Laminate veneers: Preplanning and treatment using digital guided tooth preparation

Evaluation of marginal and internal adaptation of veneers generated by the guided prosthetic tooth preparation system

OBJECTIVE

This in vitro study aimed to assess and contrast the marginal and internal adaptation of all-ceramic prefabricated veneers manufactured via the FirstFit guided tooth preparation system against all-ceramic veneers produced using the chairside Computer-Aided Design/Computer Aided Manufacture (CAD/CAM) system following identical guided preparation protocols.

MATERIALS AND METHODS

Two main groups were included, with 16 lithium disilicate veneers per group. Four typodonts were used for the test (FirstFit) and control CAD/CAM groups. Intraoral scans created master casts and preparation guides. Guides performed preparations on typodont teeth (two central incisors and two lateral incisors). Prepared teeth were scanned (CEREC Omnicam) to design and mill CAD/CAM veneers. Marginal gap thickness and cement space thickness were measured using light microscopy at four locations: marginal, cervical internal, middle internal, and incisal internal.

RESULTS

No significant difference existed between groups for marginal adaptation (p = 0.058) or incisal internal adaptation (p = 0.076). The control group had significantly lower values for middle internal adaptation (p = 0.023) and cervical internal adaptation (p = 0.019).

CONCLUSIONS

Guided preparation evaluation showed no significant differences in marginal or incisal internal adaptation. The CAD/CAM group had significantly lower middle and cervical internal adaptation values.

Influence of different immediate dentin sealing strategies on bond strength of indirect resin nanoceramic restorations

In this study, we evaluated the effect of four different strategies for bonding a CAD/CAM resin nanoceramic restoration (Lava Ultimate, 3M) to the dentin surface using a universal adhesive (Scotch Bond Universal, 3M) and adhesive resin cement (RelyX Ultimate, 3M) on the shear bond strength (SBS) and failure mode. The strategies comprised: (i) immediate sealing, immediate bonding; (ii) immediate sealing, bonding after 2 weeks with provisional restoration; (iii) immediate sealing with flowable resin composite reinforcement and bonding after 2 weeks with provisional restoration; and (iv) no immediate sealing, and bonding after 2 weeks with provisional restoration. After bonding, all the specimens were thermocycled, shear tests were performed using a universal testing machine, and failure modes were determined using stereomicroscope and scanning electron microscopy. The highest mean SBS was recorded with immediate sealing, immediate bonding strategy. Most adhesive failures with exposed dentinal tubules were noted in specimens exposed to bonding after 2 weeks with no immediate sealing, which was associated with the lowest SBS. Mixed failures predominated in all immediate dentin sealing groups. Immediate sealing with universal adhesives improves SBS, particularly in the single-visit approach, which has shown significantly better performance, whereas the provisional phase has a negative effect.

A digital guide device to facilitate CAD-CAM veneer cementation for mandibular incisors: A dental technique

The novel design of a digital guide to facilitate the cementation of computer-aided design and computer-aided manufacturing (CAD-CAM) veneers for mandibular incisors by using a polymer infiltrated ceramic network (PICN) material is described. This guide provided an efficient, reliable, and accurate approach to facilitating multiple veneers with minimally invasive preparation during cementation, reducing the technique sensitivity of freehand practice and chairside time.

The Effect of Various Preparation and Cementation Techniques of Dental Veneers on Periodontal Status: A Systematic Review and Meta-Analysis

Dental veneers are widely used to restore or/and enhance dental aesthetics. However, it is not well understood how various veneer preparation and cementation methods affect periodontal health. To provide a quantitative estimate of the overall effect size of the intervention, this study was conducted to synthesize the available evidence on the impact of various dental veneer preparation and cementation methods on periodontal status. A thorough search strategy was implemented using Medical Subject Headings keywords and Boolean operators across various major databases, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Nine papers were ultimately selected for inclusion in the review. Seven studies demonstrated a positive impact of dental veneers on overall periodontal health, while two studies reported a slight worsening. The forest plot analyses showed a somewhat protective effect of dental veneers on periodontal health, with odds ratio of 0.18 and relative risk of 0.34, suggesting that dental veneers may have a positive impact on overall periodontal health. The current study, with considerable heterogeneity among the studies, indicates that dental veneers are associated with an overall positive effect on the periodontal health. However, given the variations in study designs, sample sizes, and follow-up times, additional research may be required to confirm and generalize these results.

