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ePaper created 2015-03-10, 11:16:47 | version 1.33.01
54 — issue 1/2015 Aesthetic and Restorative Dentistry Article The Photoshop smile design technique The Photoshop smile design (PSD) tech- nique can be done on any image, and im- agescanbecombinedtoshowthefullface or the lower third with lips on or lips off. This article (Part 1) demonstrates how to perform the technique on the cheek-re- tracted view. Part 2 of this article will re- view more possibilities using the tech- nique. The first step in the PSD technique is to create a digital conversion of the actual tooth length and width, and then digitally determine the proposed new length and proportion of the teeth. Determining digital tooth size To determine digital tooth size, follow these steps: Create a conversion factor by dividing the proposed length (developed from thesmileanalysis)bytheexistinglength of the tooth. The patient’s tooth can be measured in themouthoronthecast(Fig.22).Ifthe length measures 8.5 mm but needs to be at 11mm for an esthetic smile, divide 11 by 8.5. The conversion factor equals 1.29, a 29% digital increase lengthwise. Open the full-arch cheek-retracted view in Photoshop, and zoom in on the central incisor. Select the eyedropper palette. A new menu will appear. Select the ruler tool (Fig. 23). Click and drag the ruler tool from the top to the bottom of the tooth to gen- erate a vertical number, in this case 170 pixels (Fig. 24). Multiplythe number of pixels by the conversion factor. In this case, 170 × 1.29 = 219 pixels; 219 pixels is digitallyequivalentto 11 mm (Fig. 25). Determinethedigitaltoothwidthusing the same formula. Createanewlayer,leaveittransparent, and mark the measurement with the pencil tool (Fig. 26). Applying a new proposed tooth form Next, follow these steps: Afterperformingthe smile analysis and digitalmeasurements,chooseacustom tooth grid appropriate for the patient. Select a tooth grid based on the width- to-length ratio of the planned teeth (e.g., 80/70/90 or 80/65/80). Open the image of the chosen tooth grid in Photoshop and drag the grid on to the image of teeth to be smile designed (Fig. 27). If the shape or length is deemed inap- propriate, press the command button (control button for PCs) and “z” to delete and select a suitable choice. Depending on the original image size, the tooth grid may be proportionally toobigortoosmall.Toenlargeorshrink the tooth grid created (with the layer activated), press command (orcontrol) and “t” to bring up the free transform function. While holding the shift key (holding the shift key allows you to transform the object proportionally), click and drag a corner left or right to expand or contract the custom tooth grid. Adjust the size of the grid so that the outlines ofthe central incisors have thenewproposedlength.Movethegrid asnecessaryusingthemovetoolsothat theincisaledgeofthetoothgridlinesup with the new proposed length (Fig. 28). Areas of the grid can be individually al- tered using the liquify tool (Fig. 29). Fig.23 Fig.22 Fig.24 Fig.25 Fig.26 Fig. 22 To determine the digital tooth size, a conversion factor is created by dividing the proposed length by the existing length of the tooth. Fig. 23 Select the ruler tool in Photoshop. Fig. 24 Measure the digital length of the central incisor using the ruler tool. Fig. 25 Measure the new digital length using the conversion factor created earlier. Fig. 26 Create a new transparent layer and mark the new proposed length with the pencil tool.