Retrospective clinical evaluation of a no-prep porcelain veneer protocol

Statement of problem Porcelain laminate veneers without tooth preparation (no-prep veneers) might represent a convenient and conservative option for the esthetic rehabilitation of anterior teeth. However, controversy exists about their predictability. Purpose The purpose of this clinical study was to retrospectively evaluate the performance of no-prep porcelain veneers placed as per the recently proposed “CH no-prep” protocol, which claimed to overcome many of the drawbacks of previous no-prep veneer solutions. Material and methods One hundred eight no-prep porcelain laminate veneers based on the CH no-prep protocol were placed in 21 patients between 2015 and 2017. All participants were contacted, and 15 received a recall examination: a total of 78 veneers were evaluated as per the Clinical-Photographic-Micromorphologic coding. Plaque and gingival indexes and any increase in gingival recession were recorded. Pulp vitality was verified. A survival rate based on the count of absolute failures and a success rate summarizing the effect of both absolute and relative failures were calculated. Results The mean observation period was 43.1 months, with an observation interval of 36 to 60 months and a survival rate of 97.4%. From the 5 relative failures (3 minimal fractures or chips and 2 limited marginal discolorations) and the 2 absolute failures (unrepairable fractures), an overall success rate of 91.0% was recorded, with 71 restorations that were judged excellent in terms of clinical acceptance after the recall examination. From the Clinical-Photographic-Micromorphologic evaluation, 5 restorations (6.4%) showed minimal issues for marginal integrity, while a limited porcelain overhang was identified on 2 restorations (2.8%). Micromorphologic analyses confirmed the clinical evaluations. No periodontal recession was observed, and plaque and gingival indexes appeared stable. Conclusions Porcelain laminate veneers placed as per the CH no-prep protocol demonstrated excellent performances after 36 to 60 months of clinical service. The achieved outcomes, in terms of color match and overall esthetic and anatomic integration, confirmed that a prepless approach may be safely adopted provided that strict rules for patient selection and finish line placement are adopted.