Journal of Oral Rehabililation 1997 24; 553-559
Clinical performance of porcelain laminate veneers.
A retrospective evaluation over a period of 6*5 years
F.J. S H A I N I , A . C . C . S H O R T A L L & P . M . U k'RQXJ
Birmingham, Birmingham. U.K.
SUMMARY Three-hundred and seventy-two porcelain
laminate veneers were fitted to defective and
discoloured teeth in 102 patients. Ninety per cent of
the restorations were fitted to unprepared teeth.
Restorations were reviewed up to 78 months after
cementation. Survival probabilities were calculated
Introduction
The treatment of defective and discoloured anterior
dentitions has always created a challenge for the
restorative dentist. Originally crowns were the only
possible restorative option available. Although a well
designed crown may provide excellent aesthetic results,
it is highly destructive in terms of the amount of sound
tooth structure that has to be removed to provide
adequate thickness for the durability and retention of
the restoration (Karlsson etal, 1992; Nordbo, Rygh-
Thoresen 8-Henaug, 1994).
The introduction of indirect resin laminate veneers
(Faunce & Faunce, 1975) provided a more conservative
approach to the problem. These restorations did not
require extensive tooth preparation. However, they
were not capable of providing lasting aesthetic results.
The lack of natural translucency frequently led to a dull
and lifeless appearance. In addition, these materials
exhibited low abrasion resistance making them more
prone to wear, surface staining and plaque accumulation
(Liu, Isenberg fr Leinfelder, ,1993).
The introduction of porcelain laminate veneers (PLVs)
combined the conservative requiretnent with stable
aesthetic qualities, biocompatibility and abrasion
© 1997 Blackwell Sd
IS School of Dentistry. The University of
using the Kaplan-Meier method. Results showed
higher rates of failure and problem development in
veneers fitted over existing restorations and in those
fitted by inexperienced operators. A considerable
number of veneers suffered minor problems that
were successfully repaired.
resistance. Porcelain laminates can mimic the
translucency of natural tooth structure and can provide
colour and contour stability with minimal risk of
gingival irritation, provided that proper oral hygiene
and plaque comrol are maintained (Reid, Kinane &
Adonogianaki, 1991; Coyne &• Wilson, 1994).
The use of porcelain veneers goes back to the late
1930s. They were used in Hollywood to temporarily
improve the appearance of actors' teeth during film
making. In April 1937, Dr Charles Pincus presented a
paper to the Californian State Dental Association on
this subject. He stated that these veneers were 'placed
with a denture-adhesive powder and then removed after
each film day'. At that time there was no mechanism
available to retain them permanently (Calamia, 1989).
The concept of porcelain etching was introduced by
Horn (1983). The idea was to treat the porcelain surface
with acid to create microporosites similar to the pattern
seen in etched enamel. Hydro-fluoric acid (HF) was
used in industry to etch glass, so it was expected to be
able to etch porcelain as well. It was considered that
the bond strength obtained between the etched
porcelain and the resin was sufficient to retain porcelain
restorations including porcelain veneers (Simonson &
Calamia, 1983). In Birmingham Dental Hospital (BDH),
554 F.J. SHAINI etal.

Table 1. Number and (%) of failure and problem development Table 2. Probability of survival (PS) of porcelain laminate veneers
seen in porcelain laminate veneers fitted to prepared and
unprepared teeth
PS (%) 9 5 % Cf PS (%) 9 5 % CI
(month) (A) (A) (B) (B)
PLV fitted Failure Repairable problem
12 88 84-92 85 81-89
No. No. (%) No. (%)
24 76 70-82 71 64-77
36 68 61-76 61 53-70
Tooth prep. 51 37-2 4 7-8
48 62 52-71 51 39-62
No tooth prep. 321 32-1 31 97
60 58 47-69 40 26-54
72 48 36-61 26 10^2
78 47 34-61 25 5-45
the use of PLVs started in late 1984. The aim of this
study was to evaluate the clinical performance of the PLV PS, prohahility of survival: Cl. confidence interval; A, the PS
restorations fitted in BDH over a period of 78 months. without failure; B. the PS without developing any problem.

