Purpose: This systematic review and meta-analysis investigated the effects of mandibular advancement device (MAD) therapy on temporomandibular disorders (TMDs) in patients with obstructive sleep apnea (OSA).

Study selection: We included 14 clinical studies assessing the signs and symptoms of TMDs in patients with OSA treated with MAD therapy. The analysis was divided into short-term (<6 months) and long-term (≥1 year) follow-up phases. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each study during follow-up. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology, and meta-analysis was conducted using Review Manager version 5.4.

Results: Across the 14 studies included, the average follow-up period was 18.4 months, and the overall certainty of the evidence was rated as very low. Four studies used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), six used the Helkimo Anamnestic Index, and four employed questionnaires. In short-term follow-up, a significant increase in pain-related TMDs was observed, including pain in the temporomandibular joint (TMJ) or masticatory muscles (pain-related TMDs: OR:4.49; 95%CI: 1.46 to 13.81, TMJ or masticatory muscles pain: OR:2.90; 95%CI: 1.26 to 6.71). Conversely, during long-term follow-up, the odds of pain in the TMJ or masticatory muscles were significantly reduced (OR:0.21; 95%CI, 0.05 0.89)

Conclusions: MAD therapy for OSA did not cause long-term adverse effects on the TMJ or masticatory muscles. However, its short-term use may result in pain-related TMDs, highlighting the need to monitor and manage these symptoms during this period.

Purpose: The aim of this systematic review was to analyze the reported flexural strength values of commercially available translucent zirconia materials. Additionally, data were evaluated to assess the impact of different specimen preparations and test methods.

Study selection: This systematic review was conducted according to the PRISMA guidelines. Electronic searches were performed to identify in vitro studies published between January 1, 2013, and March 15, 2025, that reported flexural strength values of translucent zirconia and included the names of the tested materials and manufacturers. Flexural strength values were analyzed to assess the effects of yttria content, specimen processing, surface treatments, and test methods using Kruskal–Wallis analysis of variance (α = 0.05) and forest plots.

Results: A total of 78 laboratory studies met the inclusion criteria. The overall flexural strength values were significantly higher for 4Y-PSZ (803± 233 MPa) than for 5Y-PSZ materials (570 ± 116 MPa) (P = 0.005). Specimen processing, surface treatments, and test methods significantly affected the flexural strength values for 5Y-PSZ (P < 0.001) but not for 4Y-PSZ (P > 0.05).

Conclusions: This systematic review highlights the challenges in comparing the flexural strength values of translucent zirconia owing to differences in processing parameters. Further standardization of test methods and adherence to ISO 6872 would improve comparability. Our findings support the clinical use of 4Y-PSZ for three-unit fixed dental prostheses (FDPs) and 5Y-PSZ for three-unit FDPs in the anterior region based on ISO 6872.

Purpose: To evaluate the effects of various cleaning methods on the bond strength between lithium disilicate (LS₂) ceramics and resin cement under short- and long-term aging conditions using network meta-analysis (NMA) and pairwise meta-analysis (PMA).

Study selection: An electronic search of seven databases (PubMed, Scopus, Embase, Web of Science, Google Scholar, Defense Technical Information Center, and LILACS) with a manual search of the reference lists was conducted for articles published up to March 10, 2025. Eligible studies included those that assessed the bond strength of LS₂, either uncontaminated or contaminated with human saliva, fit-checking materials, try-in paste, or their combinations, using different cleaning methods. Risk of bias was evaluated using the RoBDEMAT tool. A frequentist multivariable random-effects model was used to calculate the effect sizes.

Results: Fifteen studies met the inclusion criteria. Under short-term aging conditions, NMA showed higher bond strengths in the uncontaminated LS₂ group and the contaminated groups cleaned with hydrofluoric acid etching, commercial ceramic cleaning agents, or phosphoric acid etching than those uncleaned or cleaned with water or alcohol. In long-term aging, PMA and NMA exhibited higher bond strengths in the uncontaminated LS₂ group and contaminated group cleaned with phosphoric acid etching than those contaminated groups cleaned with water or alcohol.

Conclusions: Phosphoric acid etching effectively eliminates contaminants, whereas the application of water or alcohol is ineffective. Although ceramic cleaning agents effectively decontaminate surfaces under short-term aging conditions, their performance deteriorates over time, potentially compromising long-term bond durability.

