A Simulation‐Based Comparison of Freehand and Clear Mold‐Guided Anterior Composite Restorations Placed by Dental Students
Princy Thakkar, Ting‐Chia Liu, Pouya Sabanik, Snigdha Gummadi, Nathaniel C. Lawson, Augusto A. RoblesABSTRACT
Objectives
To compare the esthetic outcomes, geometric accuracy, and procedural efficiency of maxillary anterior composite restorations fabricated using a conventional freehand technique and a clear mold‐guided technique on typodonts in a controlled, within‐subject educational model.
Materials and Methods
Twenty‐one clinical‐level dental students restored maxillary anterior teeth (#7–10) on duplicate typodonts using both techniques in a randomized, within‐subject simulation study. For the freehand technique, restorations were completed using conventional composite placement and contouring procedures. For the mold‐guided technique, a transparent mold generated from a digital wax‐up guided composite placement and tooth morphology. Restoration time was recorded. Completed restorations were evaluated independently by three blinded faculty members using a standardized esthetic assessment. Geometric accuracy was quantified by comparing intraoral scans with a reference model using root mean square (RMS) deviation analysis. Data were analyzed using paired statistical tests ( α = 0.05).
Results
Inter‐rater reliability for esthetic evaluation was excellent (ICC = 0.925). The clear mold‐guided technique produced significantly higher esthetic scores than the freehand technique across all parameters and for the overall esthetic score ( p < 0.001). Geometric accuracy was significantly improved, with lower RMS deviation values (0.29 ± 0.06 mm vs. 0.43 ± 0.07 mm; p < 0.001). Procedural efficiency was also enhanced, requiring less time to complete (92.25 ± 15.53 min vs. 135.81 ± 20.15 min; p < 0.001).
Conclusions
Compared with the freehand technique, the clear mold‐guided technique produced higher esthetic scores, lower RMS deviation values, and reduced procedure time, more accurately reproducing the planned tooth morphology while requiring less operator time.