Method gingivally or level with the free gingival margin. The

The current retrospective study was performed on
patients treated with PLVs in BDH between November
1984 and February 1992. All information was obtained
through patients' dental and laboratory records. All the
patients lor whom PLVs had been made and about
whom it was possible to obtain sufficient records were
included in this study.
Patients with extensive loss of tooth structure, a
severe degree of tooth discolouration, poor oral hygiene
and periodontal problems were excluded from the
treatment. Patients with parafunctional habits were
provided with occlusal guards following treatment and
patients having gingivitis were provided with the
treatment only if they showed considerable improve-
ment in their gingival condition following oral hygiene
motivation.
In 90% of the veneered teeth, no form of tooth
preparation was undertaken. In the remainder, tooth
preparation was of a minimal labial and occasionally
proximal enamel reduction (Table 1). There was rarely
a need to use any form of temporary cover between
visits. Shade selection was performed using a standard
Vita porcelain shade guide (Plant & Thomas, 1987).
Impressions were made using elastomeric impression
materials in a stock tray. There was no need to retract
the gingival tissues during impression making. In fact,
gingival retraction was contra-indicated because the
free gingival margin was used as an important land
mark to locate the proper extension of the PLV margins.
All the restorations were constructed on a platinum
foil using Vitadur N porcelain* and were finished supra-
•Vita Zahn fabrik. Bad sackingen. Germany.
bonding surfaces of PLV were grit-blasted with 50 ]xm
aluminium oxide. Following grit-blasting, rinsing and
drying, silane coupling agent+ was applied to the surface
according to the manufacturers instructions and then
covered with a thin layer of bonding agent*. The
bonding agent was cured in the laboratory for 1 min
using a PLC 2000 tight curing unit§.
Try-in and cementation
Before try-in a thorough prophylaxis was conducted
using pumice mixed with water and applied to the
tooth surface hy way of a rubber cup. Isolation was
accomplished using cotton wool rolls and saliva ejector.
The restorations were tried-in to check their fit and
colour matching. Any salivary contamination of the
PLV bonding surface was cleaned with 37% phosphoric
acid and thoroughly washed and dried before
cementation. Whenever possihie, adjustments were
made after cementation to avoid the risk of cracking or
fracturing the brittle restorations. If the restorations
were found to be adequate in terms of colour, fit
and contour, they were cemented with light cured
microlilled composite resin''.
Finishing and polishing procedures were performed
immediately after the cementation of the veneers.
Patients were normally seen 1 week after the placement
of the restorations to review the oral hygiene and the
gingival response and to check for marginal excess.
•••Fusion; George Taub Produas & fusion Co. Inc.. 277 New York
Avenue, Jersey City NJ 07307, U.S.A.
*Heliobond: Vivadent. Schaan. Liechtenstein.
^Schulz-Dental/GmbH. Homburger StraRe 64/Gennany.
'Heliosit: Vivadent. Schaan. Liechtenstein.

© 1997 Blackwell Science Ltd. Journal of Oral Rehabilitation 24; 553-559

 CLINICAL PERFORMANCE OF PORCELAIN LAMINATE VENEERS 555

Survival time (months)

100

- A: Pr(surv.> t) =1t - B: Pt<suiv.>t) =1t

CO 0-10

Fig. L Survival probabilities ot porcelain laminate veneers. A. witbout tailtire, B, witbout developing any problem.

Table 3. Distribution of tbe fitted, failed restorations and restorations presenting with a repairable problem according to the age and
sex of tbe patients

Age PLV PLV Failed Failed Repairable problem Repairable problem

(years) fitted (F) fitted (M) (F| (M) (F) (M)

14-24 160 69 56 15 19 0
25-34 35 10 11 3 1 1
35-44 21 7 3 3 2 1
45-54 21 0 7 0 2 0
55-64 19 19 8 12 5 1
>64 8 3 3 1 3 0
Total 264 108 88 34 32 3

Any necessary adjustments or additional finishing and
polishing were performed as required.
Criteria for clinical evaluation
The veneers were reviewed and evaluated by one of
tbe staff members at variable intervals, either during
routine recall visits or wben presenting with a problem.
At each review tbe restorations were classified
either as:
1. Clinically satisfactory.
2. Presenting with a repairable problem.
3. Failed:
a) Fractured restoration(s).
b) Debonded restoration(s).
c) Other.
Tbe restorations that were classified as clinically
satisfactory were the ones that were physically intact
and aesthetically acceptable with no adverse gingival
reaction. Repairable problems were mostly in tbe form
of chipping or minor fracture and tbese were repaired
by smoothing and polishing of the chipped edge or by
restoring witb composite resin without major effect on
the aesthetic quality of tbe restoration. Restorations
classified as failures were those that presented with
problems that were not liable to repair and required
remaking or changing to an alternative treatment. This
group included fractured restorations and debonded
restorations tbat were either fractured and had to be
replaced, or intact, which were re-cemented. It also
included discoloured restorations and restorations not
acceptable to the patient due to their appearance or bulk.
All tbe restorations tbat were remade due to failure
during tbe study were treated as new ones. All tbe
restorations presenting with a repairable problem were
repaired and remained in the study, and all the sound
debonded restorations were re-cemented and were
followed up as a separate group.
Survival analysis
In this study the survival time was defined as the
period of time starting from the successful fitting of the
restoration and ending wben the restoration presented
witb an irreparable problem.
Tiie Kaplan-Meier 'product limit' estimation method

