Customized composite veneers from a totally digital workflow: A case report

Mapping the Landscape of the Digital Workflow of Esthetic Veneers from Design to Cementation: A Systematic Review

The purpose of this systematic review was to map all the existing literature on digitally designed and fabricated esthetic veneers. We aimed to compare the accuracy of digitally designed preparation and cementation guides for esthetic indirect veneers with the conventional workflow. We evaluated studies comparing the accuracy and predictability of workflows between digitally fabricated indirect-esthetic veneers and conventional indirect veneers. Searches were performed in August 2023 across three databases, specifically Google Scholar, Cochrane, and PubMed, and were restricted to English-language publications. The search strategy was based on the PICO criteria. Reference lists of identified articles were manually checked to find further pertinent studies that were not discovered during the electronic search. The titles and abstracts were reviewed in the first stage, and then the full article texts were reviewed and cross-matched against the predetermined inclusion criteria. Following the search, 169 articles were identified: 41 from Google Scholar, 44 from Cochrane, and 71 from PubMed, with 13 added manually. Of these, 20 were chosen for a detailed quality assessment of the digital veneer workflow and the accuracy of digital preparations and cementation guides for laminate veneers. Based on our findings, the digitally fabricated laminate-veneer workflow demonstrated superior predictability and accuracy compared to the conventional workflow.

Full-mouth rehabilitation in a completely digital workflow using partially adhesive monolithic zirconia restorations

OBJECTIVE

This clinical case describes a completely digital workflow using current digital technologies for a full-mouth adhesive rehabilitation with ultra-translucent multilayer zirconia restorations.

CLINICAL CONSIDERATIONS

A healthy 60-year-old man with abfractions on all upper and lower molars and severe tooth wear underwent a full-mouth rehabilitation with laminate veneers and partial adhesive restorations. A proper zirconia bonding protocol was realized to provide a durable bond between the ultra-translucent zirconia and the resin cement. Furthermore, the implementation of a digital workflow enables the clinician to have an effective communication during treatment planning and simplify the clinical and laboratory procedures, providing the patient with long-term esthetic treatment and functional results.

CONCLUSION

The implementation of a completely digital workflow and the use of ultra-translucent multilayer zirconia for indirect adhesive restorations can be an alternative with simplified and predictable procedures for patients with dental wear and teeth discolorations.

CLINICAL SIGNIFICANCE

The digital workflow described is intended to facilitate the planning and execution of a full-mouth adhesive rehabilitation and demonstrates to clinicians a reliable zirconia bonding concept for minimally invasive anterior and posterior restorations.

A comparison of accuracy between three different facial detection systems for prosthodontic esthetic preview: a single-blinded in vitro study

BACKGROUND

The aim of this study was to compare the accuracy of 3 different devices for facial images acquisition, useful for prosthodontic esthetic preview.

METHODS

Bidimensional extraoral photographs (Nikon D300), facial scans (Bellus3D) and 3D digital stereophotogrammetry photos (3dMD Face System) were acquired from 15 patients. The intraoral impressions of all subjects were digitally taken through a scanner (i500; Medit). Files obtained from each acquisition method were transferred on Exocad Software, and the measurements of the frontal teeth were performed and compared with those of the intraoral scans, assumed as reference. The data were statistically analyzed (Friedman and Dunn tests) with P<0.05.

RESULTS

As for central and lateral incisors, no significant difference emerged between 2D digital photography and intraoral scans, both in height and width. Measures obtained with Bellus3D significantly differed from the reference data in width of all teeth, except for central incisors. Values referred to canines were those more subjected to significant distortions in width for all devices.

CONCLUSIONS

Within the limits of this study, measures of frontal teeth acquired by 2D digital photography were similar to those of intraoral scans both in height and width, while those obtained with 3D facial scanners were more subjected to distortions in mesial-distal dimension.

Digital planning of composite customized veneers using Digital Smile Design: Evaluation of its accuracy and manufacturing

OBJECTIVES

This study aimed to evaluate the production of customized composite veneers starting from a two-dimensional (2D) digital preview using the Digital Smile System (DSS). MATERIAL AND METHODS: A photographic examination of 30 patients was performed by taking two digital pictures of the face and a digital preview through the DSS. Moreover, optical scans of the dental arches were obtained and the data were entered into a three-dimensional (3D) software to prepare a virtual preview. The standard tessellation language files were sent for production using CAD-CAM technology. The Friedman test, Bonferroni, and Dunn post hoc tests were used, comparing the linear measurements of the 2D and 3D plans and the final veneers (α = .05).

RESULTS

Significant differences emerged between the pictures and digital scans on the mesial-distal widths of the lateral incisors and canine. Linear measurements in the 2D plan were significantly different from those of the 3D plan, except for the height measures of incisors. No significant changes were found on comparing the parameters of the 2D and 3D plans with those of the final pieces.

CONCLUSIONS

The customized veneers were clinically adequate and similar to 2D and 3D plans, although significant differences emerged between the picture and digital scans as well as between the 2D and 3D plans.