Digitally Guided Soft-Tissue Recontouring Using a 3D-Printed Surgical Stent for Aesthetic Rehabilitation of a Patient With Moderate Dental Fluorosis: A Case Report

Generalized dental fluorosis presents aesthetic challenges due to enamel discoloration, surface pitting, and irregularities. Management often requires correction of both gingival architecture and intrinsic tooth defects. This report describes the use of a digital workflow in a patient with generalized dental fluorosis that includes Digital Smile Design (DSD Company, Madrid, Spain), Exocad dental computer-aided design (CAD) software (Exocad GmbH, Darmstadt, Germany) for mock-up, accurate evaluation of gingival contour, biological width, veneer planning, and a three-dimensional (3D)-printed periodontally guided surgical template for gingivectomy followed by lithium disilicate veneers. A 26-year-old female patient presented with a chief complaint of asymmetrical gingival display and brown discoloration of teeth. Clinical examination revealed generalized dental fluorosis with irregular gingival contours extending from tooth 14 to tooth 24, with probing depths within normal limits (2-3 mm). Extraoral and intraoral photos were used to create a digital smile design. The suggested result was then imported into Exocad software to create a diagnostic mock-up. A 3D-printed surgical guide was fabricated to perform a gingivectomy in accordance with the intended gingival contours. Following healing, minimally invasive preparations were carried out, and the digital design was used to fabricate lithium disilicate veneers. At the 12-month follow-up, a stable and harmonious gingival margin was seen with excellent veneer adaptation without any complications. This association of DSD, CAD-based digital mock-up, 3D printing of surgical guides, and lithium disilicate veneers made a predictable, minimally invasive, and aesthetic rehabilitation in a patient with generalised dental fluorosis.