© 1997 BlackweH Science Ltd, Journal of Oral Rehabilitation 24; 553-559

556 F . J . SHAINI
Table 4. Porcelain laminaie veneers fitted by students and staff
members, number and (%) of failed restorations, and restorations
presenting with a repairable problem
PLV fitted Failti Repairable problem
No. (%) No. (%)
Si[udenis 235 91 38-7 26 I M
Silafl 1 37 31 22-6 9 6.6
was utilized for the calculation of the survival
probabilities in this study (Table 2). This non-parametric
statistical technique takes account of censored
observations resulting from incomplete lollow-up
(Bulman & Osborn, 1989).
The analysis of survival probability was performed
over a period of 78 months after which it was decided
to stop because the number of restorations remaining
in the study dropped to 42; namely 11'3% of the
original number. The decision to stop at this level was
made to avoid any possible inaccuracy in the prediction
of survival probabilities due to the small number
remaining. After 78 months 208 restorations (55-9%)
were classified as censored and the remaining 122
(32-8%) presented with irreparable problems. Survival
curves were produced to estimate the probability of
survival without failure and the probability of survival
without developing any problems (Fig. 1).
Results
During the period covered by the investigation, 383
PLVs were constructed of which 372 were fitted. Eleven
PLVs fractured during try-in; these restorations were
not included in the statistical analysis because it was
decided to consider the successful cementation of each
restoration as the starting point (titne 0) of the survival
analysis. PLVs were fitted for 104 patients. 70 female
(67-3%) and 34 male (32-7%), with an average number
of 3-6 PLVs per patient, range 1-12. The numbers of
PLVs fitted for the different age groups for both sexes
are detailed in (Table 3). The mean age at the time of
cementation was 34 4 years for female patients and
29-6 years for male patients with a range of 14-71 years
{for both sexes). Two hundred and thirty-five (63-2%)
of the PLVs were fitted by students and 137 (36 8%)
by staff members (Table 4).
The greatest percentage of the PLVs incorporated in
this study (61-6%) were fitted to individuals in the 14-
© 1997 Blackwell Science Ltd. Journal of Oral Rehabilitaticn 24; 55J-559
24 year age group. As expeaed, most of the PLVs were
fitted on maxillary anterior teeth (87-4%) and only
relatively few on mandibular anterior (8-6%), maxillary
posterior (3-5%) and deciduous teeth (0-5%) (Table 5).
The PLV restorations were considered mainly to mask
tooth discolourations and to cover existing restorations.
53-7% were fitted to mask existing tooth discolouration,
a high proportion of which was due to tetracycline
staining especially in young individuals. PLV restorations
were infrequently used for a number of otber
applications including closure of inter-proximal spaces,
median diastemas and as a method of re-contouring
malformed teeth such as the case of peg-shaped lateral
incisors. The number of PLVs used for closure of spaces
between teeth was surprisingly low (4 PLV) and formed
only about 1% of the total number. The original
condition of the restored teeth that indicated the use
of PLVs are detailed in (Table 6).
The original condition of 85'5% of the teeth restored
with PLV was identified before veneering. In 14'5% of
the restorations it was not possible to identify the tooth
condition prior to veneering (reason of veneering) as
the records did not contain the relevant data.
The incidence of failure and the incidence of
occurrence of any sort of problem including failure
were analysed according to the sex and age of the
patients at the time of cementation, the location of the
restoration in the oral cavity, the tooth condition before
treatment and the operator's clinical experience. Chi-
squared tests were used to detect any significant
diflerences in the incidence of failure and problem
occurrence among the various groups (Table 7).
Discussion
when the technique of porcelain veneering was first
introduced in the Birmingham Dental Hospital in 1984
it was still in the experimental stage. Therefore, it was
considered preferable not to undertake any sort of tooth
preparation to maintain the conservative quality and
ihe reversible nature of the procedure. It is believed
that this lack of tooth preparation might be one of the
major factors contributing to the high failure rates
noticed in this study. Stress concentration is less intense
within the restoration fitted to prepared teeth (Highton,
Caputo & Matyas, 1987). Tooth preparation creates
some space for the composite resin cement to mask the
underlying discolouration and it facilitates the
positioning of the restoration during cementation
 CLINICAL PERFORMANCE OF PORCELAIN LAMINATE VENEERS 557

