Prof. Francesco Grande
DDS, MS, PhD
• Graduated cum Laude in Dentistry at the University of Bologna, he completed a second-level Master’s degree in Oral Surgery and Implantology. He obtained a PhD in Digital Prosthodontics at the Polytechnic University of Turin.
• He served as Adjunct Professor in Dental Materials at the University of Ferrara, where he continues to maintain active scientific and teaching collaborations.
• He is an Editorial Board Member of Digital Dentistry Journal and BMC Oral Health, a member of the Italian Board of the Digital Dentistry Society (DDS), an active member of SIDOC, and an Honorary Member of IDEA.
• Author of more than 40 articles in the last 5 years published in indexed international peer-reviewed journals, his clinical and research activity is mainly focused on fixed prosthodontics, implant, oral surgery and digital workflows.
introduction
introduction
The integration of digital technologies across various dental specialties—from cone-beam computed tomography and orthodontic planning to guided implant surgery and advanced prosthodontics—has revolutionized the field. These innovations enable clinicians to streamline workflows, reduce treatment times, and maintain high standards of precision, function, and aesthetics.
In particular, 3D printing has become a viable alternative to traditional subtractive methods, especially in time-sensitive, in-office procedures. Systems like the Dfab TSLA 3D laser printer with Photoshade technology allow for the rapid fabrication of both functional and aesthetic restorations directly within the dental office. Supported by both in vitro and clinical retrospective studies, this technology offers exceptional speed and precision, making it particularly well-suited for immediate restoration in single-visit treatment protocols.
This clinical report describes a fully digital, chairside workflow for the immediate restoration of two teeth using 3D-printed crowns. The process encompasses diagnosis, digital impressions, crown design, and in-office fabrication, all of which are completed in a single session. This approach demonstrates how digital tools and 3D printing technology can optimize clinical efficiency, meet patient expectations, and deliver high-quality prostheses on the same day.
Case report
Case report
A 65-year-old patient presented with the left first and second maxillary molars, which had undergone multiple treatments in the past and were currently restored with old crowns. The crowns showed marginal leakage, secondary caries, and wear. The patient sought a more permanent solution and had no time to perform conventional prosthodontic treatment. They asked that the treatment be completed as quickly as possible. Digital radiographs were taken, and a treatment plan was developed and discussed with the patient.
After the removal of the compromised crowns and carious tooth structure, endodontic treatments were performed. The teeth were restored by placing a post inside the root canals when needed. Initially, a provisional restoration—a fixed partial denture covering two teeth—was fitted chairside. Then, once the endodontic and restorative treatments were completed, full coverage preparations were performed (Fig. 1A, B). A tissue management procedure, using a retraction paste with hemostatic action, was then performed to ensure clean, visible preparation surfaces and provide clear margins for precise digital impressions.
The digital workflow began with an intraoral scan of the maxillary and mandibular arches using the Trios 3 POD scanner (3Shape), employing the pre-preparation scan function with the provisional inside the patient’s mouth. After the tooth preparations were finalized, the left first and second maxillary molars were rescanned.
Once the digital impressions were acquired, they were transferred to the computer for prosthetic crown design (computer-aided design [CAD]). In this case, the Trios Design Studio (3Shape) software was employed to design the crowns. The emergence profiles, axial contours, and occlusion were finalized before saving the designs as a standard tessellation language file (.stl). This file (Fig. 2) was then transferred to the Dfab TSLA 3D laser printer (Fig. 3) for direct printing.
Equipped with Photoshade technology, the Dfab TSLA 3D laser printer enables high-resolution reproduction with aesthetic color gradients that harmonize with the patient’s natural dentition. The crowns were printed using a 42% ceramic-filled hybrid composite, Irix Max (RD Printing), a biocompatible material validated for intraoral applications. The printing process took approximately 22 minutes, allowing for the rapid fabrication of the desired high-strength hybrid polymer crowns.
“TSLA enhances printing speed and reduces the need for large support structures, improving both efficiency and print quality.”
TSLA Printing Technology Insights
TSLA Printing Technology Insights
The Dfab TSLA 3D laser printer utilizes a unique tilted stereolithography (TSLA) technology designed for chairside manufacturing. Unlike traditional stereolithography, TSLA uses an inclined build platform and a moving high-viscosity resin, which creates a cascade effect that ensures even mixing of heavy fillers during printing (Fig. 4). This innovation enhances printing speed and reduces the need for large support structures, improving both efficiency and print quality. Once the CAD data is loaded into the Photoshade software, the crowns are auto-positioned for optimal accuracy and fit (Fig. 5A, B). This system enables the operator to adjust the color gradient to match the patient’s natural tooth transitions, with the cervical and incisal areas carefully defined to achieve the best aesthetic results (Fig. 5C, D). The print process begins with a UV laser selectively polymerizing the composite material layer by layer, building the crown from the base up (incisal/occlusal to cervical).
