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Published on: December 20, 2024
Influence of resin cement shade on esthetic outcomes in ceramic veneers: a systematic review
Subash Sharma1, Aravind Kumar2, Shruthi Rajagopal3
1Department of Aesthetics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
Introduction:
The increasing demand for minimally invasive and highly esthetic dental restorations has led to the widespread use of ceramic laminate veneers, particularly ultrathin veneers. Due to their reduced thickness and high translucency, the final color of these restorations is influenced not only by the ceramic material but also by the underlying substrate and the resin cement used for luting. Understanding the optical contribution of resin cements is therefore essential for achieving predictable and long-term clinical success. This systematic review aimed to evaluate the influence of resin cement formulation and shade on the final color of ceramic laminate veneers.
Methods:
A comprehensive electronic search was conducted in the PubMed, Web of Science, ProQuest, and Google Scholar databases up to March 2023. In vitro studies assessing the effect of resin-based luting agents on the final color of ceramic laminate veneers using objective color measurement techniques, including the CIE L*a*b* color system and spectrophotometry, were included. Studies involving full-coverage restorations or subjective shade assessments were excluded. Risk of bias was assessed using the Quality Assessment Tool for in vitro Studies (QUIN), adapted for in vitro research.
Results:
Ten studies met the inclusion criteria. White opaque and high-chroma resin cements consistently resulted in greater color changes (ΔE > 3.3), particularly when used with thin or high-translucency ceramic veneers. In contrast, translucent and low-chroma resin cements produced more esthetically favorable outcomes. Veneer thickness emerged as a key modulating factor, with thinner veneers amplifying the influence of cement shade. Artificial aging studies demonstrated significant discoloration over time, highlighting concerns regarding long-term color stability. Risk-of-bias assessment indicated moderate methodological quality in most included studies.
Discussion:
The findings of this systematic review demonstrate that resin cement shade and translucency significantly affect the final color of ceramic laminate veneers. These effects are particularly pronounced in ultrathin and highly translucent restorations. Clinicians should therefore carefully consider resin cement selection when planning esthetic treatments, especially in the anterior region. However, the predominance of in vitro evidence underscores the need for well-designed clinical trials to validate these findings and establish standardized cementation protocols.
Systematic Review Registration:
PROSPERO CRD42023450540.