Table 5. Distribution of the number and (%) of fitted porcelain laminate veneers and those presenting with irreparable and repairable
problems according to the tooth position

PLV fitted Failed Repairable Problem

No. (%) No. No. (%)

Max. centra! incisor 181 48-7 78 43-1 20 no

Max. lateral incisor 86 231 21 24 4 8 93
Max. Canine 58 1.56 11 19-0 1 1'7
Max. premolar 11 30 4 36-4 0 0
Max. molar 2 0-5 1 50 1 50
Man. centra] incisor U 3-2 4 53-3 0 0
Man. lateral incisor 10 2-7 2 20 1 10
Man. canine 10 2-7 0 0 3 30
Deciduous 2 0-5 1 50 0 0

Table 6. The distribution of the fitted, faiied and porcelain laminate veneers presenting with repairable problem (number and %)
according to the tooth condition before veneering

Reason for veneering PLV fitltd Failures Repairable problem

1. Discolouration
a. Tetracycline (Te) 119 320 29 24-4
b. Non vital (Nv) 47 12'6
12'6 20 42-5
42-5 5 10-6
c. Non specific (Ns) 34 9 1
9-1 8 23-5
23'5 4 11-8
2. Hypoplasia (Hy) 47 12-6
12 6 9 19-1
19-i 7 14-9
3. To cover existing restorations (Er). 56 1 51
151 30 53-6
53-6 6 10-7
4. Tootb wear (We) , 11 1
1 3 - 300 2 18-2
18-2 1 9-1
5. Spacing 4 II 2 50
6. Others 54 14 5 22 41-5

(GiJmour & Stone, 1993). It was reported that surface
preparation increases the bond strength of composite
resin lo the enamel by removing the aprismatic and
hyper-mineralized enamel layers which can be resistant
to acid etching (Schneider, Messer & Douglass, 1981).
Most of the clinical studies published on PLV
restorations involved some form of tooth preparation
(Calamia, 1989; Jordan, Suzuki 6-Senda, 1989, Rucker
e/fl/., 1990; Karlsson^ffl/., 1992; Dunned Millar, 1993;
Nordbo etai, 1994). Some researchers did not find any
significant difference in the clinical performance of
different veneer preparation designs (Karlsson et al..
1992; Dunne & Millar, 1993).
The acid etch technique is considered to be the
basis for successful bonding of resin to enamel. It can
be said also that bonding of porcelain to tooth enamel
through the composite resin cement is the key for
successful veneering. Bonding of porcelain to enamel
not only provides the necessary retention needed to
keep the restoration in its place, it also allows the
restoration to function as an integral part of the tooth
structure. This intimate contact allows better stress
distribution and prevents local overloading of the
brittle material. Any factor that influences this bond
is likely to be a risk factor that might affect the long
term or even the short term performance of the
restoration. This was clearly demonstrated by the
increased incidence of failure of PLV restorations that
had been cemented to teeth with reduced enamel
bonding area due to the presence of other restorations
compared with PLVs cemented to sound continuous
enamel surfaces. The same effect is expected if the
restoration is bonded to an exposed dentine surface
because of the inferior bond quality of the cementing
resin to the pre-existing restorations and dentine
compared lo enamel (Dunne & Millar, 3 993).

