Resin Composite Injection Technique With a Digital Workflow To Reconstruct Canine Guidance: A Two-Year Follow-Up

Purpose: 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.
Materials and Methods: 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.
Results: 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.
Conclusions: 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. Keywords: clear index, digital workflow, direct resin composite injection technique, pragmatic esthetics, tooth wear