Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 05 Nov 2024

3D Printed Dual Reduction Guide: A Feasible Alternative for Conservative Gingivectomy and Minimally Invasive Preparation for Ceramic Veneers

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Page Range: 634 – 641
DOI: 10.2341/24-026-S
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SUMMARY

Objectives:

This case report describes a digital workflow for designing and 3D printing a guide with the dual purpose of gingivectomy and tooth preparation in the esthetic zone, to be followed by cementation of ceramic veneers under rubber dam isolation.

Clinical Considerations:

The patient’s primary concern was to improve her smile. After clinical evaluation, our recommendation was for a minimal gingivectomy to match the gingival zenith for both central incisors, to be followed by ceramic laminate veneers. A digitally designed and 3D printed guide was used for gingivectomy and tooth preparation for the ceramic veneers. Ceramic veneers were cemented under rubber dam isolation to maximize bonding properties.

Conclusions:

A single guide can be digitally designed and 3D printed to perform controlled gingivectomy and minimally invasive tooth preparations. The outcome of the gingivectomy improved the gingival architecture for central incisors, and the ceramic veneers fulfilled the patient’s esthetic demands.

Copyright: 2024
Figure 1.
Figure 1.

Initial situation. (A) Face smiling; (B) Smile; (C) Intraoral view.

Figure 2.
Figure 2.

Digital design for the dual guide. (A) Initial intra-oral scan; (B) Digital wax-up; (C) Frontal view of the guide; (D) Lingual view of the guide; (E) Guide over wax-up frontal view; (F) Guide over wax-up occlusal view.

Figure 3.
Figure 3.

Gingivectomy procedure with the guide. (A) Frontal view with the guide; (B) Lateral view during procedure; (C) Lateral view with scalpel blade.

Figure 4.
Figure 4.

Final preparations with the guide. (A) Tooth preparation with the guide; (B) Measuring preparation depth with periodontal probe; (C) Final tooth preparations and gingivectomy procedure.

Figure 5.
Figure 5.

Final scan of the preparations. (A) Final intra-oral scan; (B) Digital wax-up from intra-oral scan; (C) Overlaying the wax-up—intra-oral view; (D) Overlaying the wax-up—facial view.

Figure 6.
Figure 6.

Bonding of the restorations with rubber dam. (A) Bonding central incisors—frontal view; (B) Bonding central incisors—lateral view; (C) All restorations bonded.

Figure 7.
Figure 7.

Final bonded restorations. (A) Face smiling; (B) Smile; (C) Intra-oral frontal view.

Figure 8.
Figure 8.

At four-years of follow-up. (A) Face smiling; (B) Smile; (C) Intra-oral frontal view.

Contributor Notes

*Corresponding author: Division of Operative Dentistry, Department of General Dentistry, University of Tennessee Health Science Center College of Dentistry, Memphis, TN USA 38163; e-mail: cjurado@uthsc.edu
Accepted: 21 Jun 2024
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