© 1997 BlackweH Science Ltd, Journal of Oral Rehabilitation 24; 553-559

558 F . J . SHAINI «a/.

Tible 7. Results of ihe chi-squared test

Problem developir

I. Sex 0-061 1 > OCi 4.474 1 <0-05

n.Age 8-88J >005 13-537 5 < 0-05
a. Groups under 55 1-202 >0-05 0'872 3 >0-05
b. Groups over 55 0-903 1 > 0-05 0-089 I >0-05
a V. b 6-706 1 <0-01 14-625 1 < 0-001
III. Pre-restoration tooth condition 25-131 t < 0-001 21-764 6 < 0-01
a. Te, Ns, Hy. We 0'667 > 0-05 0322 3 >0-05
b. Nv. Er. 1-242 1 > 005 1-302 I >0-05
a V. b 21-450 1 < 0-001 20-062 1 < 0-001
IV. Position of t h e restoration* 20-443 A < 0-001 26-604 4 < 0-001
Max. Cemral versus Max. lateral 9-201 1 < 0-01 9-750 1 <0-01
Max. Central versus Max. canine 11-397 1 < 0-001 19-789 1 < O'OOl
Max. lateral versus Max. canine 0-596 1 >0-05 2-888 1 > 0-05
AH positions excluding Max. Central Incisor 2-726 > 0-05 2-997 3 > 0-05
V. Students v. Staff 10'173 1 <0-01 15-042 1 < 0-001
VI. Tooth preparation versus no preparation 0-533 1 >0-05 0-203 1 > 0-05

*A11 restorations fitted to mandibular leeth were ( sidered as one group, and all restoration fitted to maxillary premolars and molars
were considered as one group.

Staiistical analysis showed a higher incidence t>f
failure in PLVs fitted lo discoloured non-vital teeth
(Table 7). This finding might be related to the significant
decrease in the amount of supporting tooth structure
as a consequence of extensive loss of this structure
subsequent to endoduiitic treatment. It is believed that
the possible loss of enamel bonding surface area as a
result of the presence of heavy restorations usually
encountered in endodontically treated teeth might be
a major faaor contributing to ihe increase in the rate
of problem development and failure.
The higher incidence of failure in the restorations
fitted to central incisors compared to lateral incisors and
canines is difficult to explain. This difference might be
due to the faa that a large number of restored central
incisors belong to the high risk group, i.e. non-vital
(NV) teeth and teeth with existing restorations (ER)
(71 out of 181). It is possible that the surface tooth
condition is the cause of the difference rather than the
actual tooth position.
It has been shown that the restorations fitted to older
individuals experienced a higher incidence of failure and
problem occurrence compared to younger individuals.
Approximately half of the restored teeth in older
individuals (22 out of 49) were actually from the high
risk group, which may have influenced the rate of failure
rather than the actual age of the patient. However, the
quality of bond between the cementing resin and the
highly mineralized enamel in older individuals, the
possibility of higher stress concentration in the anterior
teeth as a result of posterior tooth loss and occlusal
wear are also points to be considered.
The significantly higher incidence of failure and
problem development in PLVs fitted by students
compared to the ones fitted by staff members emphasizes
the sensitivity of the technique and the importance of
the clinical experience of the operator in both improving
the clinical pertormance and the survival probability of
these restorations. Presumably, this might be considered
as one of the main factors contributing to the higher
failure rate of PLVs found in this work. Dunne & Millar
(1993) reported similar differences in the incidence of
problem development and failures between experienced
and inexperienced operators.
The lack of significant difference between PLVs fitted
to prepared and unprepared teeth is not considered to
be strong evidence against tooth preparation due to the
tact that the number of prepared teeth included in
this study is very small compared to the number of
unprepared teeth and due to the fact that the type of
tooth preparation performed was not consistent with

