Evaluation of Clinical Performance, Shade Matching, and Patient Satisfaction of Different Resin Composite Layering Techniques Using 3D Printed Cast

Restoration of anterior fractured teeth (Class IV) presents an aesthetic and technical challenge in restorative dentistry. While direct composite restorations have traditionally relied on free-hand or conventional putty index techniques, recent advances in digital dentistry allow for 3D digital design software and 3D printed casts to create precise palatal guides and optimize anatomical contours and occlusion.

This prospective clinical trial involves 27 adult patients requiring Class IV restorations. Patients are categorized into three equal intervention groups (n=9 each) based on the application technique and resin composite system used: monochromatic layering, complex multichromatic layering, and single-shaded structurally-colored composite. Primary impressions and digital surface scans will be obtained to design missing tooth structures digitally and fabricate 3D printed models. Restoration shade selection will be conducted using both visual and DSLR digital photography techniques. All clinical restorations will be evaluated at baseline, 3 months, 6 months, and 12 months using FDI criteria for clinical performance and shade matching, alongside self-reported patient satisfaction metrics.

Inclusion criteria

• Male or female patients aged 18 years or older.
• Good oral hygiene and healthy periodontal status.
• Presence of sound adjacent teeth and opposing dentition.
• Patients requiring direct Class IV composite restoration in permanent anterior teeth.
• Cooperative patients willing to comply with the follow-up visits (12 months).

Exclusion criteria

• Patients with poor oral hygiene or severe systemic diseases.
• Teeth with pulpitis, periapical lesions, or requiring endodontic treatment.
• Presence of severe bruxism, heavy parafunctional habits, or malocclusion.
• Pregnant or lactating females.
• Heavy smokers or patients with active periodontal disease.