CAD/CAM - international magazine of digital dentistry

06 I I special _ digital smile design _Introduction Aesthetic dentistry relies on professional trust, traditional wax-ups and artistic modifications of provisionalrestorationsinthemouthtoachievethe desired final result. Many of the published articles in aesthetic dentistry discuss the same principles in smile design: Golden Proportion, gingival architec- ture, emergence profile, and shape related to facial anatomy.1–3 These principles have been followed without any significant advances in technique or case presentation. Many options are now available to predesign the most appropriate smile for the patient, such as computer imaging, diagnostic wax-ups on models or simply drawing on a patient photograph.4 For decades, dentists have been using various forms of software to preview, predict, and plan aesthetic procedures. Many of these programs lapsed into obsolescence because it took too long to develop proper diagnostic marketing or clinical guides. In this article, we demonstrate the use of Dental GPS software, developed and proven over the last fiveyears.5 Thesystemusestheparameterscaptured by one digital preoperative full-face photograph to help clinicians with aesthetic diagnosis and auto- matically generates the best smile virtual wax-ups in only minutes. The smile prescription is then sent to the laboratory for technicians to create or trans- form a new aesthetic smile with precision (Fig. 1). _From diagnosis to the smile project The system generates the virtual wax-up and laboratory prescription within minutes with the digital facebow, which captures the exact position of the dental and facial midline with the occlusal plane to prevent canting and shifting of patient cases.Thediagnosisandtreatmentplanningsystem also uses the M Ruler, an algorithm that analyses the best position of all maxillary teeth on a digital image to design the smile.5 Compared with the Golden Proportion, which offers only one ratio, 1:618, the M Ruler determines the patient’s own unique ratio for smile design. The program is used for diagnosing, planning and executing changes in the position, shape, di- CAD/CAM 4_2013 Fig. 1_An example of a smile design simulated in a few minutes and shown to the patient using Dental GPS software. Fig. 2a_Clinical case: A young female patient previously suffering from gastric reflux came to the clinic with enamel erosion, gingival recession and aesthetic demands. Figs. 2b–d_The restoration of both maxillary and mandibular arches aimed at preserving tissue and improving the aesthetic outcome. Fig. 1 Fig. 2a Projecting a new smile from a facial photograph: Anew way to plan multidisciplinarydental treatments Authors_ Drs Marco Del Corso, Italy, & Alain Méthot, Canada