Is There Space for Resin Composite Restorations in a World of CAD-CAM and Digital Dentistry? Two-Year Follow-Up of Clinical Outcomes Using the Direct-Indirect Technique.

Abstract

Objective: This clinical report seeks to elucidate the versatility and mid-term outcomes of the direct-indirect technique. It presents a comprehensive step-by-step protocol for restoring anterior dentition across various clinical scenarios in accordance with the principles of the polychromatic layering technique.

Clinical considerations: This clinical report was divided into two phases. First, an urgent procedure due to the debonding of an interim restoration in tooth #10 was followed by crafting a direct-indirect veneer. Then, in the six-month follow-up appointment, a complete esthetic improvement in the anterior dentition (teeth #8, #9) with two techniques and different materials for each tooth was observed: In tooth #8, a direct incisal edge augmentation was performed, while in tooth #9, a thin contact lens-type direct-indirect fragment was created to improve the form of the tooth. The restorations were followed up for a 24-month mean, with the following criteria: Color, wear, adaptation, marginal discoloration, and integrity.

Conclusions: The direct-indirect technique showed optimal clinical outcomes after a mid-term follow-up, making it an option to traditional direct veneering, ceramics, and CAD-CAM materials.

Clinical significance: The direct-indirect technique amplifies the scope of resin composite restorations, providing optimal esthetic performance, broad indications, and mid-term longevity regardless of the selected restorative composite material or veneer type.