Journal of Clinical and Diagnostic Research. 2019 Feb, Vol-13(2): ZE01-ZE05 1 1 DOI: 10.7860/JCDR/2019/38481.12576 Dentistry Section Effectiveness of Shade and Thickness of Resin Cement on the Final Colour of the Porcelain Laminate Veneer: A Scoping Review Review Article INTRODUCTION Aesthetic dentistry has transformed into a solution to routine hassles in dental practise concerning patient’s demand for natural appearance of restoration. Improvements in ceramic systems and resin cements have provided aesthetically successful treatments in the anterior region to correct discolourations and unaesthetic tooth forms. Porcelain fused metal restoration proved beneficial in this field but the metal coping impaired the light transmission creating shadows in the joints. For many years, all ceramic restorations has been a predictable and durable option in aesthetic correction except for the substantial removal of sound tooth structure. Porcelain laminate veneers which are more conservative has extensively contributed to the popularity of aesthetic dentistry in the past twenty years [1]. Porcelain veneers have been evolving as a reliable option for both patients and clinicians seeking superior aesthetics [2]. These restorations are preferred due to their minimally invasive tooth preparation when compared with existing treatment options [3]. Long term clinical success of laminate veneers is determined by marginal adaptation of the veneer restoration, design of preparation, functional and morphological condition of the abutment tooth. The colour of the underlying tooth structure or restorative foundation material, shade and thickness of the resin luting cement used and ceramic material selected widely attribute to the superior optical properties, biocompatibility, increased translucency and exceptional aesthetic outcome of the final restoration [4-7]. Resin luting cements, considered as active-type cements, have rising applications in the cementation of fixed prostheses, as they exhibit improved mechanical and adhesive properties when compared with other conventional luting cements. Furthermore, they offer acceptable stability and better fracture resistance of porcelain laminate veneer, in combination with a satisfactory aesthetic outcome. Currently, resin luting cements are available in various shades to improve final colour match with the adjacent natural tooth and to allow the clinicians to select the accurate cement shade to gain desirable aesthetic enhancement of laminate veneer restoration [3,5]. However, research and investigations emphasising the impact of cement shades on the final colour of ceramic restorations remains limited and the effect of resin cement thickness remains controversial. Hence, the purpose of this scoping review was to analyse whether the shade and thickness of resin cement will affect the final colour of the porcelain in the in-vitro studies as a very minimal focus was emphasised in this area of interest. MATERIALS AND METHODS Information Sources and Search Strategy An electronic database search was conducted in Cochrane, MEDLINE and PubMed via Ovid for articles published in English between 1990 and 2017. To identify the studies to be considered, search strategy was developed for each database. Additional hand search of literature for bibliographies in the chosen articles was done using Google Scholar. The subject search based on the search strategy used specific keywords and their combinations in MEDLINE [Table/Fig-1]. The Mesh terms used were Dental veneers, porcelain laminate veneers, cement thickness, cement shade, cement colour, Prosthesis Colouring and Prosthesis shade. ARUN RAVI 1 , RAJAN SARANYA RAJ 2 , ANNA SERENE BABU 3 , ARUN KEEPANASSERIL 4 , ANIL MATHEW 5 Keywords: Cement thickness, Dental cement shade, Laminate veneer, Resin based cement, Translucency and colour ABSTRACT Introduction: Porcelain laminate veneer has evolved as a dependable treatment option due to their superior optical properties similar to natural tooth and exceptional aesthetic outcome. Among the factors which influence the final shade of laminate veneers, shade and thickness of resin cement used for luting contributes to the ultimate result. Aim: To analyse whether the shade and thickness of resin cement affects the final colour of the veneer restoration. Materials and Methods: Electronic databases Cochrane, MEDLINE and PubMed were searched for articles published in English between 1990 and 2017 based on set inclusion criteria. Data screening and extraction was performed in covidence systematic review software. Pre-clinical studies which assessed the effects of resin cement shade and thickness on the final shade of porcelain laminate veneers were included in the study. The initial search of literature included 22 studies, of which five articles were excluded, a total of 17 articles for full text reading were included after which 14 articles which did not meet the inclusion criteria were eliminated and remaining three articles were accepted as eligible for the review. Results: The search resulted in three studies reporting the effect of resin cement shade on porcelain. The mean colour difference was assessed in terms of clinical acceptability and perceptibility threshold. Various resin cement systems with similar shade showed different colour parameters and changes in final translucency. None of the studies compared the thickness parameter of resin cement on the final colour of restoration. Conclusion: The aesthetic outcome of veneer restorations are reflected by the shade of resin luting cements, considering the mean colour difference within various cement systems. There is a definite need for further research to evaluate the effect of cement thickness on final colour of veneers and a standardised resin cement shade classification.