Purpose: This systematic review evaluates the effectiveness of artificial intelligence (AI) models in dental implant treatment planning, focusing on: 1) identification, detection, and segmentation of anatomical structures; 2) technical assistance during treatment planning; and 3) additional relevant applications.

Study selection: A literature search of PubMed/MEDLINE, Scopus, and Web of Science was conducted for studies published in English until July 31, 2024. The included studies explored AI applications in implant treatment planning, excluding expert opinions, guidelines, and protocols. Three reviewers independently assessed study quality using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies, resolving disagreements by consensus.

Results: Of the 28 included studies, four were high, four were medium, and 20 were low quality according to the JBI scale. Eighteen studies on anatomical segmentation have demonstrated AI models with accuracy rates ranging from 66.4% to 99.1%. Eight studies examined AI’s role in technical assistance for surgical planning, demonstrating its potential in predicting jawbone mineral density, optimizing drilling protocols, and classifying plans for maxillary sinus augmentation. One study indicated a learning curve for AI in implant planning, recommending at least 50 images for over 70% predictive accuracy. Another study reported 83% accuracy in localizing stent markers for implant sites, suggesting additional imaging planes to address a 17% miss rate and 2.8% false positives.

Conclusions: AI models exhibit potential for automating dental implant planning with high accuracy in anatomical segmentation and insightful technical assistance. However, further well-designed studies with standardized evaluation parameters are required for pragmatic integration into clinical settings.

Purpose: This systematic review evaluated the clinical performance, physical-mechanical properties, and accuracy of removable partial denture (RPD) frameworks fabricated using three-dimensional (3D) printing technologies—specifically, selective laser sintering (SLS), selective laser melting (SLM), and direct metal laser sintering (DMLS)—compared to those produced by conventional casting or methods using a partial digital workflow.

Study selection: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a literature search was conducted in the PubMed, Scopus, Web of Science, and Cochrane databases in October 2024. Studies were included if they compared the fit, accuracy, mechanical and physical properties, and clinical outcomes of metal RPD frameworks made using 3D printing technologies with those produced using conventional casting or partial digital methods. The risk of bias was assessed using appropriate tools (modified CONSORT, ROB2, and ROBINS-I) based on the study design and a qualitative analysis was conducted. This study received no funding and was registered with PROSPERO (#CRD42024597225).

Results: Thirty studies were included: 12 compared 3D printing technologies with conventional casting, eight with partial digital methods, and 10 with both. Clinically, 3D-printed frameworks could improve retention and patient satisfaction. The laboratory results showed higher density, better mechanical properties (yield strength, surface roughness, and microhardness), and varied accuracy by component and method, with SLM and DMLS often outperforming conventional casting. The evidence was limited by methodological variability, a moderate risk of bias in many studies, and inconsistencies across the study designs and parameters.

Conclusions: 3D-printed RPD metal frameworks demonstrated clinical accuracy and mechanical-physical performance comparable or superior to those of conventional and partially digital methods for RPD frameworks, with ongoing advances expected to further enhance their precision and clinical applicability.

Purpose: To evaluate the color stability of light-cured resin luting agents after artificial aging using an amine-free initiator system.

Methods: Five groups, each with eight samples, were produced. Specimens were divided as follows: two light-cured resin luting agents (PANAVIA Veneer LC; PVL [experimental group] and Variolink Esthetic LC; VEL [control group]), one dual-cured resin luting agent (PANAVIA V5; PV5 [control group]), and one composite resin (ESTELITE Σ QUICK; ESQ [control group]). The samples were divided into five groups subjected to different accelerated aging conditions: Condition 1 (air storage), Condition 2 (water storage), Condition 3 (temperature–moisture combination: as a control for Condition 2), Condition 4 (ultraviolet (UV) aging: to predict the performance in a laminate veneer restoration margin area), and Condition 5 (without UV aging to serve as a baseline control by eliminating environmental factors). Spectrophotometric measurements were performed. Changes in the color (∆E₀₀) and a transparency parameter (ΔTP₀₀) were determined. Data were analyzed using one- and two-way ANOVAs at a significance level of 5%.

Results: PANAVIA V5 in water storage exhibited the highest ΔE₀₀ across all materials, except Variolink Esthetic LC (P < 0.001). PANAVIA Veneer LC under Condition 1 did not show a statistically significant difference in ΔE₀₀ compared to the other materials (P = 1.000). PANAVIA Veneer LC and ESQ showed significantly smaller ΔTP₀₀ values than the other materials (P < 0.001).

Conclusions: Based on the results of this study, PANAVIA Veneer LC shows better color stability, even under artificial aging conditions, which is clinically desirable.

