A Novel Computer-Aided Method to Fabricate a Custom One-Piece Glass Fiber Dowel-and-Core Based on Digitized Impression and Crown Preparation Data

Purpose Fiber-reinforced composite dowels have been widely used for their superior biomechanical properties; however, their preformed shape cannot fit irregularly shaped root canals. This study aimed to describe a novel computer-aided method to create a custom-made one-piece dowel-and-core based on the digitization of impressions and clinical standard crown preparations. Materials and Methods A standard maxillary die stone model containing three prepared teeth each (maxillary lateral incisor, canine, premolar) requiring dowel restorations was made. It was then mounted on an average value articulator with the mandibular stone model to simulate natural occlusion. Impressions for each tooth were obtained using vinylpolysiloxane with a sectional dual-arch tray and digitized with an optical scanner. The dowel-and-core virtual model was created by slicing 3D dowel data from impression digitization with core data selected from a standard crown preparation database of 107 records collected from clinics and digitized. The position of the chosen digital core was manually regulated to coordinate with the adjacent teeth to fulfill the crown restorative requirements. Based on virtual models, one-piece custom dowel-and-cores for three experimental teeth were milled from a glass fiber block with computer-aided manufacturing techniques. Furthermore, two patients were treated to evaluate the practicality of this new method. Results The one-piece glass fiber dowel-and-core made for experimental teeth fulfilled the clinical requirements for dowel restorations. Moreover, two patients were treated to validate the technique. Conclusion This novel computer-aided method to create a custom one-piece glass fiber dowel-and-core proved to be practical and efficient.