CAD/CAM - international magazine of digital dentistry

16 I I special _ digital smile design arrival can be seen and where the sublabial dental composition can be seen (i.e. superimposing the micro-aestheticimageswiththemini-andmacro- aesthetic ones, and being able to observe above and below the labial and perilabial soft tissue). Indicate and record on the photograph the unit of measurement chosen for the conversion scale ofthesoftwaresothatthedataapproximatesclin- ical reality. If the measurements were previously according to an analogue or digital scale, you will be able to obtain optimal indications as regards reference points. For example, the position of the maxillary central incisors can provide information about the distance between the incisal edge or cervical margin and the subnasal or bi-pupillary line. Therefore, remember to indicate and record on the photograph the unit of measurement chosen for the software conversion scale so that the data approximates the clinical reality of the subject photographed. _Verify and modify the gingival architecture con- cerningtheaestheticcomponentandtissueratios. The positioning of the zenith, papillae and cervical parabolas represents an absolute value in aes- thetic analysis for planning. It is particularly sen- sitive data useful for deciding on therapy with the periodontist. _After finishing the positioning of the teeth and gingivae, shape them morphologically according to the customised aesthetic “plan”, bordering on the aesthetic dental composition (Fig. 18e). _Every image editing step relating to the simu- lation must be saved in the software format so that no data is lost to allow modification at a later date. The same must be done for JPG and similar formats in the patient’s file, re-naming them in a sequential manner, which permits a more reliable and revisable back-up for the smile designer and the aesthetic dental team, and permits a better method of communicating the various therapeutic possibilities to the patient. It also provides essential information for checking the positioning of the prototypes (Figs. 20c & 21a-c). _At this point, we have at our disposal the digital wax-up, which we can transfer to the dental technician so that he or she can create an actual diagnostic wax-up, which once photographed can be inserted into the oral cavity. Note that, where it is already possible to transfer the ADSD fileintoCAD,theCAMphasewillproduceamodel that is useful for reducing the time and synchro- nising the methods implementing the protocols. Bydecreasingtheopacityoftheimageandwork- ing on the transparency, we can check whether the virtual records and indications conform to the analogue model. _If everything corresponds, it is possible to make modifications then to continue with the direct or indirectmock-up,whichnecessitatestheprepara- tion of a silicone key to accommodate provisional material to be adapted to the teeth or a workpiece producedbythedentaltechnicianwithoutitbeing necessary to adapt the material to the teeth, such as composite veneer, resin and PMMA. _Having positioned the aesthetic model in the oral cavity, it is inspected and approved with thepatient,correctinganyindividualorfunctional details from the point of view of occlusion, fa- cial expressions and the dento-labial relationship, Figs. 23a & b_Zirconia restorations in situ showing harmony of forms and biological integration. CAD/CAM 2_2014 Fig. 23b Fig. 23a CAD0214_12-17_Bini 13.05.14 11:14 Seite 5