CAD/CAM - international magazine of digital dentistry

14 I I special _ dentofacial aesthetic analysis The analysis of the clinical case in question demonstrated a drastic closure overjet of about 3 mm as the final post-orthodontic treatment out- come (Fig. 4d). Since the soft tissue of the lips and of the vestibule lie on the skeletal structures, it is possible to predict the future dentolabial relation- ship (Fig. 4e). At this point, aesthetic predictability for the patient is important because at this stage the combined results of dentistry and aesthetic medicine are shown. In fact it is possible to simu- late virtually the new labial dimension following aesthetic dental treatment and cosmetic labial or perilabial surgery. _Clinical case: Orthodontic treatment and hyaluronic acid A 47-year-old female patient presented with malocclusionwithcrowdedteethinthemaxillaand mandible and an incongruous dentolabial relation- ship.Theclinicalcasewastreatedwith28upperand 20 lower aligners, with interproximal reduction and attachments in both arches. The superior/inferior midline was moved during the process of sagittal correction (Fig. 5a). In keeping with the protocol described above, and at the explicit request of the patient, it was decided to approach treatment in accordance with the dentofacial aesthetic analysis obtained using ClinCheck 3-D (Fig. 5b). Using software to show the predicted movement on the grid allows the patient to see the expected changes (showing the lips with or without surgical remodelling; Figs. 5c & d). The preoperative analysis can be verified at the end of therapybysuperimposingalloftheimagesavailable (Fig. 6a). Once the dental treatment had been completed, wedecidedtogetherwiththepatienttoincreasethe lipvolumeusinghyaluronicacid(Figs.6b&c).About two weeks after surgery, it was possible to verify what had been expected in the analytical aesthetic phase (Figs. 7a–c & 8). _Conclusion Combined aesthetic dentistry and aesthetic medicine can offer optimal and predictable treat- ment in the majority of clinical aesthetic cases. Using digital technology, the predicted outcome of such treatment for smile design can be shown to the increasing number of patients presenting for aesthetic treatment._ Editorial note: A complete list of references is available fromthepublisher. Figs. 7a–c_Patient after completion of aesthetic dental treatment and aesthetic medical treatment. Fig. 8_Digital verification of treatment outcome. CAD/CAM 1_2013 Dr Valerio Bini, DDS in dentistry and dental prosthetics from the University of Genoa in Italy,is a cosmetic dentist.He is a member of the European Society of Cosmetic Dentistry,a fellow of SIED (Italian society of aesthetic dentistry),a fellow of the ItalianAcademy of Esthetic Dentistry,andAlignTechnology Invisalign certified.He regularly attends courses for specialist clinicians in aesthetic dentistry and aesthetic medicine.He has been a speaker at international conferences on aesthetic dentistry and aesthetic medicine.He is also the author of many articles published in international journals. DrValerio Bini Piazza Martiri della Libertà 3 13900 Biella BI Italy info@studio-bini.com CAD/CAM_about the author Fig. 8Fig. 7cFig. 7bFig. 7a