Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Apr 25;24(1):492.
doi: 10.1186/s12903-024-04228-3.

A comparative study of the use of digital technology in the anterior smile experience

Jiayi Liu #  1 , Maihepireti Maihemaiti #  2 , Lijuan Ren  1 , Mierzhati Maimaiti  3 , Nan Yang  1 , Yuan Wang  1 , Minxiang Wang  1 , Xiaoping Wang  1 , Yating Fu  4 , Zhenhua Wang  5
Affiliations
Randomized Controlled Trial

A comparative study of the use of digital technology in the anterior smile experience

Jiayi Liu et al. BMC Oral Health. .

Abstract

Objectives: this study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations.

Methods: Sixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index.

Results: Based on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction.

Conclusion: Digitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.

Keywords: 3D printing; Crown lengthening; Digital dual positioning guides; Digital smile design (DSD); Gingivoplasty.

PubMed Disclaimer

Conflict of interest statement

The study was approved by the Ethics Committee of Urumqi Stomatological Hospital (WKY-LS-2023–005) and written informed consent was obtained from all patients. And we will do our best to protect the rights and privacy of the subjects, and there is no conflict of interest in the content and results of the study.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Diagnostic wax-up die guide plat (a) Handmade die guide plat (b) Surgical positioning of the die guide plat combined with the "shu" double-armed ruler (c) Crown lengthening surgery with the die guide plat combined with the "shu" double-armed ruler (d) Gingival contouring with a temporary crown made of DMG resin
Fig. 2
Fig. 2
Clinical flowchart of digital compression membrane guide. a Preoperative intraoral photograph (b) 3D printed model after digital design, pressure film fabrication of crown lengthening guide (c) Crown lengthening surgery guided by digital pressure film guide (c) Gingival contouring by wearing a 3D printed temporary crown
Fig. 3
Fig. 3
Dual positioning guide design and performing surgery. a-b Fitting CBCT and oral scan data and design (c) Crown lengthening surgery guided by digital dual positioning guides (c) Gingival contouring by wearing a 3D printed temporary crown
Fig. 4
Fig. 4
a Preoperative (b-c) digital design process (d) Dual positioning of the crown lengthening guide (e–f) Crown lengthening procedure guided by the guide (g) Design of the provisional crown (h) 3D printing of the provisional crown
Fig. 5
Fig. 5
Shaping process of wearing 3D printed temporary crowns (i) Immediately after surgery (j) Wearing temporary crowns for 4 weeks (k) Wearing temporary crowns for 3 months (l) Wearing temporary crowns for 6 months
Fig. 6
Fig. 6
Results of the PES index score.C:control group;E1:experimental group1;E2:experimental group2
Fig. 7
Fig. 7
Results of WES index score.C:control group;E1:experimental group1;E2:experimental group2
Fig. 8
Fig. 8
Comparison of the amount of gingival changes in the three groups.C:control group;E1:experimental group1;E2:experimental group2
Fig. 9
Fig. 9
Comparison of Satisfaction of the Three Groups;a:costs;b:No. of visits;c:comfort of use;d:Restoration profile;e:Restoration Colour;f:overall satisfaction.C:control group;E1:experimental group1;E2:experimental group2
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Balletti C, Ballarin M. Guerra F.3D printing: State of the art and future perspectives. J Cultural Heritage. 2017;26:172–182. doi: 10.1016/j.culher.2017.02.010. - DOI
    1. Lee JY, An J, Chua CK. Fundamentals and applications of 3D printing for novel materials. Appl Mater Today. 2017;7:120–133. doi: 10.1016/j.apmt.2017.02.004. - DOI
    1. Zotti F, Marchesini F, Lanzaretti G, et al. Traditional, 2D and 3D Workflows: what is better for aesthetic rehabilitation of superior anterior teeth? Appl Sci. 2023;13(10):6205. doi: 10.3390/app13106205. - DOI
    1. Belser UC, Grütter L, Vailati F, et al. Outcome evaluation of early placed maxillary anterior single-tooth implants using objective esthetic criteria: a cross-sectional, retrospective study in 45patients with a 2-to 4-year follow-up using pink and white esthetic scores. J Periodontol. 2009;80(1):140–151. doi: 10.1902/jop.2009.080435. - DOI - PubMed
    1. Joda T, Ferrari M, Bragger U. A prospective clinical cohort study analyzing single-unit implant crowns after three years of loading: introduction of a novel Functional Implant Prosthodontic Score (FIPS) Clin Oral Implants Res. 2017;28(10):1291–1295. doi: 10.1111/clr.12955. - DOI - PubMed

Publication types

LinkOut - more resources