Digitally designed and additively manufactured tooth reduction guides for porcelain laminate veneer preparations: A clinical report

Porcelain laminate veneers are a conservative treatment to enhance esthetics, tooth shape, color, and contours. Enamel preservation during tooth preparation is essential for the long-term success of these micromechanically retained partial coverage restorations. Different methods have been described to clinically assess tooth preparation relative to definitive restorative contours. This clinical report describes a digital workflow to fabricate 3-dimensionally (3D) printed tooth reduction guides based on digital esthetic planning. These 3D printed reduction guides help clinicians visualize and gauge tooth preparations relative to the desired restorative contours, aid in enamel preservation, and overcome some of the limitations associated with conventionally fabricated tooth reduction guides.

Digital guided veneer preparation: A dental technique

This article describes a digital workflow for ceramic veneer preparation using computer-aided design and computer-aided manufacturing technology. A digital waxing was planned on the exocad software program to reestablish esthetic and functional parameters. Then, the digital guides for veneer preparation were designed by using the Meshmixer design software program to control the tooth structure removed during preparation to the minimal thickness necessary for the definitive restorations. The digital guides were printed in an additively manufactured clear resin and used in the preparation appointment, allowing a more conservative and controlled preparation.

Preparation of ultrathin translucent zirconia laminate veneers using 3D printing reduction guides

Minimizing and controlling the amount of tooth reduction during the preparation of ultrathin laminate veneers is a challenge for minimally invasive dentistry. The use of reduction guides is advised to reach the optimal space required for the definitive restoration without excessive reduction. The digital production of a reduction guide used to control tooth preparation for ultrathin laminate veneers is described.

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.

Influence of Augmented Reality Appliances on Tooth Preparation Designs-An In Vitro Study

The aim of this work was to analyze and compare the tooth structure removal between a free-hand preparation technique and a computer-aided preparation technique using an augmented reality appliance for complete-crowns preparation designs and "root mean square" (RMS) alignment value. Ten upper teeth representatives of all dental sectors were selected from a generic model library as "Standard Tessellation Language" (STL-1) digital files and 3D-printed in an anatomically based acrylic resin experimental model. Then these were randomly assigned to the following tooth preparation techniques: Group A: free-hand preparation technique (n = 5) (FHT) and Group B: computer-aided preparation technique using an augmented reality appliance (n = 5) (AR). Experimental models were submitted to a digital impression through an intraoral scan and (STL-2) uploaded into a reverse engineering morphometric software to measure the volumetric reduction in the planned and performed tooth structure (mm3) and RMS using the Student's t-test and the Mann-Whitney non-parametric test. Statistically significant differences were observed between the volumetric reduction in the planned and performed tooth structure (mm3) of the AR and FHT study groups (p = 0.0001). Moreover, statistically significant differences were observed between the RMS of the planned and performed tooth preparations in both the AR and FHT study groups (p = 0.0005). The augmented reality appliance provides a more conservative and predictable complete-crowns preparation design than the free-hand preparation technique.

Accuracy of the preparation depth in mixed targeted restorative space type veneers assisted by different guides: An in vitro study

PURPOSE

Most veneers are mixed targeted restorative space (MTRS)-type restorations that are partially within the original tooth and require inconsistent preparation depths. This study aimed to evaluate the accuracy of the preparation depth for MTRS veneer preparation.

METHODS

MTRS veneer preparation models were developed using the twisted maxillary central incisor (MCI) as the original tooth and the standard MCI as the waxing. Veneer preparations were performed using freehand (MF), silicone (MS), thermoplastic (MT), 3D-printed uniform (MD), and auto-stop (MA) guides. The prepared and original MCI were scanned and superimposed using a custom-made base. The mean absolute differences (MADs) were measured to evaluate the accuracy of the preparation depth. Statistical analysis was performed using the multivariate analysis of variance (MANOVA) test (α=0.05).

