Retention & Fracture of Emax Laminate Veneers Clinical Trial
Official title:
One Year Clinical Evaluation of E.Max Laminate Veneers With and Without Using Grape Seed Extract as a Natural Collagen Cross-linking Agent Before Bonding
The aim of this study is to evaluate the clinical performance of E-max veneers cemented with and without using grape seed extract before bonding.
Justification for undertaking the trial:
Ceramic veneers have become a popular dental procedure since its introduction because they
provide excellent esthetics.1 Achieving the good esthetic results especially with ceramic
veneers is probably the most challenging task encountered by dental practitioners and
ceramist today. Ceramic veneers are indicated for teeth with moderate discoloration,
restoration of traumatized, fractured, worn dentition and abnormal tooth anatomy.2 Many
factors affect the long term success of ceramic laminate veneers. The most repeated failure
patterns associated with ceramic laminate veneer were fractures, microleakage, colour change
and detachment of restoration.3 The main reasons for failure were large marginal defect and
fractures.4 The clinical performance of ceramic veneer has shown that the estimated survival
rate for the teeth prepared with butt joint design are higher than for the teeth prepared
with palatal chamfer design.5 The bonding technique, which is a time-consuming and technique
sensitive procedure, is a key to the long-term success of these types of restorations. The
strength and the durability of the bond between the porcelain, the luting cement and the
enamel/dentin interface play an important role in the outcome of ceramic veneers,
particularly when dentin is involved. 6
Expected benefits for the patient
1. Achieving a more predictable esthetic restoration while being conservative. 2. Increasing
the long term prognosis of the restoration. Expected benefits for the clinician
1. Enriching the professional skills of the dentist with a new material to improve the
clinical performance of the restoration.
2. Improving the confidence in the patient-dentist relationship.
Explanation for Choice of Comparators Resin cements are generally used for the bonding of
all ceramic restorations since they provide adequate aesthetics, low solubility in oral
environment, high bond strength to tooth structures, superior mechanical properties and
support for ceramic.7 Since their retention relies solely on adhesion, durable adhesion of
resin luting cements to both the enamel/dentin and the cementation surface of the ceramic is
crucial. Luting cements used in conjunction with phosphoric acid etching followed by
adhesive application on enamel show reliable adhesion.8 By studying the effect of
incorporation of natural cross-linkers into the primer of a self-etching adhesive on
resin-dentine bond strength, it had a positive influence on the immediate μTBS (micro
tensile bond strength) and mechanical properties of the bonded interface.9
Statement of problem:
Ceramic veneers have become a popular dental procedure since its introduction because they
provide excellent esthetics while being conservative. However, high failure rates of PLVs
have been attributed to the exposure of dentin surface during preparation which greatly
decrease the bonding strength at the dentin-cement interface. Natural and synthetic
cross-linking agents have been introduced to restore dentin function, enhance bonding
strength as well as positively affect the remineralization process in artificial roots. They
have the ability to enhance the mechanical properties and stability of dentin matrix by the
use of PA-rich collagen cross-linkers most likely due to the formation of a PA-collagen
complex.10
Research hypothesis The null hypothesis of the study that there won't be a difference in the
clinical performance & adhesion of laminate veneers after application of grape seed extract
before bonding.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment