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Injectable technique in treating tooth wear: digitally guided no-prep composite veneers and tabletops.
Abstract:
The injectable technique is a minimally invasive, fully guided molding procedure that predictably reproduces the functional and esthetic design from the digital model to the final composite restoration. This method utilizes a highly filled flowable composite in combination with a transparent silicone index serving as a mold. Recent advancements in the mechanical and esthetic properties of newly developed flowable composite materials have positioned the injectable technique as a potential treatment option for tooth wear. As a purely additive approach, this technique offers protection by preserving tooth structure while achieving both functional and esthetic goals. A comparison with other direct and indirect techniques is provided. The present case outlines a multidisciplinary approach to the treatment of generalized tooth wear in a young adult patient, with a 3-year follow-up. The step-by-step clinical procedure for both composite veneers and tabletops fabricated using the injectable technique protocol is described. A detailed digital plan is presented, including specific guidelines for designing composite tabletops for oral rehabilitation. Emphasis is placed on the preparation of the final model and the adaptation of the transparent silicone index for optimal intraoral application. Using the double-model technique, the single-veneering concept can be applied, improving index stability and the precision of the interproximal marginal areas, preventing material overflow onto adjacent teeth, and reducing chair time. The advantages of the injectable technique lie in its predictability, repeatability, simplicity, minimal invasiveness, and financial accessibility. This article updates the authors' previous publication in this journal on the composite veneer protocol by presenting a more comprehensive treatment approach in a challenging case.