RESULTS

The accuracy of the preparation depth was 0.237±0.090, 0.191±0.099, 0.149±0.078, 0.093±0.050, and 0.059±0.040 mm in MF, MS, MT, MD, and MA, respectively. The MADs between the groups were significant (P<0.05). The accuracy of the trial restoration was 0.140±0.081 mm in the MS, and the accuracy of the guiding tube was 0.055±0.033, 0.036±0.011, and 0.033±0.010 mm in the MT, MD, and MA, respectively.

CONCLUSIONS

In MTRS veneer preparation for MCI, tooth preparation guides improved the accuracy of the preparation depth by visualizing the TRS profile and providing clear measurement points. The accuracy of the guide is influenced by its flexibility, and the accuracy of the preparation depth is affected by the accuracy of the measurement points.

Conventional Versus Minimally Invasive Veneers: A Systematic Review

This systematic review aimed to synthesize and analyze a collection of studies focused on comparing conventional veneers (CVs) and minimal or no-preparation veneers (MPVs) within the domain of prosthodontics. The review sought to explore various attributes, techniques, outcomes, and considerations associated with these two approaches. The key aspects investigated included esthetics, longevity, periodontal health, patient satisfaction, structural influences such as microleakage and marginal fit, cement thickness, and color stability. A systematic literature search was conducted to identify relevant studies published up to the present date. Studies meeting specific inclusion and exclusion criteria were selected for review. Studies pertaining to various methodologies were identified initially as part of the strategy and bias assessment was performed to determine the credibility of their assessments before inclusion in this review. Four comparative assessments gleaned from the selected studies provided a comprehensive overview of the strengths and limitations associated with CVs and MPVs. MPVs demonstrated advantages such as enhanced survival rates and extended mean success periods, implying their potential as viable long-term restorative options. Meticulous patient management and optimal preparation techniques emerged as crucial factors influencing successful outcomes. Structural attributes, including microleakage and marginal fit, varied depending on the preparation techniques employed. Moreover, considerations related to color changes in veneers underscored the intricate interplay between material properties and fabrication methods. The insights underscore the significance of patient-centric care, precision preparation methodologies, and material choices in guiding successful outcomes. However, the diverse methodologies and constraints of certain studies warrant careful interpretation. This study accentuates the potential for future research directions, interdisciplinary collaboration, and the advancement of evidence-based practices within veneer dentistry.

An Innovative 3D Printed Tooth Reduction Guide for Precise Dental Ceramic Veneers

Tooth reduction guides allow clinicians to obtain the ideal space required for ceramic restorations. This case report describes a novel design (CAD) for an additive computer-aided manufactured (a-CAM) tooth reduction guide with channels that permitted access for the preparation and evaluation of the reduction with the same guide. The guide features innovative vertical and horizontal channels that permit comprehensive access for preparation and evaluation of the reduction with a periodontal probe, ensuring uniform tooth reduction and avoiding overpreparation. This approach was successfully applied to a female patient with non-carious lesions and white spot lesions, resulting in minimally invasive tooth preparations and hand-crafted laminate veneer restorations that met the patient's aesthetic demands while preserving tooth structure. Compared to traditional silicone reduction guides, this novel design offers greater flexibility, enabling clinicians to evaluate tooth reduction in all directions and providing a more comprehensive assessment. Overall, this 3D printed tooth reduction guide represents a significant advancement in dental restoration technology, offering clinicians a useful tool for achieving optimal outcomes with minimal tooth reduction. Future work is warranted to compare tooth reductions and preparation time for this guide to other 3D printed guides.

