Four-Year Outcomes of Anterior Pressed Lithium Disilicate Veneers Fabricated from 3D-Printed Burn-Out Patterns: A Clinical Case Report

<b>Background/Objectives:</b> Lithium disilicate (LD) veneers are widely used for minimally invasive anterior rehabilitation because of their favorable optical and mechanical properties. Fully digital workflows have been proposed as alternatives to conventional milling. These approaches combine computer-aided design and manufacturing (CAD/CAM) with 3D-printed burn-out patterns and subsequent heat pressing of LD ingots. However, clinical documentation of multi-unit anterior cases fabricated exclusively through this additive-plus-pressing route remains scarce. This case report aims to describe a fully digital additive-plus-pressing workflow for four maxillary anterior LD veneers and to report 48-month clinical outcomes. <b>Case Presentation:</b> A 52-year-old female presented with esthetic concerns involving the maxillary central and lateral incisors (teeth 11, 12, 21, and 22). After clinical and radiographic evaluation, a minimally invasive veneer-based rehabilitation was planned. Preparations were performed under magnification, and immediate dentin sealing was applied. Digital impressions were obtained with an intraoral scanner, and veneers were designed using CAD software(Exocad DentalDB 3.0 Galway (Exocad GmbH, Darmstadt, Germany). Castable resin patterns were 3D-printed, invested, and heat-pressed using LD ingots, followed by finishing and glazing. Adhesive cementation was performed under rubber dam isolation after hydrofluoric acid etching and silanization of the intaglio surfaces and conditioning of the tooth substrates according to the adhesive protocol, using a dual-cure resin cement. At the 48-month follow-up, all veneers remained intact, with clinically acceptable marginal adaptation, stable color and surface gloss, and no signs of secondary caries or marginal discoloration. The patient reported sustained esthetic satisfaction and comfortable function without postoperative sensitivity. <b>Conclusions:</b> This single-patient report suggests that a fully digital additive-plus-pressing workflow may be clinically viable for high-demand anterior LD veneers, providing favorable medium-term esthetics and patient-centered outcomes with no technical or biological complications. The reproducible protocol described may facilitate the integration of 3D printing and heat pressing into digital veneer rehabilitation and supports further controlled clinical investigations.