Page 28 - GP Spring 2025

Combining Direct Composite and 3D Printed Resin for

Esthetic Enhancement: A Visual Essay

Author: Arthur R. Volker, DDS, MSc, MSEd

Introduction:
There are many potential patients who would benefit from en-
hanced esthetics or an improved occlusal scheme but cannot afford
indirect ceramic restorations to accomplish this. Direct composite
stands as a viable option but is often thought to be too difficult and
technique sensitive for predictable success. This case presentation
will demonstrate the use of direct composite in conjunction with a
3D printed Maryland bridge to address such a concern.

Case Presentation:
The patient was a 19-year-old female in good overall health. She
was unhappy with the appearance of her smile. She had a history
of orthodontic treatment, was congenitally missing tooth #10, and Figure 3. Frontal view of intra-oral scan.
#7 was peg-shaped. Due to the patient’s age, considerations for
an implant in #10 would be delayed until developmental growth
was complete. In the interim, the treatment plan was for a poly-
chromatic direct composite veneer on tooth #7. A resin Maryland
bridge from #9-11 would be printed. As printers can only currently
generate monochromatic restorations, the bridge would be further
characterized with composite tints and opaquers to match the sur-
rounding dentition.

Procedure:

Figure 4. Digital design of #7 and 10 (3Shape Design Studio).

Figure 1. Pre-operative presentation.

Figure 5. Using pumice to clean prepared areas on #9 and 11.

Figure 2. Occlusal view of intra-oral scan (Trios, 3Shape).

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