A clinical case by our Community member Dr Hüseyin Şimşek
This article and its content are published under the Author’s responsibility as an expression of the Author’s own ideas and practice. Styleitaliano denies any responsibility about the visual and written content of this work.
Computer aided design-computer aided manufacturing (CAD-CAM) can be subtractive (milling) or additive (three-dimensional (3D) printing). Recently, dentists’ interest has been shifting to 3D printing, also known as rapid prototyping. Models, surgical guides, occlusal splints, complete dentures, clear aligners are produced with 3D printer in dental offices and dental laboratories. However, it is now possible to obtain permanent restorations, perhaps the most important item produced by dentists, with 3D printing. 3D printing system presented some advantages over milling as production of complex geometries, less waste material, lower cost, higher accuracy, and faster production.
Fig.1
An 8-year-old patient came to the clinic complaining from sensitivity to cold. It can be clearly seen on the image that the carious lesion affected all the cusps.
Fig.2
Peri-apical x-ray revealed an incomplete root formation with deep occlusal caries lesion.
Fig.3
Extensive carious lesion under rubber-dam isolation.
Fig.4
Unsupported occlusal enamel was removed to better detect caries boundaries.
Fig.5
The infected dentin was removed, leaving only the affected dentin in the parts close to the pulp.
Fig.6
The enamel was etched with 37% phosphoric acid gel for 30 seconds.
Fig.7
Immediate dentin sealing was performed with a universal adhesive (Clearfil S3 Bond, Kuraray) and a flowable composite (G-aenial Universal Injectable, GC).
Fig.8
Composite build-up with packable composite before overlay preparation.
Fig.9
Overlay preparation.
Fig.10
A retraction cord was used to retract the gingiva and to better identify the preparation margins in the digital impressions.
Fig.11
The final design of the indirect overlay (Exocad DentalCAD).
Fig.12
Slicing was done using the application ChituBox.
Fig.13
Indirect overlay restoration was produced with 3D printer (Phrozen Sonic Mini 8k) and 3D printing resin (Saremco Print Crowntec, SP).
Fig.14
After cementation with self-adhesive dual-cure resin cement (Panavia SA Cement, Kuraray).
Fig.15
The 3D-printed restoration was stained and glazed using the Optiglaze (GC America).
Fig.16
Post-cementation x-ray was taken to evaluate the adaptation of the margins and the excess cement.
Fig.17
Occlusal view (Immediate post-op).
Fig.18
Natural occlusal anatomy (lateral view).
Conclusions
3D printing is constantly improving, and this technology is increasingly being used in dentistry. In the future of dentistry, a lot of 3D printing will be seen.
Bibliography
- Giannetti, L., Apponi, R., Mordini, L., Presti, S., Breschi, L., & Mintrone, F. (2022). The occlusal precision of milled versus printed provisional crowns. J Dent, 117, 103924.
- Donmez, M. B., & Okutan, Y. (2022). Marginal gap and fracture resistance of implant-supported 3D-printed definitive composite crowns: an in vitro study. J Dent, 124, 104216.
- Corbani, K., Hardan, L., Skienhe, H., Özcan, M., Alharbi, N., & Salameh, Z. (2020). Effect of material thickness on the fracture resistance and failure pattern of 3D-printed composite crowns. Int J Comput Dent, 23(3), 225-233.
