PATIENTS: This case report presents a minimally invasive approach to replace a missing mandibular lateral incisor using a dual-injection molding technique with flowable composite resins. Integrated with a comprehensive digital workflow, this method achieves a structurally and esthetically biomimetic, bi-layered prosthetic solution. A 34-year-old woman with congenital absence of a mandibular lateral incisor was successfully rehabilitated using a direct composite resin-bonded fixed partial denture (RBFPD). DISCUSSION: Two specialized three-dimensional (3D)-printed flexible indices stabilized by a custom-designed 3D-printed rigid holder were employed to ensure the meticulous injection molding of flowable composite resins formulated to emulate the inherent chromatic gradations between dentin and enamel. The inherent flexibility of the indices, combined with the holder, facilitated accurate and seamless adaptation to the complex morphological features of the dental arch, thereby mitigating the challenges commonly associated with rigid 3D-printed resin indices. CONCLUSIONS: The bilayered direct composite RBFPD using 3D printed flexible indices prepared with a full digital workflow has several advantages over other dental prosthetic solutions, including noninvasiveness, cost-effectiveness, biomimetic esthetics, repairability, and shortened treatment times. Although the initial results are promising, further longitudinal studies with larger patient cohorts are required to confirm the long-term efficacy of this approach.

Department of Dental Laboratory Tokushima University Hospital Tokushima Japan

Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology Cambridge USA

Department of Mineralized Tissue Biology The ADA Forsyth Institute Cambridge USA

Department of Oral Medicine Injection and Immunity Harvard School of Dental Medicine Boston USA

Department of Orthodontics and Dentofacial Orthopedics Tokushima University Graduate School of Biomedical Sciences Tokushima Japan

Department of Periodontology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

Department of Regenerative Dental Medicine Tokushima University Graduate School of Biomedical Sciences Tokushima Japan

Division of Interdisciplinary Research for Medicine and Photonics Institute of Post LED Photonics Tokushima University Tokushima Japan

Institute of Dental Medicine 1st Faculty of Medicine of the Charles University and General University Hospital Prague Prague Czech Republic

The Research Laboratory of Electoronics at Massachusetts Institute of Technology Cambridge USA

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