Aim: This case report aims to describe a fully digital, no-prep restorative approach for the management of worn dentition using a 3D-printed transparent index. Methods: A 52-year-old male patient presented with generalized severe dental wear, sensitivity to thermal and acidic stimuli, and dissatisfaction with smile esthetics. Due to financial limitations, a minimally invasive, cost-effective treatment was selected. After clinical and radiographic examination, photos, videos, and digital intraoral scans (TRIOS 5) were obtained. A digital full-mouth wax-up was created by the dental technician, followed by the fabrication of a 3D-printed transparent index (Formlabs). A mock-up trial was performed to validate esthetics and function. Under rubber dam isolation, the teeth were alternatevely covered with PTFE tape, sandblasted with 50 µm alumina, etched with 37% phosphoric acid, and treated with universal adhesive (Universal Bond Quick 2). A highly filled flowable resin (CLEARFIL MAJESTY™ ES Flow – Low, A1) was injected through the seated index and light-cured for 20 seconds. Finishing was performed with Twist Dia polishers (Kuraray), and final polishing was completed one week later. At the 3-month follow-up, all restorations remained intact, with no sensitivity, chipping, or periodontal issues. Discussion: The patient reported full satisfaction. This predictable, additive technique enabled a fast, esthetic, and conservative full-mouth rehabilitation. Conclusion: The described 3D printed index technique offers a predictable, efficient, and cost-effective restorative solution for the management of worn dentition. FULL ABSTRACT Aim: Patients presenting with varying degrees of hard tissue wear can benefit from minimally invasive or non-invasive restorative strategies that preserve remaining tooth structure. This case report introduces a novel, fully digital, additive restorative protocol using a 3D-printed transparent index. The technique enables precise transfer of a digital full-mouth wax-up onto the dentition via a flowable composite injection approach, with no need for tooth preparation. The proposed method supports occlusal vertical dimension (OVD) increase based on thorough esthetic and functional planning, optimizing both esthetic outcomes and patient comfort. Materials and Methods: A 52-year-old male presented at the Dental Clinic of the University of Bologna with generalized severe dental wear, associated with thermal and acidic sensitivity, and dissatisfaction with smile aesthetics. Due to financial constraints, a cost-effective, minimally invasive treatment was prioritized. Following comprehensive diagnostic evaluation—including clinical examination, radiographs, photographic/video documentation, and digital intraoral scanning (TRIOS 5)—a full-mouth rehabilitation was planned using a flowable resin injection technique. A diagnostic wax-up was digitally designed and fabricated by the dental technician. A transparent index was generated from the wax-up using a 3D printer (Formlabs). Following a successful mock-up trial, the restorative procedure was carried out under rubber dam isolation. Each tooth was selectively prepared by air abrasion with 50 µm aluminum oxide particles, followed by phosphoric acid etching (37% H₃PO₄) and application of a universal adhesive (Universal Bond Quick 2). Teeth were isolated individually with PTFE tape. The 3D-printed index was seated, and a highly filled flowable resin composite (CLEARFIL MAJESTY™ ES Flow – Low, shade A1, Kuraray Noritake) was injected and light-cured for 20 seconds through the matrix. Final finishing was performed with diamond-impregnated rubber polishers (Twist Dia, Kuraray), and definitive polishing was completed one week later. Results: The patient expressed high satisfaction regarding the esthetic and functional outcome. No postoperative sensitivity or complications were reported. At the 3-month follow-up, clinical evaluation revealed intact restorations, with no evidence of chipping, wear, or periodontal inflammation. Conclusion: The described 3D printed index technique offers a predictable, efficient, and cost-effective restorative solution for the management of worn dentition. This fully digital, no-prep approach allows for a precise transfer of the planned occlusion and morphology, facilitating a single-appointment full-mouth rehabilitation. Mastery of adhesive protocols and composite handling is critical to ensure long-term success and clinical excellence.
Pieri, G., Forte, A., D'Alessandro, C., Mazzitelli, C., Maravic, T., Josic, U., et al. (2025). The 3D Printed Index Technique in the Management of Worn Dentition: A No-Prep, Digitally-Guided Restorative Workflow.
