Porcelain Veneers: Dentin Bonding Optimization and Biomimetic Recovery of the Crown

Purpose: The purpose of this study was to investigate the biomimetic principle in porcelain veneer reconstruction, or in other words, to assess the extent to which the restoration can mimic the biomechanics and structural integrity of the original tooth. Using an optimized luting procedure, porcelain veneers are expected to present such features even when bonded to an extensive dentin surface. Methods and Materials: Dentin-bonded porcelain veneers were assessed using functional and cyclic thermal loads with respect to two parameters: coronal stiffness (investigated using experimental strain gauges and finite element analysis) and morphology of the tooth-restoration interface (scanning electron microscope evaluation). Two different application modes of the same dentin-bonding agent, Optimbond FL, were valuated: a traditional method (dentin adhesive applied when proceeding to luting the veneer) and an alternative method (dentin adhesive applied to dentin and cured before taking the impression for the veneer). Results: In the finite element model, the crown compliance increased by a factor of 2.16 after facial enamel removal and returned to 96% of its original value after the placement of the veneer. The finite element values showed a good correlation with strain gauge experimental results (one-sample t test, P > 0.35 after facial enamel removal and P > 0.19 after veneer placement). The dentin adhesive application mode was not critical to the recovery of tooth stiffness (analysis of variance, P = 0.10). However, qualitative scanning electron microscope observations demonstrated that the traditional dentin adhesive application was associated with bonding failures between the hybrid layer and the overlying resin, whereas unbroken and continuous interfaces were obtained with the new mthod using the same dentin adhesive. Conclusion: The results of this study definitely favor the biomimetic behavior of porcelain veneers bonded to teeth using an optimized application mode of dentin adhesives, because this treatment modality proved to restore both the mechanical behavior and microstructure of the intact tooth.