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Case report demonstrates successful minimally invasive restoration in severe dental fluorosis, indicating predictable aesthetic and structural outcomes.
A comprehensive preoperative evaluation was conducted for a patient with severe dental fluorosis exhibiting anterior tooth discoloration, morphological anomalies, midline deviation, diastemas, and canine crossbite. After multidisciplinary consultations in orthodontics and prosthodontics, direct composite resin restoration was selected as the definitive treatment. This case aims to propose a minimally invasive restoration strategy aligned with Chinese aesthetic standards for patients presenting with chromatic, morphological, and dental arch spatial aesthetic defects. For chromatic correction, resin infiltration technology was employed to optimize tooth shade. To address morphological irregularities and spatial discrepancies, a digital workflow was implemented, comprising sequential procedures: digital smile design (DSD), computer-aided diagnostic wax-up, 3D-printed model fabrication, and transparent silicone guide production. Guided flowable composite injection was achieved through synergistic application of a customized silicone index and bioclear matrix systems, ensuring precision, efficiency, and reproducibility. Under the dual-guide technique, the esthetic deficiencies in color, morphology, and dental arch space within the anterior dentition have been effectively ameliorated. Besides, four Chinese aesthetic parameters were successfully achieved: 1) uniform dental proportion, 2) natural tooth whiteness (Vita Classic A2 shade), 3) harmonious facial integration, and 4) minimally invasive intervention (≤0.5 mm enamel reduction). The restoration demonstrated exceptional structural integrity and color stability throughout a 12-month follow-up period, as verified by standardized photographic documentation and spectrophotometric analysis. The final result achieved a mutually satisfactory outcome for both doctors and patients. Digital workflow-driven template guidance streamlines complex aesthetic rehabilitation, offering minimally invasive strategies aligned with Chinese aesthetic principles.
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Sun et al. (2025) studied this question.
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