et al Mean follow up time <5 years or 200037. data from the other studies was pooled Liechtenstein) glass ceramics. compared to the rest of 16 years. neers is presented in Table 4. Smales & Etemadi 200440. A total of 577 glass. The Empress II. Granell-Ruiz et al 201043. Schaan. Jordan et al 198926. Studies Reason for exclusion Jensen & Soltys 198625. Schaan. Calamia 198928.&t/6. Mean follow up time <5 years and #VSLF-VDDBSPUUJ48 -VDDBSPUUJ#VSLF49 no statement of material or method No tooth preparation Shaini et al 199750. Liechtenstein) and separately. followed by marginal integrity sion in the analysis.&3 . These high rates ceramic and 517 feldspathic veneers reflected the effect of mainly two stud- were observed over a minimum period ies.. Christensen & Christensen 199130 #BSOFTFUBM31. All of the studies reported on the sur- ceramic veneers utilized the same com. ies of ceramic veneers fabricated out of The most frequent complication report- high-strength ceramics and CAD/CAM ed was marginal discoloration (9% at systems fulfilled the criteria for inclu.9–7. vival and complication rates of ceramic mercially available material.63 which presented with higher of 0. so those results were not one with lithium disilicate-reinforced (IPS included in the statistical analysis. Cötert et al 200942.55. Dumfahrt & Schäffer 200039. Dunne & Millar 199333. Chen et al 200541.

PETRIDIS ET AL University University University eers. There- 145 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. Systematic reviews are often useful NR 30 46 22 61 17 21 in the evaluation of various materials 9 9 Study design and demographics of included studies. fractured or anatomically malformed an- out % Drop terior teeth. with strict inclusion and exclusion cri- Year 2009 2007 2008 2005 2004 2002 2000 1998 1995 teria. no study has com- NR 0 pared the complication rates between different materials.&3 .#&3t46. glass-ceramic). 17m) 61 (38f.64 The gold standard for systematic reviews is to include randomized con- Aykor and Ozel53 Guess and Stap- trolled clinical trials.3f 36. They differ from other NR: Not reported. There was no statistically significant difference in the event rates 38. 25 (12f. 12m) more comprehensive. Although various materials NR 64 12 25 0 0 0 0 0 with different inherent properties have been proposed2 for the fabrication of Drop 16/25 3//25 3//12 0/30 0/46 0/61 0/17 out ceramic veneers. 23m) of patients 21 (9f.63 Dimitra59 Walton54 Table 3 Study were prospective uncontrolled clinical pert55 trials. and interventions. f: Female.7 between the subgroups of different ma- 43f 45 m 45. they represent a comprehen- sive summary of the available evidence. and to provide more reliable results upon which to draw con- clusions and make clinical decisions. m: Male types of reviews. the 5 years complication Setting Private Private Private Private Private NR rates were low for the rest of the stud- ies (Table 5). which directly com- Peumans et al57 Fradeani et al56 Sieweke et al60 pare various interventions..65 The major- Layton and Fradeani61 ity of the studies included in this review Aristidis & Walls62.14. Overall.8m Mean age 41 +/. (y) NR NR NR 41 44 Discussion 19–64f 20–45 m 19–65f 20–66m Age range 15–73 28–54 19–69 18–70 24–69 Ceramic veneers are considered the (y) NR NR treatment of choice for the conservative esthetic restoration of discolored.&t/6. in that they adhere to a strict scientific protocol to make them 100 (83f. Rather than reflecting the views of the Category of evidence A1(P RCT) authors or being based on only a (pos- C (R) C (R) C (P) C (P) C (P) C (P) C (P) C (P) sibly biased) selection of the published literature. 17m) Planned no. P: Prospective.24 terials (feldspathic vs. of patients Actual no. 13m) 46 (29f. to eliminate the 30 25 17 12 likelihood of bias. No study existed that directly com- pared different veneer materials. worn. R: Retrospective.

1 6–7 6 Stappert 200855 Heat pressed 182 = 39 veneers: Feldspathic refractory Fradeani et al Feldspathic.&t/6.25–7.4 5 technique NR: Not reported. Study Material/ Planned no.7 200060 Heat pressed Fradeani IPS-Empress/ 83 only 36 with follow up 36 0/36 0 5–6 5 199861 Heat pressed period 5 years Feldspathic porcelain/ Walls 199562.69 200556 143 veneers: Heat pressed THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY IPS-Empress CLINICAL RESEARCH Feldspathic porcelain/ Peumans et al refractory die 87 81 9//87 10 NA 10 200457 technique Aristidis & Feldspathic porcelain 186 186 0/186 0 NA 5 Dimitra 200259 Sieweke et al IPS-Empress/ 36 36 0/36 0 0.2–5.#&3t46. Actual no. Drop Drop Follow-up Mean follow- technique of veneers of veneers out out % range (y) up (y) Aykor & Ozel IPS-Empress II/ 300 300 0/300 0 NA 5 200953 Heat pressed Feldspathic porcelain/ Layton & Walton 304 veneers in study.IPS-Empress/ 182 0/182 0 NR–12 5. refractory die 168 12/180 6.3 4..7 6–16 6 200754 180 for at least 6 years technique 70-6.&3 Guess & IPS-Empress/ 66 23 43/66 65. NA: Not applicable . die .9 6. 146 Table 4 Information of ceramic veneers in included studies.63 refractory die 54 43 11//54 20.

