31 January 2022

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Occlusal splint to protect feldspathic veneers in patient with bruxism

Allegra Comba

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Demand of esthetic outcomes is becoming more and more frequent in dentistry and ceramic laminate veneers represent one of the main choices to functionally and esthetically solve certain cases. Among different possible materials, feldspathic ceramics represent a gold standard in terms of optical and biocompatibility properties, the fabrication of veneers to restore anterior teeth. Feldspatic veneers represent a minimally invasive and conservative treatment option in  case of discoloration, fractures, incisal wear, modifications of dental size and shape, as well as for treatment of dental misalignment. Moreover, this material has the great advantage to be etched and adhesively bonded to the dental substrate. Considering all the advantages of employing feldspatic veneers on patients the group of Vincente Faus-Matoses from the Department of Stomatology, Faculty of Medicine and Dentistry, of the University of Valencia, Spain performed a 8-year prospective clinical investigation on the survival rate of feldspathic ceramic veneers and focused on the influence of the occlusal splint in patients with parafunctional bruxism.

Materials and Methods
To conduct their research, the authors of the manuscript entitled “An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: Influence of occlusal splint in patients with bruxism” selected three hundred and sixty-four veneers fabricated using conventional feldspathic ceramic that were provided in 64 patients. Among the patient sample 40 individuals with bruxism were included. During the follow-up period, the effect of wearing the occlusal splint on the incidence of failure (fracture and/or debonding) in patients with bruxism was also assessed. Vincente Faus-Matoses et al. determined the survival rate of veneers using the Kaplan-Meier estimator and the statistical significance was set at p < 0.05 with a confidence interval of 95%.

Results
The results obtained by the authors that conducted the research included 364 veneers and each selected patient received a number of veneers between 1 and 20. However, Vincente Faus-Matoses et al. evaluated each veneer individually, as a single statistical element. The analysis of the data showed that the occurrence of fracture for the feldspathic veneers tested in this study was 7.7%, while only 1.9% of the total number of veneers debonded. The overall survival rate was 93.7% after 3 years, 91% after 5 years, and 87.1% after 8 years. Patients with bruxism using an occlusal splint showed a survival rate of 89.1% after 7 years, while the survival rate in patients with bruxism using no occlusal splint was 63.9% (p < 0.05).

Conclusion
The authors of the papers concluded that conventional feldspathic porcelain veneers can be considered an acceptable and predictable treatment with long-lasting performances. Moreover, feldspathic porcelain veneers could be considered as a suitable clinical option for the treatment of patients with bruxism, especially if associated with regular use of an occlusal splint to protect the veneers.

For additional information:  A 8-year prospective clinical investigation on the survival rate of feldspathic veneers: Influence of occlusal splint in patients with bruxism.