Research Progress and Clinical Application of All-Ceramic Micro-Veneer

Anterior teeth problems affect the patient's daily eating, communication, social activities, self-confidence, and mental health. The trend in dentistry is to address anterior tooth problems with minimally invasive and aesthetic treatments. With the development of adhesive materials and ceramics, micro-veneers have been proposed as an alternative treatment for enhancing the aesthetic appearance and avoiding unnecessary tooth reduction. A micro-veneer is a veneer that can be cemented to the surface without or with minimal tooth preparation. These benefits include no need for anesthesia, postoperative insensitivity, good adhesion to enamel, reversibility of treatment, and higher patient acceptance. However, the micro-veneer repair is suitable only for specific cases and must be strictly controlled regarding indication. Treatment planning is a crucial step to achieving functional and aesthetic rehabilitation, and following the clinical protocol is helpful for the longevity and success of micro-veneer restorations. However, more precise and predictable tooth preparation methods, such as minimally invasive microscopic tooth preparation and digitally guided veneer preparation, are recommended rather than the traditional free-hand method. Therefore, this paper clarifies micro-veneers and compares them with other restorations to gain a deeper and more comprehensive understanding. The authors also review indications, materials, cementation, and effect evaluation of micro-veneers to provide clinicians with valuable information. In conclusion, micro-veneers are minimally invasive treatments that provide good restoration results when used appropriately and are worthy of promotion for the aesthetic restoration of anterior teeth.

3D-Printed Overlay Template for Diagnosis and Planning Complete Arch Implant Prostheses

Dental implants are a reliable alternative to treating edentulism. In clinical situations where the dentition has been severely affected by partial edentulism, advanced wear, or periodontal disease, establishing important occlusal elements such as the occlusal plane, incisal guidance, and esthetics can be hard to visualize at the diagnostic stage. Contemporary data-acquisition technologies such as 3D scanners and CAD/CAM systems permit the precise manufacture of highly complex devices applicable to any stage of restorative treatment. The present clinical report presents an alternative technique for evaluating the projected artificial tooth relationships, vertical dimension, and occlusal plane in patients with severely weakened dentition by using a 3D-printed overlay template.

Direct guided restorations from planning to definitive restoration: A clinical report

A direct composite resin placed by using digitally planned prototyped 3D guides and retained with a digitally guided fiberglass micropin was used to restore an extensively damaged maxillary left central incisor.

Preparing guiding planes for removable partial dentures: comparison between assisted CAD-CAM template procedure and freehand preparation: An in vitro study

OBJECTIVES

To compare the trueness of computer-aided design and computer-aided manufacturing (CAD-CAM) assisted procedure and freehand procedure for preparing guiding planes for removable partial dentures (RPDs).

METHODS

Forty identical mandibular resin casts were divided into two groups in which the guiding planes of two abutment teeth were prepared freehand (control group, n = 20) and using rigidly constrained templates (test group, n = 20). The template was designed on a digital cast of virtually prepared guiding planes and fabricated by selective laser melting using cobalt-chromium alloy. To assess the 3D trueness, all prepared guiding planes (Test data) were digitized using a laboratory scanner and compared to the virtually designed guiding planes (Reference data). The angle deviation between the Test data and the designed direction of the path of placement was measured for assessing the direction trueness of guiding plane preparation.

RESULTS

The 3D trueness of guiding plane preparation was significantly better in the test group (48.4 ± 12.9 μm) than in the control group (128.5 ± 37.6 μm, p < 0.01). The direction trueness of guiding plane preparation was also significantly better in the test group (1.20 ± 0.55°) than in the control group (7.68 ± 3.00°, p < 0.01).

CONCLUSIONS

The CAD-CAM template assisted procedure can significantly improve tooth preparation of the guiding planes compared to the freehand preparation. The CAD-CAM template could help clinicians prepare parallel guiding planes in a predictable manner.

Accuracy of Reduction Depths of Tooth Preparation for Porcelain Laminate Veneers Assisted by Different Tooth Preparation Guides: An In Vitro Study

PURPOSE

To evaluate the accuracy (trueness and precision) of reduction depths of guided veneer preparation assisted by four tooth preparation guides.

MATERIALS AND METHODS

Fifty resin artificial teeth were randomly divided into five groups (n = 10): a freehand group (F), silicone guide group (S), thermoplastic guide group (T), 3D printed uniform guide group (D), and 3D printed auto-stop guide group (A). A preparation for a window veneer on the maxillary right central incisor was performed by two surgeons who used tooth preparation guides for assistance. The maxillary right central incisors were scanned before and after the preparation. The reduction depths were measured in the cervical, middle, and incisal thirds of the prepared surface, and depth maps were created using Geomagic Control X software. The accuracy of the reduction depths at each third was evaluated using both trueness and precision values. The trueness of the reduction depths was determined by calculating the mean absolute differences (MADs) compared to the planning depth, and precision was determined by the standard deviation (SD). The collected data were statistically analyzed using one-way ANOVA and the least significant difference test (α = 0.05).

