3D-printed tooth reduction guide for minimally invasive veneer preparations. A case report.

Abstract

Aim: Current CAD/CAM techniques allow clinicians to design and 3D print tooth reduction guides that facilitate controlled preparations in the esthetic zone. The present case report describes the workflow for designing and printing a tooth reduction guide intended to assist ceramic veneer preparations. This 3D-printed guide divides the facial surface of the teeth into four areas and allows the measuring of all areas, including the incisal edge, with a periodontal probe. Using this 3D-printed appliance can simplify and expedite tooth preparation for ceramic veneers and reduce the risk of excessive tooth reduction.

Clinical considerations: A 45-year-old female patient presented at the clinic with the primary concern of the esthetics of her smile, which she wanted to improve. The initial evaluation revealed clinical signs of wear, spaces between the teeth, and the lack of anterior tooth symmetry. Therefore, to improve the appearance of her anterior teeth, a treatment plan that consisted of veneer restorations from the maxillary right second premolar to the left second premolar was formulated and presented. The patient accepted the option of undergoing minimally invasive anterior tooth preparations with a digital tooth reduction guide.

Materials and methods: A diagnostic intraoral scan was performed and a tooth reduction guide was digitally designed and 3D printed. Subsequently, the tooth preparations were performed with the aid of the guide. An intraoral scan of the preparations was performed and used to design and manufacture lithium disilicate ceramic veneers using subtractive techniques. Subsequently, the restorations were finished, treated, and cemented under rubber dam isolation.

Conclusions: The treatment fulfilled the patient's esthetic demands. This novel 3D-printed tooth reduction guide permits a more comprehensive assessment of the available tooth structure and provides ample access to more tooth surfaces than traditional silicone tooth reduction guides. Overall, this type of guide can significantly assist clinicians in performing tooth preparations in the esthetic zone.