CAD/CAM - international magazine of digital dentistry

12 I I special _ dentofacial aesthetic analysis Inthecasepresentedhere,threeextra-oralpho- tographsweretakenfromthefrontandthreeextra- oral photographs were taken from the side (Fig. 2). Intra-oral examination found that the patient pre- sented with a Class III/I malocclusion with a pro- nounced overjet. From the extra-oral photographs, the macroscopic incongruity in the labial relation- shipisevidentbecausealthoughthepatienthadher mouthclosedandlipssoftthelipsarenottouching. The face is asymmetrical in the inferior third and the smile line is not aligned with the occlusal plane, and is oblique and does not run parallel to the bipupillary line. _3-D software in aesthetic dentofacial analysis Today, we can design smiles more reliably and inamoresophisticatedmannertocorrectthesmile of our patients (smile makeover) using 2-D and 3-D dental soft- ware(Fig.3a).ClinCheck 3-D software (Align Technology) for use by dentiststocreatetrans- parent orthodontic and dental aligners has proven to be an excel- lent tool in dentofacial aesthetic analysis, not only from an orthodontic perspective but also from an aesthetic perspective. In this case, orthodontic therapy using Invisa- lign (Align Technology) was proposed. Impressions takenofthedentalarches,X-rays,photographsand diagnosis with a treatment plan were processed by ClinCheck 3-D, which converts everything into 3-D images to allow the dentist to see and change all the therapeutic orthodontic steps necessary to align the teeth. ClinCheck is sophisticated software that processes data captured by clinicians, allowing high-fidelity 3-D reproduction, where each step corresponds to the action by a single aligner able to perform movements of 0.12 to 0.25 mm (Fig. 3b). Biomechanical steps ensure greater predictabil- ityinorthodonticclinicalcasesforboththeclinician and the patient. The initial phase of aligner move- ment and the final situation can be superimposed on a photograph of the face of the patient using 2-D software (Fig. 3c). ClinCheck has among its op- tionsamillimetregridthatcanbesuperimposedon the photograph and the steps shown according to conventionalreferencelines(Figs.4a–c).Inthisway, one can obtain a predictable dentofacial analysis from both a dentoskeletal perspective (alignment) and a dentolabial perspective (labial/perilabial re- positioning). Fig. 5a_Initial and final phase of alignment shown using ClinCheck. Fig. 5b_Lateral intra-oral view before and after orthodontic treatment. Fig. 5c_Lateral extra-oral view at the start of treatment. Fig. 5d_Virtual prediction of labial profile after orthodontic treatment. Fig. 5e_Virtual prediction of labial profile with remodelling. Fig. 6a_Aesthetic analysis with superimposition of all the available elements after treatment. Figs. 6b & c_Immediately post-treatment with labial hyaluronic acid. CAD/CAM 1_2013 Fig. 5eFig. 5dFig. 5c Fig. 5a Fig. 6cFig. 6bFig. 6a Fig. 5b