No Single Veneer Preparation Design Offers Superior Biomechanical Performance: Study

A new study published in the Journal of Esthetic and Restorative Dentistry showed that the way veneer restorations are prepared and the angle at which they are loaded have a big impact on how stress is distributed. However, there is no one preparation method that always offers the best biomechanical performance in every situation.

Ceramic veneers are commonly used to enhance the appearance of front teeth due to their great visual qualities, compatibility with the body, and the minimal need for altering the tooth. Nonetheless, the durability of veneers in the long run relies on the even distribution of pressure within both the ceramic veneer and the tooth underneath it. The way the tooth is prepared, such as how much enamel is removed, the coverage on the biting edge, and the shape of the preparation, can significantly impact where stress gathers and the likelihood of fractures. Various preparation styles can change how pressure is distributed at the point where the ceramic, cement, and tooth meet, especially when faced with regular or excessive forces.

This systematic examination examined stress distribution patterns in front ceramic veneers with various tooth preparation styles through the analysis of finite element studies. The goal was to enhance comprehension of this biomechanical element associated with clinical results.

A thorough exploration of PubMed, Scopus, Web of Science, and Embase, as well as gray literature outlets, was conducted from January 1990 to June 2025 to find studies on Finite Element Analysis (FEA) comparing different preparation designs according to a revised classification. Information was gathered utilizing a tailored template, and the likelihood of bias was evaluated using the ROBFEAD assessment tool.

Out of a total of 9576 research studies, 34 were selected for inclusion. Stress concentration in veneers and cement layers was commonly identified in both the incisal and cervical areas, with a prevalence of cervical concentration in the tooth structures.

Stress values were found to increase with higher loading angles. Preparations that did not involve incisal reduction often exhibited stress values similar to or higher than those with incisal reduction. Designs featuring a palatal chamfer often exhibited added stress concentration in the palatal region.

Overall, the way veneer restorations are prepared, designed, and loaded can impact how stress is distributed. Yet, there is no one design that always proves to be biomechanically better in all situations. It is suggested to conduct additional standardized FEA studies with well-supported modeling assumptions.

Reference:

Feiz, A., Farajzadeh, M., & Farajzadeh, A. (2026). Influence of various tooth preparation designs on stress distribution in anterior ceramic veneers: A systematic review of finite element analysis studies. Et al [Journal of Esthetic and Restorative Dentistry], (jerd.70261). https://doi.org/10.1111/jerd.70261