53. levels. It was Veneer fracture rates were not signifi- interesting to note that only one spe. compared to more conservative The exclusion of papers in languages veneer preparations. duces crack propagation initiated at the The follow-up time chosen was set at internal surface of ceramic veneers and a minimum of 5 years.66 the lack of clinical documentation the same pre-cementation treatment. even cific glass-ceramic material brand was in studies55.67 a fact that non-English papers are selected. the is probably absent in extended veneer contents must be translated based on preparations. complication rates of feldspathic and The results of this systematic review glass-ceramic veneers.#&3t46..23. with the risk of interpreta. compared to feldspathic ceramics. tween feldspathic and a high-strength ous review. cantly higher for both materials. by locating the preparation margins of es of these journals.63 which included extended included in the final group of studies.&t/6. This cementation protocol re- follow-up time was less than 5 years.&3 . and it is difficult to define ginal microleakage can be minimized the features of the peer-review process. 147 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6. which included ceramic surface etch- ical study52 of veneers fabricated out of ing and silanating along with the bond- a high-strength ceramic via CAD/CAM ing procedure to the underlying tooth technique was identified but the mean structure. On the where a frequency of approximately 9% other hand. it is difficult to gain access at 5 years was estimated when pooling to non-English-language journals from the results of all included studies. difference was detected between the tion issues. in the loss of some information. A recent clin- were generally low after 5 years of clin. is an issue of concern. ceramic veneers were fabricated on the ies included showed that the various anterior part of the dentition where oc- complication rates for ceramic veneers clusal forces are reduced. which could be acts as a similar strengthening mecha- considered adequate for at least short. One possible ex- Although other commercial brands may planation for the lack of difference be- possess similar chemistry and proper. Similarly low complication failed to show differences in survival be- rates have been reported in a previ. when the veneer in enamel. Mar- over the world. appeared to have higher complication tion rates of different veneer materials. This was more evi- other than English may have resulted dent concerning marginal microleakage.16 Only one clin. PETRIDIS ET AL fore the results of this study present an showed that extended ceramic veneers indirect comparison between complica. son could be the fact that the majority of The statistical analysis of the stud. especially regarding veneer materials documented for a period of fractures because glass-ceramics pos- clinical function that exceeds 5 years sess improved mechanical properties were feldspathic ceramics and a heat. ical study15 of all-ceramic crowns also ical service. tween materials could be attributed to ties. No statistically significant their abstracts. This is an import- showed that the only ceramic veneer ant finding. nism for both materials. Moreover.12 pressed glass-ceramic material. veneer preparations.68 Another rea- term results.23 The rate of complications ceramic material.

Study Material Number Mean Total Number Estimated Number of of follow.8) 1 (0–3.69 1036 5 2. NA: Not applicable. exposure of fracture rate (per 100 debonding veneers up (y) time events prostheses events years) Aykor and Ozel IPS-Empress 300 5 1500 NR NR 0 200953 II Guess and IPS-Empress 23 6 138 3 2.4 0 200457 porcelain Aristidis & Feldspathic 186 5 930 3 0.#&3t46.2 1 Stappert 200855 Fradeani et al IPS-Empress 182 5.95 P = 0.5–6.2 NA 200556 porcelain Peumans et al Feldspathic 81 10 810 11 1.3 0 Dimitra 200259 porcelain Feldspathic Walls 199562. CLINICAL RESEARCH Table 5 Ceramic veneers complication data.3) 0.6 NA 199861 TOTAL 577 Summary estimate (95% CI) 0.7 (0.4 (0.2) 0.7 NA 200556 Sieweke et al IPS-Empress 36 6.2–1.4) Fradeani et al Feldspathic 39 5.7 (0.53 effects model NR: Not reported.7 241 4 1. CI: Confidence interval 148 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6..7 2 200060 Fradeani IPS-Empress 36 5 180 1 0.4 (1–5.7) Cumulative 5y rates % (95% CI) 3.2) Cumulative 5y rates % (95% CI) 3.&3 .1–1.06 (0–0.2 (0–0.&t/6.63 43 5 215 6 2.3) 0.69 222 0 0.8 0 porcelain TOTAL 349 Summary estimate (95% CI) 0.3 (0–1) Material comparison glass vs. feldspathic ceramic based on mixed P = 0.

.0 8 1.16–3.06 15 1.9) P = 0.04 (0–0.3) 3.63 P = 0.9 (0–8. events prostheses years) tion events years) events ses years) years) 0.3) 7.6 (0–4.&3 .2 NA NA NA NA NA NA NA 2.5) NA NA NA NR NR NR NR 0.03 0.5 0 0.8 (0–1.3 (0–0.03 5 0.8) 1.0 0.8) 9 (0–17.0 (0.6) 1.9) 0.8 16 2.9 (0–3.05 2 0. PETRIDIS ET AL Estimated Number of Estimated Number of Estimated Number Estimated rate (per 100 marginal rate (per 100 marginal rate (per of caries rate (per 100 prostheses discolora.8 NR NR NR NR 0 0. prostheses integrity 100 prosthe.26 149 THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY 70-6.2 1 0.#&3t46.6 1 0.59 P = 0.05 0.3 NA NA NA NR NR NR NR 0.2 (0–0.7 12 8.8–17.7) 0.3 5 0.5 (0.7 (0–20.8) 0.&t/6.1 0 0.5 (0–3.7 5 3.2 12 5.3 0 0.1) 9.2 1.8) 0.6 0 0.

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