The 3D Printed Index Technique in the Management of Worn Dentition: A No-Prep, Digitally-Guided Restorative Workflow
Giovanni Pieri;Annamaria Forte;Carlo D'Alessandro;Claudia Mazzitelli;Tatjana Maravic;Uros Josic;Diego D'Urso;Annalisa Mazzoni;Lorenzo Breschi;Edoardo Mancuso
2025
Abstract
Aim: This case report aims to describe a fully digital, no-prep restorative approach for the management of worn dentition using a 3D-printed transparent index. Methods: A 52-year-old male patient presented with generalized severe dental wear, sensitivity to thermal and acidic stimuli, and dissatisfaction with smile esthetics. Due to financial limitations, a minimally invasive, cost-effective treatment was selected. After clinical and radiographic examination, photos, videos, and digital intraoral scans (TRIOS 5) were obtained. A digital full-mouth wax-up was created by the dental technician, followed by the fabrication of a 3D-printed transparent index (Formlabs). A mock-up trial was performed to validate esthetics and function. Under rubber dam isolation, the teeth were alternatevely covered with PTFE tape, sandblasted with 50 µm alumina, etched with 37% phosphoric acid, and treated with universal adhesive (Universal Bond Quick 2). A highly filled flowable resin (CLEARFIL MAJESTY™ ES Flow – Low, A1) was injected through the seated index and light-cured for 20 seconds. Finishing was performed with Twist Dia polishers (Kuraray), and final polishing was completed one week later. At the 3-month follow-up, all restorations remained intact, with no sensitivity, chipping, or periodontal issues. Discussion: The patient reported full satisfaction. This predictable, additive technique enabled a fast, esthetic, and conservative full-mouth rehabilitation. Conclusion: The described 3D printed index technique offers a predictable, efficient, and cost-effective restorative solution for the management of worn dentition. FULL ABSTRACT Aim: Patients presenting with varying degrees of hard tissue wear can benefit from minimally invasive or non-invasive restorative strategies that preserve remaining tooth structure. This case report introduces a novel, fully digital, additive restorative protocol using a 3D-printed transparent index. The technique enables precise transfer of a digital full-mouth wax-up onto the dentition via a flowable composite injection approach, with no need for tooth preparation. The proposed method supports occlusal vertical dimension (OVD) increase based on thorough esthetic and functional planning, optimizing both esthetic outcomes and patient comfort. Materials and Methods: A 52-year-old male presented at the Dental Clinic of the University of Bologna with generalized severe dental wear, associated with thermal and acidic sensitivity, and dissatisfaction with smile aesthetics. Due to financial constraints, a cost-effective, minimally invasive treatment was prioritized. Following comprehensive diagnostic evaluation—including clinical examination, radiographs, photographic/video documentation, and digital intraoral scanning (TRIOS 5)—a full-mouth rehabilitation was planned using a flowable resin injection technique. A diagnostic wax-up was digitally designed and fabricated by the dental technician. A transparent index was generated from the wax-up using a 3D printer (Formlabs). Following a successful mock-up trial, the restorative procedure was carried out under rubber dam isolation. Each tooth was selectively prepared by air abrasion with 50 µm aluminum oxide particles, followed by phosphoric acid etching (37% H₃PO₄) and application of a universal adhesive (Universal Bond Quick 2). Teeth were isolated individually with PTFE tape. The 3D-printed index was seated, and a highly filled flowable resin composite (CLEARFIL MAJESTY™ ES Flow – Low, shade A1, Kuraray Noritake) was injected and light-cured for 20 seconds through the matrix. Final finishing was performed with diamond-impregnated rubber polishers (Twist Dia, Kuraray), and definitive polishing was completed one week later. Results: The patient expressed high satisfaction regarding the esthetic and functional outcome. No postoperative sensitivity or complications were reported. At the 3-month follow-up, clinical evaluation revealed intact restorations, with no evidence of chipping, wear, or periodontal inflammation. Conclusion: The described 3D printed index technique offers a predictable, efficient, and cost-effective restorative solution for the management of worn dentition. This fully digital, no-prep approach allows for a precise transfer of the planned occlusion and morphology, facilitating a single-appointment full-mouth rehabilitation. Mastery of adhesive protocols and composite handling is critical to ensure long-term success and clinical excellence.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