S> 1997 Blackwell Science Ltd, Journal of Oral RehabiUtation 24; 553-559
 CLINICAL P E R F O R M A N C E OF P O R C E L A I N LAMINATE VENEERS
the currently recommended preparation designs (Hui
elai, 1991).
A laboratory-based study has been nndertaken to
compare tbe shear bond strength of resin-based
composite with both grit-blasted and HF add-etched
porcelain using bonding materials and technique similar
to those employed in the clinical study. The results
showed no statistically significant differences in the
bond strength according to the porcelain surface
preparation (Shaini, 1995).
Conclusions
1. The survival probability of PLVs in this study is
low in comparison to a similar study where tooth
preparation was undertaken.
2. A significantly higher failure rate and problem
development is seen with inexperienced operators
(students compared to staff members).
3. An increase in failure rate and problem development
has been shown when PLV restorations are fitted
over existing restorations.
4. The high incidence of porcelain fractures suggests
that porcelain is the weakest link in this system.
5. A considerable number of PLV problems may be
resolved by repair, a procedure that will significantly
prolong the service life of these restorations.
6. Proper case selection is a key factor in the success of
PLV restorations.
PLV restoration can be considered as one alternative
when dealing with aesthetic treatment of anterior teeth.
Full understanding of the limitations and potential
drawbacks of this technique must always be kept
in mind and explained to the patient prior to the
start of the treatment. The sensitivity of the technique
demands meticuJous attention to the detail before,
during and after treatment. Patient co-operation and
understanding of the importance of home care are
essential for optimum results.
Acknowledgments
The authors would like to thank Mr G Thomas and
the Dental Records Department in Birmingham Dental
Hospital for their assistance.
References
BULMAN. J.S. & OsBORN. J.E (1989) Statistics in Dentistry, pp. 9 1 -
99. British Dental Association, London.
© 1997 Blackwell Science Ltd, Journal of Oral Rehabilitation 24: 553-559
559
CALAMIA. J R . (1989) Clinical evaluation of etched porcelain
veneers. American Journal of Dentistry. 2, 9,
COYNE, B . M . C . A . & WILSON, N . H . P . (1994) A clinical evaluation of
ihe marginal adaptaton of porcelain laminate veneers. European
Journal of Prosihodontics and Restorative Dentistry, 3. 87.
DUNNE, S.M. 6- MILLAR, B J. (1993) A longitudinal study of the
clinical performance of porcelain veneers. British Dental Journal.
175, 317.
FAUNCE, F,R. & FAUNCE, A.R. (1975) The use of laminate veneers
for restoration of fractured discoloured teeth. Tixas Dental
Journal, 9 8 , 6.
GiLMOUR, A.S.M.& STONE, D C . (1993) Porcelain laminate veneers:
a clinical success. Dental Update. 20, 167.
HiGHTON, R., CAPUTO, A . A . & MATYAS, J . (1987) A photoelastic
study of stresses on porcelain laminate preparations. Journal of
Prosthetic Dentistry, 58. 157,
HORN, HR. (1983) Porcelain laminate veneers bonded to etched
enamel. Dental Clinics of North America, 27, 671.
HUI, K . K . K . , WILLIAMS, B., DAV[S, E . H . & HOLT, R . D . (1991) A
comparative assessment of the strengths of porcelain veneers
for incisor teeth dependent on their design characteristics. British
Dental Journal, 171, 51.
JORDAN, R.E., SUZUKI, M . fr SENDA, A, (1989) Four year recall
evaluation of labial porcelain veneer restorations. Journal of
Detttal Research. 68, 249 /Abstract No. 544).
KARLSSON, S,, LANDAHL, I,, STEGERSJO, G, &• MSLLEDING, P. (1992) A
clinical evaluation of ceramic laminate veneers. The International
Journal of Prosthodontics, 5,447.
LIU, F-R., ESENBERG, B P. & LEfNFEi.DER, K.F. (J993) Evaluating CAD-
CAM generated ceramic veneers. Journal of American Dental
Association, 124, 59.
NoRDBO, H,, RYGH-THORESEN, N , & HENAUG, T. (1994) Clinical
performance of porcelain laminate veneers without incisal
overlapping: 3-year results. Journal of Dentistry, 22, 342.
PLANT, C G . & THOMAS, G , D . (1987) Porcelain facings: a simple
clinical and laboratory method. British Dental Journal, 163, 231.
REID. J.S., KINANE, D F. & ADONOGIANAKI, E. (1991) Gingival health
associated with porcelain veneers on maxillary incisors.
International Journal of Paediatric Dentistry, 1, 137.
RucKER, L.M., RjcHTtR, W., MACENTEE, M . & RICHARDSON, A, (1990)
Porcelain and resin veneers clinically evaluated: 2-year results.
Journal of American Dental Association. 121, 594.
SCHNEIDER, P.M-, MESSER, L.B. & DOUGLAS, W , H , (1981) The effea
of ename! surface reduction in vitro on the bonding of composite
resin to permanent human enamel. Journal of Dental Research,
60, 895.
SHAINI, F J . (1995) Clinical performance of porcelain laminate
veneers and the factors affecting Composite/Porcelain bonding.
M.Sc. thesis. University of Birmingham,
StMONSEN, R.J. & CALAMIA, J R . (1983) Tensile bond strength of
etched porcelain. Journal of Dental Research. 7, 297 (Abstract
No. 1154).
Correspondence: Dr F.J. Shaini, The School of Dentistry, St. Chad's,
Queensway, Birmingham B4 6NN, D,K.