Purpose: To investigate the effect of ceramic material (lithium disilicate, LDS vs. composition-gradient multilayered zirconia [4Y-PSZ and 5-PSZ], Z) and ceramic layer thickness (0.5 mm, 1.0 mm, and 1.5 mm) on fatigue performance and failure load of occlusal veneers on molars.

Methods: Seventy-two CAD-CAM-fabricated occlusal veneer restorations (IPS e.max CAD; IPS e.max ZirCAD Prime Esthetic, Ivoclar Vivadent) were divided into six groups (n=12, LDS-1.5, LDS-1.0, LDS-0.5; Z-1.5, Z-1.0, Z-0.5). Restorations were adhesively cemented (Variolink Esthetic DC, Ivoclar Vivadent) to dentin-analogue composite dies (Z100, 3M ESPE) and exposed to thermomechanical fatigue (1.2 million cycles, 49 N, 1.6 Hz, 5-55° C). Single-load-to-failure was tested with a universal testing machine. Data were analyzed using ANOVA with Tukey post-hoc tests and t-tests (P < 0.05).

Results: The overall success rate across all materials and layer thicknesses was 91.7%. Half of the specimens of group Z-0.5 revealed cracks after chewing simulation. Occlusal veneers fabricated from LDS withstood significantly higher failure loads than gradient multilayered zirconia veneers in all tested thicknesses. The mean failure load values led to the following ranking: 3194 N (LDS-0.5)>2683 N (LDS-1.0)>2338 N (LDS-1.5)>1744 N (Z-1.5)>1310 N (Z-0.5)>1198 N (Z-1.0).

Conclusions: Ultrathin LDS occlusal veneers outperformed thin and standard thick counterparts, as well as gradient multilayered zirconia veneers at all thickness levels. Ultrathin gradient multilayered zirconia occlusal veneers were prone to cracks during thermomechanical fatigue. Individual mechanical properties need to be considered when aligning the restoration within the multilayered zirconia blank.

Purpose: Sleep-disordered breathing (SDB) has received limited attention in stroke rehabilitation, and screening for SDB is inadequate. This study aimed to examine the association between nocturnal hypoxia and functional independence improvement in stroke patients during recovery, with a focus on the potential relevance of SDB in rehabilitation outcomes.

Methods: This prospective cohort study included 89 patients admitted for stroke rehabilitation in Chiba, Japan, between August 2021 and March 2024. SDB was assessed using WatchPAT, focusing on nocturnal oxygen saturation parameters, including the minimum SpO₂ (MinSpO₂) and the oxygen desaturation index at 3% (ODI3%). The functional independence measure (FIM) improvement per day of hospitalization (FIM change rate) was the primary outcome. The covariates included age, sex, body mass index, stroke severity, comorbidities, and levels of consciousness.

Results: Multivariate regression analyses showed that MinSpO₂ was significantly associated with the total FIM change rate (B [95% CI] = 0.008 [0.003–0.012], P = 0.001) and had a standardized coefficient of 0.337, whereas ODI3% showed no significant association. MinSpO₂ was associated with both motor and cognitive FIM change rates.

Conclusions: Nocturnal hypoxia is associated with functional recovery in patients with stroke, highlighting the importance of sleep monitoring in rehabilitation. As a detectable and modifiable factor, it may present opportunities for dental professionals to contribute to patient care through airway assessment and collaborative intervention.

Purpose: To evaluate the clinical use of CAD/CAM hybrid ceramics in patients with severe tooth wear.

Methods: Forty-nine patients with severe tooth wear underwent prosthetic management with 116 hybrid ceramic restorations. The restorations were evaluated at 1 week and at 3, 6, 12, 18, 24, 30, and 36 months after placement. The amount of wear on the restorations, antagonist teeth, and opposite teeth was compared using digital superimposition analysis. A questionnaire was used to evaluate participants’ satisfaction with the restorations. Complications were recorded, and survival rates were estimated using Kaplan–Meier analysis.

Results: The clinical performance of the restorations was stable for esthetic, functional, and biological parameters up to 3 years, except for greater changes in “surface and margin staining” and “fracture and retention.” There was no significant difference in the amount of progressive wear among the restorations, antagonist teeth, and opposite side teeth until 18 months; however, the wear on the restorations increased gradually up to 36 months. Higher scores and identical satisfaction results were obtained for the chewing efficiency and cleanability during the observation period. The most common complications were restoration dislodgement (5.2%) and partial marginal chipping (4.3%), which were clinically repaired. Four restorations (3.4%) were extensively fractured and replaced. The estimated survival rate of the hybrid ceramic restorations at 3 years was 88.0%.

