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ePaper created 2015-05-14, 11:05:01 | version 1.38.0
I special _ smile analysis and smile design “stroke”; choose black for colour, and select a two- pixel stroke pencil line (Fig. 17), which will create a perfecttracingofyourselection.Click“OK”tostroke the selection. Select (trace with the lasso selection tool) one tooth at a time and then stroke it (Fig. 18). Select and stroke (trace) the teeth up to the second premolar (the first molar is acceptable; Fig. 19). _Theimageshouldbesizednowforeasyfutureusein a smile design. In the authors’ experience, it is best to adjust the size of the image to a height of 720 pixels (Fig. 20) by opening up the image size menu and selecting 720 pixels for the height. The width will adjust proportionately. _Atthistime,thetoothgridtracingcanbesaved,with- outtheimageoftheteeth,bydouble-clickingonthe layer of the tooth image. A dialog box reading “new layer”willappear;click“OK.”Thisprocessunlocksthe layeroftheteethsoitcanberemoved.Dragthelayer of the teeth to the trash, leaving only the layer with thetracingoftheteeth(Fig.21).Inthefilemenu,click “save as” and choose “.png” or “.psd” (Photoshop) as the file type. This will preserve the transparency. You do not want to save it as a JPEG, since this would createawhitebackgroundaroundthetracing.Name the file appropriately (e.g., 75% W/L central). _By tracing several patients’ teeth that have tooth sizeandproportionintheaestheticzoneandsaving them, you can create a library of tooth grids to cus- tom design new teeth for your patients who require smile designs. _The Photoshop smile design technique The Photoshop Smile Design (PSD) technique canbedoneonanyimage,andimagescanbecom- bined to show the full face or the lower third with lips on or lips off. This article demonstrates how to perform the technique on the cheek-retracted view. 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. Determiningdigitaltoothsize Todeterminedigitaltoothsize,followthesesteps: _Create a conversion factor by dividing the proposed length (developed from the smile analysis) by the existing length of the tooth. _Thepatient’stoothcanbemeasuredinthemouthor on the cast (Fig. 22). If the length measures 8.5mm but needs to be at 11 mm for an aesthetic 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 Photo- shop, and zoom in on the central incisor. _Select the eyedropper palette. A new menu will appear. Select the ruler tool (Fig. 23). 16 I CAD/CAM 2_2015 Fig. 27_Open the image of the chosen tooth grid in Photoshop and drag the grid on to the image of teeth to be smile designed. This will create a new layer in the image to be smile designed. Fig. 28_Adjust the grid as required while maintaining proper proportions by using the free transform tool from the edit menu. Fig. 29_Modify the grid shape as necessary using the liquify tool. Fig. 30_Select all of the teeth in the grid by activating the magic wand selection tool and then clicking on each tooth with the grid layer activated (highlighted) in the layers palette. Fig. 27 Fig. 28 Fig. 30Fig. 29