3D-Printed Cementation Guide to Ensure Precise Placement of Dental Restorations

The cementation of dental prostheses is a critical step in treatment, as misplacement can result in marginal gaps, improper occlusion, and may require removal and replacement of the restoration.

A 50-year-old male presented seeking replacement of a missing maxillary left lateral incisor and overall smile improvement. Examination revealed mild incisal wear, a porcelain-fused-to-metal crown on the right central incisor, and a large metal restoration on the left central incisor. While comprehensive treatment was proposed, including veneers, crowns, and an implant, the patient opted to proceed only with the implant and crowns for the central incisors due to financial limitations, using a fully digital workflow. A diagnostic intraoral scan was performed, followed by tooth preparation and implant placement. Digital impressions were used to design both interim restorations and a custom 3D-printed seating guide, which ensured accurate and efficient placement of the restorations. After three months, final digital impressions were taken, and full-contour zirconia crowns were digitally designed and milled. A refined 3D-printed seating guide was again fabricated to aid in precise delivery of the final restorations. The patient was highly satisfied with the functional and esthetic results.

A full-digital workflow for tooth-supported and implant-supported restorations in the esthetic zone successfully met the patient's expectations. The use of a 3D-designed and printed seating guide ensured precise placement of restorations, minimizing errors. This type of guide can greatly assist clinicians in accurately seating restorations and allows for simultaneous placement of multiple prostheses.