TSLA Printing Technology Insights
TSLA Printing Technology Insights
After printing (Fig. 6), the restoration underwent the standard finishing steps:
1. Washing: The crown was washed with 95% ethanol (Fig. 7A-D) to remove residual composite material, ensuring accuracy and maintaining the precision of the print.
2. Support Removal: The support structure was easily detached using a twisting motion, facilitated by the patented “easy break” system.
3. Post-Curing: The restoration was then placed in a dual-energy (UV light and heat) curing unit (Dcure, RD-Printing) for a nine-minute cycle to maximize material conversion and mechanical properties (Fig. 8A, B).
4. Finishing and Polishing: The margins were finished and polished using diamond-impregnated polishers (Diacomp, EVE) at low speed (≤8,000 rpm) to ensure smooth surfaces with better resistance to plaque adhesion (Fig. 9).
“The restoration was then placed in a dual-energy curing unit for a 9-minute cycle to maximize material conversion and mechanical properties.”
The clinical try-in confirmed excellent marginal adaptation and passive fit, integrating seamlessly with adjacent teeth. The intaglio surfaces were sandblasted with 50 µm Al₂O₃ powder at 2.0 bar for 10 seconds to enhance the adhesion of the luting cement. The operative field was isolated, and after internal steam cleaning, the restoration was cemented using a dual-polymerized resin cement and corresponding adhesive bonding system, following the manufacturer’s guidelines (Fig. 10A, B). Minimal occlusal adjustments were necessary, and final polishing was performed with diamond-impregnated wheels for an excellent finish without splattering. The patient was discharged with full functional restoration achieved in a single appointment. Post-treatment follow-up confirmed the patient’s high satisfaction with both the comfort and aesthetics of the restorations.
Discussion and Conclusion
Discussion and Conclusion
Material and Print Performance
The Photoshade technology employed in the Dfab TSLA 3D laser printer enabled high-quality, aesthetic reproduction with realistic color gradients. The rapid printing and post-processing times make this system significantly faster than traditional milling or laboratory-based 3D printing, making it ideal for immediate chairside applications.
Clinical Relevance
This case report demonstrates that 3D printing technology can facilitate the delivery of high-precision, functional crowns in a single visit. Using the Dfab TSLA 3D laser printer, which incorporates Photoshade technology, clinicians can produce prostheses that are both structurally stable and aesthetically pleasing, reducing the traditional time required for prosthetic delivery. This case highlights the potential of chairside additive manufacturing to streamline workflows, enhance patient satisfaction, and improve the quality of care. As 3D printing technologies and materials continue to advance, single-visit prosthetic solutions are expected to become the new standard in modern dental practices, offering increased speed, precision, and personalization.
Final Remarks
This report highlights the growing potential of 3D printing in modern dentistry, especially in providing same-day, high-quality restorations.
The integration of the Dfab TSLA 3D laser printer into the chairside workflow not only improves clinical efficiency but also meets the rising patient demand for immediate, reliable dental care.
References
1) Alammar A, Att W, Beuer F. The Accuracy of 3D-Printed Fixed Dental Restorations. J Esthet Restor Dent 2024 Dec 8. doi: 10.1111/jerd.13365.
2) Dede, D.Ö., Zeller, D. K., Demirel, M., Al Johani, H., Schimmel, M., Çakmak, G., Yilmaz, B., & Donmez, M. B. (2025). Effect of manufacturing trinomial and preparation design on the fabrication and fit accuracy of additively and subtractively manufactured resin-based overlay restorations. Journal of Dentistry, 157, 105687.
3) Demirel, M., Donmez, M. B., Çakmak, G., Dede, D. Ö., Hinz, S., & Yilmaz, B. (2025). Effect of manufacturing trinomial and restoration thickness on the fabrication trueness, fit, and margin quality of additively manufactured resin-based ultrathin laminate veneers. Journal of Dentistry, 155, 105606.
4) Mangano, F. G., Mangano, C., Loktionova, M., Dudnik, O., Malanova, O., Elovskaya, A., Maltseva, A., & Dybov, A. (2025). Additively manufactured hybrid composite implant-supported restorations: A retrospective clinical study of 145 patients with up to 2 years of follow-up. Journal of Dentistry, Advance online publication, 105999.
5) Mangano, F. G., Yang, K. R., Lerner, H., Porrà, T., Khachatryan, L. G., Gordienko, I. D., & Admakin, O. (2024). 3D printed short-span hybrid composite implant-supported restorations fabricated through tilting stereolithography: A retrospective clinical study on 85 patients with 1 year of follow-up. Journal of Dentistry, 147, 105095.