Conclusions: The clinical use of hybrid ceramic restorations in patients with severe tooth wear improved chewing efficiency and esthetics, provided adequate resistance for load-bearing, and delivered a stable treatment outcome after functional use.

Purpose: This in vitro study evaluated the adaptation and fracture resistance of screw- and cement-retained implant-supported restorations using lithium disilicate crowns cemented onto titanium bases and universal abutments of different heights.

Methods: Thirty crowns were designed, milled, and divided into three groups: TBA (titanium base abutment - 4.7-mm-height and 4.65-mm-diameter), UA-4 (universal abutment - 4.0-mm-height and 4.5-mm-diameter), and UA-6 (universal abutment - 6.0-mm-height and 4.5-mm-diameter) (n=10). The abutments were placed in a mandibular first premolar model, torqued to 20 Ncm, and scanned using a digital intraoral scanner. The crowns were designed and fabricated using computer-aided design/computer-aided manufacturing technology. Adaptation was assessed using a stereomicroscope before and after ceramic sintering and after cementation with RelyX Ultimate resin cement. Fracture resistance was evaluated using a universal testing machine, and the failure modes were analyzed. The collected data were subjected to statistical analysis using one-way ANOVA and the Tukey least significant difference test (α=0.05).

Results: The abutment type influenced restoration adaptation and fracture resistance. No differences in adaptation were found before or after luting (P > 0.05). However, after sintering, the TBA group exhibited smaller marginal gaps than the UA-4 (P = 0.0339) and UA-6 (P = 0.0006) groups. TBA showed a higher fracture resistance than UA-4 (P = 0.0093); no differences were observed between TBA and UA-6 or between UA-4 and UA-6 (P > 0.05). The UA-4 and UA-6 groups showed higher ceramic fracture rates, whereas the TBA group showed increased abutment deformation and ceramic fractures.

Conclusions: The type and height of abutments influenced the fracture of screw-and-cement-retained implant-supported restorations.

Purpose: To assess the predictability of using the roots of the maxillary anterior teeth in advantageous positions to guide immediate implantation and enhance the positioning precision of placed implants.

Methods: Existing root canals were used in the test group for manual preparation of the implant bed, whereas traditional freehand techniques were employed in the control group. The three-dimensional position of the placed implants was measured using radiological images taken on the day of surgery and again six months post-surgery and evaluated using self-developed rating criteria for the radiographic positions of the implants. The spatial relationship between the axial orientation of the implant and prosthetic crown was assessed using a self-developed scoring scale. Statistical analysis of the three-dimensional positional imaging scores of the implants was conducted immediately after surgery and at six months post-implantation. Intergroup statistical analysis was conducted on the scores reflecting the spatial relationship between the axial orientation of the implants and their prostheses.

Results: The test group demonstrated significantly higher scores for the labial-palate and horizontal positions, both immediately following surgery and at six months post-implantation, than the control group. Furthermore, the test group significantly outperformed the control group in terms of scores reflecting spatial relationships.

Conclusions: Utilizing the roots of the anterior teeth in advantageous positions as guides for preparing implant beds can lead to more ideal implant placement than traditional manual techniques.

Purpose: This study aimed to evaluate the performance of 3D-printed denture base resins (DBRs) compared with conventionally packed and milled DBRs, examine their biofilm formation and physical properties, and determine the viability of 3D-printed DBRs as a superior alternative in removable prosthodontics.

Methods: The DBR samples were fabricated using traditional packing (TRA), milling (MIL), and 3D printing (3DP) methods. All samples were serially polished with an abrasive paper. Biofilm formation was assessed using SYTO 9 and propidium iodide staining as well as confocal laser scanning microscopy. Color and dimensional stability were evaluated following immersion in artificial saliva, and volumetric changes were assessed after the samples were subjected to thermocycling (TC) and highly accelerated stress (HA) aging. Statistical analyses were conducted using one-way analysis of variance with post-hoc Tukey’s honestly significant difference test (α = 0.05).

Results: MIL exhibited the highest Aggregatibacter actinomycetemcomitans biofilm coverage (94.59%), whereas 3DP exhibited the lowest coverage (58.86%). All DBRs exhibited slight perceptible color changes after immersion in artificial saliva, with 3DP demonstrating the least dimensional changes (2.86%). Following TC and HA aging, all DBRs experienced a volume increase, with TC inducing greater volumetric changes (2.8%–3.9%) than HA (0.8%–2.4%); however, the difference was not statistically significant (P < 0.05).

