Predictors of patient dissatisfaction with ceramic veneers: A matched case-control study

Area of Science:

• Dental Prosthodontics
• Esthetic Dentistry
• Digital Dentistry

Background:

• Patient dissatisfaction with dental veneer aesthetics can lead to costly refunds and retreatment.
• The choice of mock-up technique and shade-matching protocol may influence esthetic outcomes.

Purpose of the Study:

• To evaluate the association between different mock-up techniques (chairside bis-acryl vs. 3D-printed) and shade-matching protocols (chairside visual vs. lab-assisted/digital) with patient-initiated esthetic dissatisfaction.
• To determine if these factors increase the likelihood of refunds or retreatment within 12 months of veneer delivery.

Main Methods:

• A 1:1 matched case-control study involving 46 patients in a private prosthodontic practice.
• Compared outcomes based on chairside bis-acryl versus digitally fabricated 3D-printed mock-ups and chairside visual versus laboratory-assisted/digital shade matching.
• Utilized exact conditional methods for matched pairs and multivariable logistic regression, calculating E-values for robustness.

Main Results:

• Chairside mock-ups and chairside-only shade selection were significantly associated with higher odds of esthetic dissatisfaction leading to refunds or retreatment.
• The odds ratio for chairside versus digital mock-ups was ∞ (P=0.0010), and for chairside versus lab-assisted shade matching was 6.00 (P=0.0129).
• Adjusted models confirmed these associations, with odds ratios of 5.87 for mock-up technique and 4.41 for shade protocol.

Conclusions:

• Chairside bis-acryl mock-ups and chairside-only shade matching are linked to increased early esthetic dissatisfaction and subsequent refunds or retreatment.
• Standardized digital workflows, including digitally designed/3D-printed mock-ups and calibrated shade protocols, are recommended.
• Adopting digital methods serves as a clinical quality-assurance measure to reduce esthetic dissatisfaction risks.