Dávila-Sánchez Andrés, Fahl Newton
Department of Restorative Dentistry and Dental Materials, Universidad San Francisco de Quito, USFQ, Quito, Ecuador.
Clinical and Scientific Director, Fahl Center, Curitiba, Brazil.
J Esthet Restor Dent. 2025 Jul;37(7):1632-1644. doi: 10.1111/jerd.13430. Epub 2025 Mar 2.
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.
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.
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.
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.
本临床报告旨在阐明直接-间接技术的多功能性和中期效果。它根据多色分层技术的原则，提出了一个全面的逐步方案，用于在各种临床情况下修复前牙列。
本临床报告分为两个阶段。首先，由于10号牙临时修复体脱粘而进行了紧急处理，随后制作了直接-间接贴面。然后，在六个月的随访预约中，观察到前牙列（8号、9号牙）通过两种技术和针对每颗牙齿使用不同材料实现了完全的美学改善：在8号牙上进行了直接切缘增强，而在9号牙上制作了薄的隐形眼镜型直接-间接修复体片段以改善牙齿形态。对修复体进行了平均24个月的随访，依据以下标准：颜色、磨损、贴合度、边缘变色和完整性。
直接-间接技术在中期随访后显示出最佳临床效果，使其成为传统直接贴面、陶瓷和CAD-CAM材料之外的一种选择。
直接-间接技术扩大了树脂复合材料修复的范围，无论选择何种修复复合材料或贴面类型，都能提供最佳美学性能、广泛适应证和中期使用寿命。
