A Fully Digital Esthetic Restoration Based On Dynamic Virtual Patient

The virtual patient, combined with intraoral scans (IOS), facial scans (FS), and Cone Beam Computed Tomography (CBCT) data, enables accurate replication of both intraoral and extraoral information, marking a significant advancement in digital dentistry. This case report presents a fully digital workflow for esthetic restorations, utilizing dynamic virtual patient technology to achieve optimal esthetic and occlusal outcomes. A 25-year-old male presented with esthetic concerns regarding the upper anterior teeth, including spacing and morphological abnormalities. IOS, FS, and CBCT data were acquired, and a dynamic virtual patient was constructed using an innovative digital facebow. After a comprehensive analysis of esthetics and occlusion, a virtual wax-up was created, and an intraoral mock-up was performed, with the patient satisfied. The treatment proceeded with minimally invasive tooth preparation guided by the virtual design, and digital impressions were taken. Glass-ceramics were chosen for high-precision milling. Personalized dies, incorporating subgingival tooth morphology, were fabricated using IOS and CBCT data, enabling precise margin polishing. The crowns were bonded intraorally, with esthetics and occlusion closely matching the preoperative design. The 5-year follow-up demonstrated excellent stability in esthetics and occlusion. A novel digital facebow was created for dynamic virtual patient construction, allowing for precise intraoral and extraoral representation. Additionally, personalized dies were fabricated to achieve a smooth transition between crown margins and subgingival tooth structure, promoting long-term periodontal health and stability. Based on dynamic virtual patient, both esthetic and functional restoration can be achieved, resulting in effective and stable outcomes.