Masking ability of bi- and tri- laminate all-ceramic veneers on tooth-colored ceramic discs

STATEMENT: A predictable esthetic outcome is imperative when placing ceramic veneers. Discolored teeth pose a major challenge as sufficient material thickness is required to achieve a good esthetic result. There is limited evidence in the literature that compares the masking ability of multi-laminate veneers.

PURPOSE: The aim of this in-vitro study was to compare the masking ability of bi-laminate (BL) and tri-laminate (TL) all-ceramic veneers cemented on tooth-colored ceramic discs.

MATERIALS AND METHODS: A total of 40 veneers (shade A1, 10-mm diameter, 0.8-mm thick) were manufactured-20 BL veneers (0.4-mm pressable ceramic coping veneered with 0.4-mm thick enamel layer) and 20 TL veneers (0.4-mm coping veneered with 0.2-mm thick opaque interlayer and 0.2-mm thick enamel layer). A bonding apparatus was utilized to adhesively cement all veneers on the ceramic discs (shade A1), simulating teeth of light and dark color. The resulting groups (N = 10 each) were the reference groups (shade A1 ceramic base) BL-1 and TL-1 veneers, and the test groups (shade A4 ceramic base) BL-4 and TL-4 veneers. The color of the cemented veneers was measured using a spectrophotometer. The data were converted to CIE L*a*b* coordinates, and ΔE* were calculated to allow for statistical analysis.

RESULTS: The color differences between the samples with the A1 and A4 ceramic bases were significantly lower when covered with TL veneers (mean ΔE*: 3.2 units) than with BL veneers (mean ΔE*: 4.0 units: p < 0.001), indicating a better masking ability of the TL veneers.

CONCLUSION: The 0.8-mm thick TL veneer was able to mask darker tooth-colored ceramic disc within clinically acceptable limits.

CLINICAL SIGNIFICANCE: Increased understanding of the masking ability of ceramics and of color science is necessary in these esthetically aware times. Providing tri-laminate veneers for darker colored teeth seems to result in more predictable esthetical results than when using bi-laminate veneers. Patients with discolored/darker teeth may benefit from a more predictable esthetic result when teeth restored with tri-laminate rather than bi-laminate veneers.