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采用数字工作流程的复合注射技术:一种用于突出中央门牙修复的实用方法。

Composite Injection Technique With a Digital Workflow: A Pragmatic Approach for a Protruding Central Incisor Restoration.

作者信息

Muslimah Diana F, Hasegawa Yuichi, Antonin Tichy, Richard Foxton, Hosaka Keiichi

机构信息

Department of Regenerative Dental Medicine, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, JPN.

Department of Dental Laboratory, Dental Hospital, Tokyo Medical and Dental University, Tokyo, JPN.

出版信息

Cureus. 2024 Apr 22;16(4):e58712. doi: 10.7759/cureus.58712. eCollection 2024 Apr.

DOI:10.7759/cureus.58712
PMID:38779243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11109782/
Abstract

Esthetic concerns frequently drive individuals to seek dental treatment, leading to a rising demand for minimally invasive and time-efficient procedures. The Minimal Intervention Dentistry (MID) concept, which employs dental adhesive and resin composites, offers an effective approach for enhancing esthetics while preserving natural tooth structure. This case report outlines the esthetic enhancement of a protruding maxillary right central incisor through a direct composite restoration approach, utilizing a composite injection technique with a digital workflow. A 42-year-old male patient presented with a discolored and protruding maxillary right central incisor. After declining orthodontic treatment due to time and cost constraints, the patient opted for an alternative approach. A digital wax-up was 3D printed to create a clear silicone index, enabling precise resin composite injection to achieve the desired esthetic outcome. After internal bleaching and minimal labial surface reduction, a flowable resin composite was applied freehand to the mesial-proximal surface using a curved plastic matrix manufactured universally. The composite injection technique was subsequently employed through the incisal opening of the clear silicone index to shape the labial surface and incisal edge. In order to address insufficient tooth reduction, an additional partial labial resin composite cutback was performed, ensuring minimal reduction while enhancing esthetics. This direct composite veneer restoration, combining conventional proximal surface creation with a composite injection technique utilizing a custom-made clear silicone index prepared via a digital workflow, emerged as a pragmatic solution in a case where orthodontic treatment was not preferred. Moreover, in situations of insufficient dentin preparation, additional cutback preparation and composite placement can enhance color matching with minimal reduction. The direct composite restoration, facilitated by the composite injection technique and digital workflow, effectively rectified the inclination of the protruding maxillary central incisor, highlighting the potential of this approach in addressing esthetic dental concerns. The research and clinical technique presented in this case report hold clinical importance by offering a minimally invasive and practical alternative to orthodontic treatment and conventional restorations for patients with esthetic concerns. The composite injection technique with a digital workflow preserves natural tooth structure, reduces chair time, and enhances esthetic outcomes. This approach is particularly relevant to esthetic dentistry as it addresses anterior dental malalignment and discolored teeth while prioritizing patient satisfaction and individualized care, aligning with the principles of pragmatic esthetics and MID. The potential for long-term durability and patient satisfaction makes it a valuable addition to esthetic dental practice.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/6e7811800628/cureus-0016-00000058712-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/c309b08103e0/cureus-0016-00000058712-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/0af3da4c037d/cureus-0016-00000058712-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/0e3cd5e44f44/cureus-0016-00000058712-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/4e4e9fa564e6/cureus-0016-00000058712-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/6e7811800628/cureus-0016-00000058712-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/c309b08103e0/cureus-0016-00000058712-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/0af3da4c037d/cureus-0016-00000058712-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/0e3cd5e44f44/cureus-0016-00000058712-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/4e4e9fa564e6/cureus-0016-00000058712-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/208e/11109782/6e7811800628/cureus-0016-00000058712-i05.jpg
摘要

美学方面的考虑常常促使人们寻求牙科治疗,导致对微创和高效省时的治疗程序的需求不断增加。采用牙科粘合剂和树脂复合材料的微创牙科(MID)概念,为在保留天然牙体结构的同时提高美观性提供了一种有效方法。本病例报告概述了通过直接复合树脂修复方法,利用复合树脂注射技术和数字化工作流程,对上颌右侧中切牙突出进行美学改善的过程。一名42岁男性患者,上颌右侧中切牙变色且突出。由于时间和成本限制,患者拒绝正畸治疗,选择了另一种方法。通过3D打印数字化蜡型制作了一个透明硅橡胶导板,以便精确注射树脂复合材料,实现理想的美学效果。在进行内漂白和最小限度的唇面磨除后,使用通用制造的弯曲塑料基质,徒手将流动树脂复合材料涂抹于近中邻面。随后通过透明硅橡胶导板的切端开口采用复合树脂注射技术塑造唇面和切缘。为了解决牙体磨除不足的问题,额外进行了部分唇面树脂复合材料的削减,确保在提高美观性的同时尽量减少磨除量。这种直接复合树脂贴面修复,将传统邻面制备与利用通过数字化工作流程制备的定制透明硅橡胶导板的复合树脂注射技术相结合,在患者不倾向于正畸治疗的情况下成为一种切实可行的解决方案。此外,在牙本质预备不足的情况下,额外的削减预备和复合树脂放置可以在尽量减少磨除量的情况下增强颜色匹配。由复合树脂注射技术和数字化工作流程辅助的直接复合树脂修复,有效纠正了上颌中切牙突出的倾斜度,突出了这种方法在解决牙齿美学问题方面的潜力。本病例报告中介绍的研究和临床技术具有临床重要性,为有美学需求的患者提供了一种微创且实用的替代正畸治疗和传统修复的方法。具有数字化工作流程的复合树脂注射技术保留了天然牙体结构,减少了椅旁时间,并提高了美学效果。这种方法与美学牙科特别相关,因为它解决了前牙排列不齐和牙齿变色问题,同时优先考虑患者满意度和个性化护理,符合实用美学和微创牙科的原则。其长期耐久性和患者满意度的潜力使其成为美学牙科实践中的一项有价值的补充。

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Oper Dent. 2023 Sep 1;48(5):483-489. doi: 10.2341/23-007.
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Accuracy of Direct Composite Veneers via Injectable Resin Composite and Silicone Matrices in Comparison to Diagnostic Wax-Up.
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J Funct Biomater. 2023 Jan 5;14(1):32. doi: 10.3390/jfb14010032.
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