LUMINEERS BY CERINATE (4 yr)

Description

LUMINEERS® BY CERINATE® are leucite-reinforced, pressed ceramic veneers. Minimal to no tooth reduction is needed to accommodate these restorations of as little as 0.2 mm of thickness. When traditional tooth preparation is utilized, the same Cerinate ceramic is used. Resin cement such as Ultra-Bond Plus with Tenure MPB (Multi-Purpose Bonding System) is recommended for cementation of LUMINEERS. This product received a 96% clinical rating.

Clinical Evaluation Protocol

• Two hundred sixty-nine restorations were placed in 61 patients. These included 39 anterior crowns, 228 veneers and one onlay (Figure 1).
• Fifty-four of the 228 veneers were placed on teeth prepared using the minimal reduction technique. Twelve veneers were placed on unprepared teeth. One veneer was placed on an existing ceramic-metal crown where the facial ceramic had fractured (Figure 2).
• Restorations ranged in age from one to four years (Figure 3).
• Restorations were fabricated by Nellmar Laboratory, Ann Arbor, MI.
• LUMINEERS were bonded with Ultra-Bond Plus with Tenure MPB.
• Restorations were evaluated on a 1-5 scale:
  1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent .

Clinical Observations

Resistance to Fracture
During the four-year clinical evaluation of LUMINEERS, five patients experienced chips or fractures of their restorations, including six anterior veneers and one premolar of traditional thickness (Figure 4). Six restorations were replaced and one was polished. All fractures occurred during the first year of placement. Three anterior veneers of minimal preparation and one veneer of traditional preparation debonded and were recemented.

Esthetics
LUMINEERS continue to provide excellent esthetics and vitality after four years in service. The life-like appearance and gloss have been maintained from the time of insertion. Of the 269 restorations placed, nine restorations on two patients exhibited surface stain which was readily removed with a ceramic polishing system (Figure 4). The stain has not returned.

Resistance to Marginal Discoloration
No microleakage was reported in 99% of LUMINEERS (Figure 4). During the first year in service, two anterior veneers experienced black marginal staining and were replaced. No additional microleakage has occurred.

Wear Resistance
No visible wear was noted on any of the LUMINEERS BY CERINATE (Figure 4). No wear of opposing dentition was attributed to the ceramic.

Conclusions

After four years in service, LUMINEERS have maintained surface texture, gloss, and life-like appearance noted at placement. Proper case selection is critical when determining the best preparation design. Minimal preparation is best suited for undersized teeth or those with spaces, thus allowing proper thickness of the ceramic and preventing a bulky appearance. Traditional preparation is required with teeth that are crowded, malposed or darkly stained. Using both the minimal preparation and traditional preparation techniques, LUMINEERS has demonstrated excellent esthetics.