Critical appraisal: clinical considerations for restoring mandibular incisors with porcelain laminate veneers

Porcelain laminate veneers have been proven to be a successful treatment modality for maxillary incisors in clinical practice and in controlled clinical studies. However, the data in clinical studies on the success of veneers for restoring mandibular incisors are limited. Clinically, the successful restoration of mandibular incisors with porcelain laminate veneers is one of the more challenging procedures in all of esthetic restorative dentistry. Limited coronal dimensions, the small amount of enamel available for bonding (particularly in the cervical areas), materials and techniques for the bonding procedures, and the response of the tooth-veneer complex to forces generated during the incisal loading in both functional as well as parafunctional contacts must be considered as potential sources of success or failure. This Critical Appraisal reviews three recent scientific articles to shed some light on these issues and, as in all research endeavors, leads the reader to identify additional areas of concern that might stimulate further scientific inquiry. The first publication studied predictors for enamel thickness for mandibular incisors. The second examined bonding protocols for exposed dentin and suggested immediate dentin sealing. The third paper addressed fracture behavior of mandibular incisors restored with porcelain laminate veneers in vitro.