This study presents a methodology for developing and validating digital models of tooth-inlay systems, aiming to trace the complete workflow from clinical procedures to simulation by involving dental professionals—dentists for manual cavity preparation and dental technicians for restoration modelling—while integrating micro-computed tomography (micro-CT) imaging with finite element analysis (FEA). The proposed workflow includes (1) the acquisition of high-resolution 3D micro-CT scans of a non-restored tooth, (2) image segmentation and reconstruction to create anatomically accurate digital twins and mesh generation, (3) the selection of proper resin and the 3D printing of four typodonts, (4) the manual preparation of cavities on the typodonts, (5) the acquisition of high-resolution 3D micro-CT scans of the typodonts, (6) mesh generation, digital inlay and onlay modelling and material property assignment, and (7) nonlinear FEA simulations under representative masticatory loading. The approach enables the visualisation of stress and deformation patterns, with preliminary results indicating stress concentrations at the tooth-restoration interface integrating different cavity alternatives and restorations on the same tooth. Quantitative outputs include von Mises stress, strain energy density, and displacement distribution. This study demonstrates the feasibility of using image-based, tooth-specific digital twins for biomechanical modelling in dentistry. The developed framework lays the groundwork for future investigations into the optimisation of restoration design and material selection in clinical applications.

Severely compromised distal teeth present significant challenges in restorative dentistry, necessitating innovative approaches that align with natural biological structures. Biomimetic principles offer a promising framework for reconstruction, emphasizing materials and techniques that mimic the mechanical and aesthetic properties of natural teeth. This review explores key biomimetic strategies, including advanced adhesive systems, dentin-enamel interface replication, and regenerative protocols that enhance long-term functionality. Additionally, biomimetic frameworks guide the selection of materials and methods that optimize tooth restoration while minimizing biological disruption. Stress-reducing techniques/protocols, such as improved occlusal design and reinforcement strategies, further contribute to the longevity and resilience of restorations. The role of matrix metalloproteinases (MMPs) in dentin degradation and adhesive failure is also examined, highlighting strategies for their inhibition to enhance restoration durability and longevity. By integrating these principles, clinicians can achieve restorations that closely resemble natural dentition, promoting durability and patient comfort.