CAD/CAM - international magazine of digital dentistry

10 I I special _ digital smile design The virtual wax-up generated by the computer generates an electronic prescription that can be sent to the laboratory to create an accurate wax-up oftheproposedsmile.Oncethepositionofthemax- illary cast correlates to the smile prescription and the articulator, it is possible to fabricate provisional andfinalrestorationsthatmatchthevirtualwax-up with the software. This guides the laboratory tech- nicianinarrangingeachfinalrestorationaccording to length, width and position to establish the new smile line, occlusal plane, and vertical dimension of occlusion(Figs.13a&b).Theceramistsimplyfollows the GPS digital prescription to create the final restorations. This new concept allows practitioners to in- creasetheircosmeticworkflowintheirpractice.The visual simulation allows the patient to understand the treatment plan from the preoperative image through to the final cementation of the restora- tions. Several aesthetic projects can be simulated anddiscussedwiththepatientinthefirstconsulta- tion, whereas traditional laboratory wax-up allows the patient to visualise only one smile design possi- bility, often with no idea of the final aesthetic result with respect to the rest of the face. Traditional mock-ups also help practitioners and patients to evaluate the smile design; however, in many cases withdiastemasormalpo- sitioned teeth, the mock- up itself—derived from the traditional wax-up— still gives only one alter- native and cannot simu- late the final result accu- rately without reducing teeth. In addition, it en- tails a great deal of work to take an impression, create a wax-up and try the mock-up in the pa- tient’s mouth for an eval- uation. Even if a diag- nostic wax-up is made by the dental laboratory and showntothepatient,orif aprovisionalismadefrom the wax-up and tried as amock-upinthepatient’s mouth, this single pro- posed wax-up may not be the optimal aesthetic solution for that partic- ular patient.12 _Conclusion This article demon- strates the accuracy of imaging using the digital facebow, a 3-D cast positioning system that re- quires a single facial photograph of your patient, andtheMRuler,adiagnosticdeviceforsmiledesign. Practitioners are able to fit the best possible smiles in minutes to the patient’s face by trying different simulated smiles using morphing technology to create predictable and pleasing smiles for their patients. This simple protocol saves significant time and chairside adjustments. Moreover, patients receive better cosmetic dental treatment by seeing their best custom smiles, and can actively partici- pate in the smile design process._ Editorial note: A complete list of references is available fromthepublisher. Figs. 12a & b_The final restorations were realised with a CAD/CAM technique using IPS Empress CAD blocks milled with the CEREC system. Figs. 13a & b_The final smile and facial improvement. The smile design contributes to the changed facial appearance. CAD/CAM 4_2013 Fig. 13a Dr Marco Del Corso (DDS,DIU) is in private practice inTurin in Italy.He can be contacted at marco.delcorso@fastwebnet.it. Dr Alain Méthot (DDS,MSc) is in private practice in Laval in Canada.He can be contacted at alain@drmethot.com. CAD/CAM_about the authors Fig. 12a Fig. 12b Fig. 13b