RESULTS

The MAD ± SD values of the reduction depths in the cervical-third region in groups F, S, T, D, and A were 0.19 ± 0.04, 0.12 ± 0.03, 0.09 ± 0.02, 0.07 ± 0.02, and 0.05 ± 0.01 mm, respectively. In the middle-third region, the MAD ± SD values of groups F-A were 0.19 ± 0.05, 0.13 ± 0.02, 0.09 ± 0.01, 0.06 ± 0.01, and 0.05 ± 0.01 mm. In the incisal-third region, the MAD ± SD values were 0.27 ± 0.05, 0.16 ± 0.04, 0.11 ± 0.03, 0.07 ± 0.01, and 0.05 ± 0.01 mm, respectively. Significant differences in trueness and precision values were found across different groups (F = 45.378, p = 0.000), where group F showed higher MADs than the other 4 groups (p = 0.000), and the highest MADs were detected in group S among the 4 groups in all regions (p = 0.000). Group T showed significantly higher MADs than groups D (P = 0.008) and A (p = 0.001), except in the cervical-third region, where no significant difference was observed between groups T and D (p = 0.077). There was no significant difference between groups D and A (p = 0.148). The deviation map showed significant differences among groups (F = 15.963, p = 0.000), group T presented less deviation than group F (p = 0.000) and group S (p = 0.027) and showed more deviation than group A (p = 0.007).

CONCLUSION

Tooth preparation guides provided more accuracy for veneer preparation than freehand preparation. Among the 4 guides, the 3D printed auto-stop guide presented the lowest absolute difference (0.05 mm) and the silicone guide showed the highest absolute difference of preparation (0.12-0.16 mm).

Immediate Dentin Sealing: A Literature Review

Purpose

The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application.

Materials and Methods

The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies.

Results

After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation.

Conclusion

There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.

Predictable 3D guided adhesive bonding of porcelain veneers using 3D printed trays

OBJECTIVE

This clinical report describes a novel digital technique to facilitate and improve the porcelain laminate veneers adhesive bonding procedure using a customized 3D printed guide.

CLINICAL CONSIDERATIONS

Porcelain veneers can be stabilized in their fully seated position with a digitally design 3D printed guide before the resin cement is polymerized. The excess cement can be carefully and predictably removed without the risk of dislodgement, rotation or misfit, allowing the clinician to light cure them under controlled pressure in the correct seating position without the risk of fracturing the ceramic material.

CONCLUSIONS

Fabricating a custom 3D printed guide for veneer bonding provides significant assistance to an otherwise cumbersome and daunting clinical procedure.

CLINICAL SIGNIFICANCE

Adhesive bonding of multiple ceramic veneers is a challenging and technique sensitive procedure. The use of a custom 3D printed guide presented in this article offers a practical aid to achieve a more predictable and precise outcome.

Multipurpose application of custom, rigid, clear matrix for fabricating trial restorations, tooth preparation guides, and interim veneers

Interim veneers present an esthetic and functional challenge for restorative dentists. Moreover, inadequate fit or trauma to the soft tissue during their fabrication or subsequently may affect soft-tissue health and stability and lead to bleeding that will compromise the adhesive cementation of the definitive ceramic veneers. This article describes a technique for the atraumatic fabrication of interim veneers with a custom, rigid, clear matrix designed for multipurpose use during the patient's restorative care. Based on a diagnostic waxing, the clear matrix is made and first used for the fabrication of the trial restorations and as a tooth-preparation guide. Subsequently, it is used for the atraumatic fabrication of interim veneers with a photopolymerizing direct restorative material.

