08 April 2021

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Digital Smile Design - Chairside 3D digital design and trial restoration workflow

Lorenzo Breschi

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Different digital tools have been used in clinical practice to plan the rehabilitation of patients. Some applications and software programs used in <strong> esthetic planning<strong/>  allow simulation of the <strong> smile design<strong/>, improving communication between patients and clinicians. However, digital applications are often difficult to use, time-consuming, unattractive to present to the patient and, most of all complicated to include in a 3D workflow. 

In an interesting article, published on The Journal of Prosthetic Dentistry, Dr. Christian Coachman and his team presented a new <strong> 3D digital smile design app <strong/> for esthetic planning, smile simulation, chairside 3D virtual wax pattern, and trial restoration performed with portable devices.

Methods: 

The authors described all the stages needed to complete the <strong/> smile design <strong/> and integrate it into a 3D workflow: a facial frontal photograph, a facial scan standard tessellation language (STL) file, and a maxillary intraoral scan STL file are uploaded to the app. The files are calibrated to each other to allow a 3D facially driven smile design project. The definitive maxillary 3D digital waxing of facial templates is exported to a 3D printer as an STL file. The printed resin templates are directly placed in the mouth with flowable composite resin for an immediate trial restoration without the need for casts, silicone guides, or auto-polymerizing resin. The workflow presented in this article linked the 3D app project to a printer and allowed straight forward chairside trial restorations. In addition, Dr. Coachman suggested to create a presentation with all the photo of the patient to better motivate him/her.

Discussion: 

Nowadays is very important to <strong/> integrate digital tools in the clinical practice <strong/> in order to make digital technology ordinary and simplify daily routine. In the present article, Dr. Coachman underlined how this app is important to simulate the future smile of a patient and communicate the benefits of a better smile. Further, the use of the app allows the clinicians to create a trial restoration and test it in the patient mouth. 

Dr Coachman suggested the use of the app not only to sell a treatment plan to the patient, but also during the restorative treatment itself to digitally correct the shape and contour of definitive restorations, thus, reducing the time for adjustments in the clinical evaluation appointment. 

Conclusion: 

From the considerations drawn by the work of Dr. Cochman and his team it can be concluded that the new <strong> DSDApp 3D <strong/> is a straightforward and versatile tool for performing digital planning in dental practice. The app is easily accessible and the clinicians could use it even from mobile devices. For dentists who wish to improve the <strong> smile analysis <strong/>, the app could be used in combination with other digital technologies. In addition, <strong> esthetic planning <strong/> might be optimized by face scanning to make a facial video with smile dynamics that helps designing the 3D smile in the app to print the resin templates, and perform the mock up in the same appointment.

For more information: Chairside 3D digital design and trial restoration workflow.