Advanced digital workflows and additive manufacturing are transforming the field of restorative dentistry. In this feature, we highlight a full-mouth rehabilitation case managed by Dr. Guvinder Gakhal, where SprintRay 3D printed crown resin was used to restore a patient with severe generalized tooth wear. Leveraging structured workflows learned through Avant Garde’s education program, the case demonstrates how precision, efficiency, and minimally invasive techniques can deliver outstanding clinical and aesthetic outcomes.
Using 3D Printing to Help Restore Tooth Wear
A 56-year-old male electrician had extensive tooth wear resulting from chronic nocturnal bruxism, which is the habitual grinding or clenching of teeth during sleep. Although the patient was not experiencing any pain, the ongoing loss of tooth height placed him at high risk of pulp exposure, meaning the inner nerve and blood vessels of the tooth could become exposed. Early intervention was important to preserve his natural teeth, prevent more complex restorative challenges in the future, and maintain proper oral function.
From top left to bottom right, 3D printing was able to help mitigate the patients’ extensive tooth wear.
Dr. Gakhal took a patient-centered approach, discussing treatment goals that included protecting the remaining tooth structure, restoring the occlusal vertical dimension, which is the natural distance between the upper and lower jaws when the mouth is closed, and improving aesthetics while keeping the treatment as minimally invasive as possible. The patient’s case presented several challenges, including severely shortened clinical crowns (the visible parts of the teeth above the gum line) with near pulp exposure, alveolar compensation (a change in the position of the jawbone that occurs as teeth wear down and can affect the bite), asymmetrical gingival zeniths (uneven gum heights that affect the smile line), and buccally positioned canines (teeth angled outward toward the cheeks). Each of these required careful planning to achieve a natural and functional result.
Digital Workflow and 3D Printing
The rehabilitation followed a fully digital workflow, beginning with a diagnostic wax-up, which is a digital or physical model that visualizes the planned tooth shapes and positions. This was converted into a trial smile using bisacryl resin, a temporary material that allows patients to preview the proposed design. The trial smile gave the patient an opportunity to approve the planned bite, aesthetics, and speech before moving forward. Once the design was approved, the final STL files were sent to the SprintRay Pro 2 printer for fabrication of the permanent crowns. Post-processing included hand-cleaning with 99% isopropyl alcohol, coating, final curing, polishing, and precise fitting. The cementation process involved careful surface preparation, priming, and final curing under glycerine to ensure an optimal fit and long-term durability.
Advantages of 3D Printed Restorations
While composite resin is traditionally preferred for cases involving tooth wear because it can be easily repaired and requires minimal tooth preparation, 3D printed crowns provided several key advantages in this case. The technology allowed for exceptional accuracy, precise marginal adaptation (the tight fit where the crown meets the edge of the tooth), and improved structural strength. The digital workflow ensured that each crown matched the approved trial design, providing predictable functional and aesthetic results while preserving as much natural tooth structure as possible.
The final product showcases the power of 3D printing within the dental sector.
The patient was immediately pleased with the improved appearance and comfort. Follow-up assessments at two weeks, one month, two months, and three months confirmed that he had successfully adapted to the restored occlusal vertical dimension and new restorations. By preserving enamel and minimizing tooth reduction, this approach reduced the risk of pulpal complications (inflammation or irritation of the tooth nerve) while optimizing patient comfort and long-term oral health.
Dr. Gakhal reflected on the benefits of integrating digital workflows and SprintRay 3D printing into complex wear cases. He noted that this approach enhanced collaboration between clinical and laboratory teams, preserved natural tooth structure, and delivered predictable, long-lasting, and aesthetically pleasing results. The case also provided valuable insights into the long-term performance of 3D printed restorations in complex rehabilitations. With the introduction of ceramic-dominant resins, which are resins reinforced with ceramic particles for greater strength, future applications are expected to offer even more durability while maintaining accuracy, repairability, and the advantages of minimally invasive treatment. Although further studies are needed to evaluate long-term outcomes, this case highlights the strong clinical potential of 3D printed definitive restorations.
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*Cover Photo Credit: VistaDent / *Photo Credits for All Images Except Graph: Guvinder Gakhal