Utsumi Yuta, Watanabe Keiichiro, Matsuki Sooha, Sakamaki Takuma, Tanaka Eiji, Hosaka Keiichi
J Adhes Dent. 2025 Aug 18;27:155-161. doi: 10.3290/j.jad.c_2213.
Orthodontic treatment often requires anatomical tooth reconstruction for esthetic and functional reasons. Direct resin composite (RC) restorations, which preserve tooth structure while providing high bond strength, are widely used. Recently, orthodontic treatment plans increasingly incorporate RC restorations for correction of tooth form. This report presents a case in which RC injection, aided by a digital workflow, successfully restored lost canine morphology.
An intraoral scanner was used to obtain optical impressions and occlusal records, which were then imported into a computer-aided design (CAD) system for analysis using a virtual articulator. Lateral movements were simulated in the virtual articulator to replicate occlusal contacts. Subsequently, a digital wax-up was used to fabricate a 3D-printed model, and a transparent silicone index with designated openings for RC injection was created. A flowable RC (Filtek™ Supreme Ultra Flowable Restorative, Solventum) was injected through the incisal access opening of the index.
By utilizing a clear index designed through the digital workflow, the wear of the canine teeth was efficiently restored using the injection technique. Evaluation of occlusal guidance with a digital articulator revealed that minimal morphological adjustment was required, resulting in a significant reduction in chair time. At the two-year follow-up, the clinical outcomes remained highly favorable.
Preoperative occlusal simulations enable precise transfer of tooth form, enhancing clinician-technician communication and reducing chair time. Despite requiring additional visits for index fabrication and specialized equipment, digital workflow-assisted RC injection guarantees esthetic and functional outcomes.
出于美观和功能方面的原因，正畸治疗常常需要进行牙齿解剖结构重建。直接树脂复合材料（RC）修复体在保留牙齿结构的同时能提供较高的粘结强度，因而被广泛应用。近来，正畸治疗方案越来越多地纳入RC修复体以矫正牙齿形态。本报告介绍了1例通过数字工作流程辅助进行RC注射成功恢复缺失犬齿形态的病例。
使用口腔内扫描仪获取光学印模和咬合记录，然后将其导入计算机辅助设计（CAD）系统，利用虚拟牙合架进行分析。在虚拟牙合架中模拟侧向运动以复制咬合接触。随后，使用数字蜡型制作3D打印模型，并制作带有用于RC注射的指定开口的透明硅橡胶导板。通过导板的切端开口注射流动性RC（Filtek™ Supreme Ultra Flowable Restorative，Solventum）。
通过利用数字工作流程设计的透明导板，采用注射技术有效恢复了犬齿的磨损。使用数字牙合架评估咬合引导发现，所需的形态调整极少，从而显著减少了诊疗椅旁时间。在两年随访时，临床结果仍然非常理想。
术前咬合模拟能够精确转移牙齿形态，加强临床医生与技师之间的沟通并减少诊疗椅旁时间。尽管制作导板和使用专用设备需要增加就诊次数，但数字工作流程辅助的RC注射可确保美观和功能效果。