Conclusions: The 3D-printed DBRs demonstrated superior resistance to biofilm formation, along with good color and dimensional stability. These properties indicate strong potential for enhanced hygiene maintenance, esthetics, and long-term clinical performance in denture applications.

Purpose: This study evaluated the effects of two additive manufacturing technologies and three orientations on the accuracy of three-dimensional (3D)-printed complete dentures. Additionally, we examined whether resin differences affected the accuracy of the denture bases under varying printing systems and orientations.

Methods: We printed denture bases using digital light processing (DLP) and a liquid crystal display (LCD) in three orientations (0°, 45°, and 90°) with two photopolymer resins (n = 6). Intaglio surfaces were scanned to obtain experimental data. We evaluated trueness by superimposing experimental data onto master data, and assessed precision by pairing and superimposing two of the six datasets. Deviation was evaluated using root mean square (RMS) and color map data. Statistical analysis was conducted using the Kruskal–Wallis method and Mann–Whitney U test (α = 0.05).

Results: The DLP printer achieved the highest trueness at an orientation of 90°, whereas the precision was minimally affected by the orientation or printing systems. DLP printers performed well with both recommended and non-recommended resins; however, LCD printers demonstrated better accuracy with the recommended resins. At 0° orientation, the trueness color map for both printers showed negative deviation patterns over the entire palatal surface. Across all manufacturing methods, the precision color maps indicated high reproducibility.

Conclusions: Printing system and orientation affect the trueness of 3D-printed dentures. DLP printers set at 90° demonstrated superior trueness for clinical applications. The accuracy was affected by resin, printer, and orientation.

Purpose: To evaluate and compare the effect of bulb wall thickness and build angle on the trueness and weight of an open-hollow obturator fabricated using digital light processing (DLP) technology.

Methods: A 3D model of an edentulous maxillary jaw with an Aramany Class I defect was designed using computer-aided design (CAD) software, and 45 obturators with bulb wall thicknesses of 1, 2, and 3 mm were fabricated using a DLP printer at build angles of 0, 45, and 315 degrees, respectively. The weight of each obturator was measured. All obturators were scanned using cone-beam computed tomography, and the data were converted to the standard tessellation language format. The CAD and scanning data were superimposed for inspection. Statistical analysis was performed using two-way analysis of variance (ANOVA) and Tukey’s test.

Results: The two-way ANOVA showed a significant effect of the build angle on the denture base (P < 0.001); however, the bulb wall thickness had no significant effect (P = 0.73). Both the bulb wall thickness and build angle significantly affected the inner and outer bulb surfaces (P < 0.001), and a significant interaction between these factors was observed (P < 0.05). Significant differences were observed between bulbs (P < 0.001). Additionally, weight was significantly affected by both factors and their interactions (P < 0.001).

Conclusions: The bulb wall thickness and build angle significantly influenced the trueness and weight of the open-hollow DLP obturator, with the least error observed at a zero-degree build angle.

Purpose: To evaluate how the depth of the intaglio surface on the denture and the scanning method influence the trueness using two types of intraoral scanners (IOS) for complete dentures.

Methods: Four complete denture types (Extra-deep, Deep, Moderate, Shallow) with varying intaglio surface depths (Extra-deep > Deep > Moderate > Shallow) for the maxilla and mandible were designed using two computer-aided design software, resulting in 8 denture models. Reference data were obtained using a laboratory scanner (D2000). Each denture was scanned eight times using two IOSs: a confocal microscopy-based scanner (Trios 5) and a dual-triangulation-based scanner (i700), resulting in 64 scans per IOS (128 scans in total). Scan data were superimposed using three-dimensional editing software, and the root mean square (RMS) was calculated to assess trueness. Statistical analyses included the Shapiro-Wilk test for normality and two-way analysis of variance with Bonferroni correction (α=0.05).

Results: For Trios 5, the RMS value for the Extra-deep was significantly higher than that for the Moderate and Shallow in both the maxilla and mandible. Furthermore, the Deep showed significantly higher RMS values than the Shallow in the maxilla. For i700, the RMS values did not significantly differ among the denture types. Across all denture types, the RMS values for i700 were significantly higher than those for Trios 5.