Questions about the numerical value and quantitative data transfer of tooth preparation-from experience guidance to digital guidance

Tooth preparation is a common operation in dental clinical practice. This procedure is irreversible and invasive from the point of view of tooth preservation. Conditions of the abutment tooth, treatment methods, and restoration materials for target restoration affect tooth preparation. To achieve the goals of tooth tissue preservation, dental pulp protection, and periodontal health, dentistry professionals agreed on the importance of minimizing the amount of tooth reduction. The foundations for realizing this consensus are as follows. First, the available restoration materials with improved comprehensive performance need less target restoration space. Next, teeth can be prepared under a digital guide, and the real-time measurement of restoration space can be verified due to the invention of digital technologies for the analysis of the quantity and shape of the prepared tooth and tooth measurement. Moreover, guiding methods for preparation have been developed from freehand operation under the naked eye based on accumulated personal experience to digital-guidance jointing microscope. These innovations indicate the creation of a prototype of guided prosthodontics that is precise and applies real-time measurement throughout the process of tooth preparation. From the perspective of the evolution of digital, guided, and micro prosthodontics, this article raised seven questions about the numerical value and quantitative data transfer of tooth preparation and evaluated the authenticity of existing numerical requirements from the perspective of the four elements of measurement. Identifying unified measuring methods and developing measuring tools with a precision of hundred or ten microns will be the key to solving the problem about the authenticity of numerical measurement. Furthermore, this paper summarizes the methods of how to control tooth reduction and explains in depth why the currently dominant tooth preparation technology, which is based on empiricism, cannot effectively achieve the goals in digital prosthodontics. Therefore, we strongly call for rebuilding the digital foundation of prosthodontic treatment immediately.

Efficacy of Computer-Aided Static Navigation Technique on the Accuracy of Endodontic Microsurgery. A Systematic Review and Meta-Analysis

The aim of this systematic review and meta-analysis was to analyze the efficacy of the computer-aided static navigation technique on the accuracy of root apex location in endodontic microsurgery.

MATERIAL AND METHODS

A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated the apex location rate of the computer-aided static navigation techniques applied to endodontic microsurgery. A total of four databases were consulted in the literature search: Pubmed-Medline, Scopus, Cochrane, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and the quantitative analysis.

RESULTS

The root apex location success rate stated at 96.8% (confidence interval (CI): 93.0-100%) of the cases performed through a computer-aided static navigation technique. The prediction interval ranges from 91.4% to 100%. The meta-analysis did not detect heterogeneity between the combined studies (Q-test = 6.15; p-value = 0.407; I2 = 2.4%). The computer-aided static navigation techniques showed a root apex location success rate 27 times higher than conventional endodontic microsurgery procedures (Q test = 0.80; p = 0.671; I2 = 0%). Three studies of computer-aided static navigation techniques and control group were compared using a random effects model with the Mantel-Haenszel method with a statistically significant odds success ratio of 27.7, with a 95% confidence interval between 11.3 and 68.1 (z test = 7.23; p < 0.0001).

CONCLUSIONS

According to in vitro studies analyzed, endodontic microsurgeries performed through computer-aided static navigation techniques show a high precision.

A stereolithographic template for computer-assisted teeth preparation in dental esthetic ceramic veneer treatment

OBJECTIVE

This article describes a digital dental esthetic ceramic veneer treatment workflow using a stereolithographic template for teeth preparation.

CLINICAL CONSIDERATIONS

We have presented the case of a 33-year-old woman with dental fluorosis who wanted an esthetic ceramic veneer treatment. A digital smile design was created on a virtual patient, and a virtual diagnostic wax-up was made. Based on the suggested ceramic material thickness, virtual teeth preparation was performed on the diagnostic wax-up. A special-teeth preparation template was then created digitally and fabricated using a stereolithographic technique. This template guided the teeth preparation using a special bur with a stopper. The veneers were fabricated by CAD/CAM and delivered good esthetics and function.

CONCLUSIONS

The stereolithographic tooth reduction template helps realize digital restorative planning. It provides better control of the reduction depth of the labial and incisal preparation, making the operation simpler.

CLINICAL SIGNIFICANCE

The digital dental esthetic ceramic veneer treatment workflow described here using a stereolithographic template for teeth preparation helped with the accurate control of reduction depth for minimally invasive teeth preparation, making the operation simpler, which is a significant improvement over the previous methods.