Any treatment performed should stand the test of time. When dealing with the esthetic restoration of teeth, what you see during the time of insertion is expected to remain stable for years going forward. There has been much speculation regarding the gingival stability surrounding porcelain laminate veneers (PLV).
Although short-term studies have shown favorable stability of gingival tissue around PLV restorations, there have not been any long-term studies available. Fortunately Arif et al., have recently published a 14 years retrospective study following the changes if any, of the surrounding gingiva, following restoration of teeth with PLV.
The Study
This study followed 24 patients, combining for 109 veneers placed. The veneers assessed were on canine, lateral and central incisor teeth, the majority of which were on the maxillary arch.
The average periodontal pocket depth on the facial of maxillary PLVs was 2.17mm and 2.16mm on the mandible. On the lingual surface, 2.10 mm on the maxilla, and 2.22 mm for the mandible. The study showed no significant difference in the pocket depth between the restored facial surface of teeth and the unrestored lingual surfaces.
From 109 veneers placed, 43% had normal gingiva with no bleeding, 15% had mild inflammation and 42% had moderate inflammation with BOP.
Out of the 109 veneers placed, 27% showed gingival recession on the facial surfaces. Maxillary lateral incisors and canines were the teeth most affected by recession. However, it was noted that the same degree of recession may be observed on both restored and unrestored teeth, and that the recession observed was a “result of time.”
Conclusion
Following 14 years of observation, it was shown that the gingival responses to porcelain veneers were clinically and esthetically acceptable by the patient and the provider. The state of gingival inflammation was normal to moderate. Periodontal pocketing was between 1-2mm on average, and mild recession was noted in 27% of cases. Most of the recession was observed on the lateral incisors.