Conclusions: The depth of the intaglio surface on the denture influenced trueness when using the Trios 5. The Trios 5 showed higher trueness than the i700 did across all denture types.

Purpose: This study aimed to investigate the characteristics of jaw movement trajectories in the horizontal plane and the maximal activities of the masseter muscle during grinding events associated with rhythmic masticatory muscle activity (RMMA), as a potential biomarker for the diagnosis of sleep bruxism.

Methods: The biological signals and jaw movement data of eight participants were recorded using a custom-developed intraoral sensor, a six-degree-of-freedom magnetic jaw-tracking device, and polysomnography. These recordings were synchronized using Global Positioning System time data. Jaw movement data during grinding events were compared with simulated grinding (lateral excursion) data obtained before sleep, focusing on deviations from the anteroposterior direction in the horizontal plane. Additionally, the timing of the maximal masseter muscle activity was examined.

Results: No sleep disturbances were reported by the participants. During tooth grinding, the jaw movement trajectories of the lateral excursions in the horizontal plane frequently deviated from the simulated grinding trajectories, indicating variability among participants. Notably, the deviations were more pronounced during lateral excursions to the lateral side, with movements diverging both anteriorly and posteriorly from the simulated grinding trajectories. Regarding the masseter muscle activity, greater activity was observed on the balancing side. Peak masseter muscle activity increased when the jaw movement trajectories deviated posteriorly from the simulated grinding trajectory, on both the working and balancing sides.

Conclusions: Excursions deviating posteriorly during RMMAs from the simulated grinding were associated with significantly greater masseter muscle activity than either excursions deviating anteriorly or those along the simulated grinding trajectory.

Patients: A 56-year-old man with a left-sided cleft lip and palate was referred to our department due to mastication and speech difficulties. His existing prostheses have become unstable owing to changes in the remaining dentition over 10 years. For the fabrication of the new interim maxillofacial prostheses, a digital impression technique was selected as the conventional technique posed medical risks due to hypermobile teeth and maxillary defects. New interim maxillofacial prostheses were fabricated using a combination of the digital impression technique and a bite-seating impression, performed with trial prostheses and impression material. The patient has been using the new interim prostheses comfortably since delivery. The oral functional evaluation yielded favorable results.

Discussion: Patients with cleft lip and palate should use their existing maxillofacial prostheses during the fabrication of new ones, even if they are of suboptimal quality. Although addressing these issues using conventional techniques is challenging, digital technology provides a viable solution. However, impression material is essential for capturing mucosal defects and complex anatomy in cleft lip and palate cases; therefore, digital data should be supplemented by either well-adjusted existing prostheses or bite-seating impressions using impression material before new prostheses fabrication. Although his occlusal force was lower than the criterion for the oral hypofunction test, his masticatory performance remained favorable. Speech analysis revealed persistent air leakage; however, all scores improved with the prostheses.

Conclusions: Digital technology has enabled the safe fabrication of interim maxillofacial prostheses, resulting in improved masticatory and speech performance.

Patients: A 22-year-old female patient presented with a lower right first molar exhibiting an extensive carious lesion beneath an old direct resin composite restoration. Radiographic evaluation revealed pulpal involvement with a periapical infection, accompanied by grade II mobility and a circumferential probing depth of <3 mm. The compromised molar rehabilitation was carried out using a multichromatic 3D-printed onlay. A fully digital workflow was employed, enabling the completion of the procedure in a single clinical session. Following endodontic and restorative treatments, intraoral scans were acquired using a Trios5 scanner. The restoration was digitally designed and 3D printed from STL files using the DWS Systems Dfab printer. The hybrid composite onlay was adhesively luted using a universal self-adhesive resin cement (Panavia SA, Kuraray). Clinical evaluations at 6 months and 1 year demonstrated favorable outcomes, with high patient satisfaction.

Discussion: 3D printing represents a digital evolution in the fabrication of dental restorations, introducing an additive manufacturing approach distinct from the subtractive processes used in traditional CAD/CAM systems. In cases of severely compromised teeth, 3D-printed, adhesively bonded partial restorations represent a viable treatment option. The hybrid composite used in this study demonstrated favorable clinical and esthetic performance, enabling minimally invasive preparations while preserving sound tooth structure.

Conclusions: Chairside 3D printing technology presents an alternative approach for the fabrication of indirect composite restorations in posterior teeth. Although 3D printing is not yet widely adopted in restorative dentistry, its versatility may offer significant advantages for both clinicians and patients in the production of indirect partial restorations.