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ePaper created 2015-08-28, 13:01:48 | version 1.38.0
I 17 special _ Digital Smile Design I cosmeticdentistry 2_2015 which can easily be tested using phonetic tests. In this phase, as well as giving the patient the opportunity to look at himself or herself in a mir- ror, it is very useful to use the camera again, since the recording of the physiology of the smile in relation to the phonetics and facial expressions may become the subject of further live 3-D analy- sisofthepatient.Themoreinformationwesendto the dental technician, the more it will be possible for him to observe the patient and update himself or herself on the analysis being carried out. While thedentistisinhisorhersurgery,thetechnicianin the laboratory can watch the video clips, analyse the photographs and communicate via the tele- phoneorvideo-conferencingonSkype.Allthisof- fers many advantages to this protocol. Being able to dispel any doubts will give greater satisfaction to the dental team and result in clinical success, clearly demonstrated by the aesthetic harmony in the smiles of our patients. _Once the mock-up has been approved with the consent of the patient, who will have been the first critical spectator of and commentator on the video clip, one can take another traditional dental impression or take an impression using an inter- oralscanner(opticalimpression).Duringthevideo playback, the patient is able to observe peculiari- ties about himself or herself that he or she would notbeabletoseeusingonlyamirror,thefirstbeing seeinghimselforherselfinprofilethroughimages that are not static and precisely because of their dynamic nature correspond to spontaneity and naturalness. _Carryoutdigitalsmilemorphingoftheimagesstep by step to demonstrate and transmit the actual simulation corresponding to virtual planning. Thisphaseisofgreatinterestandeffectforthepa- tientbecausemorphing,beingshownsequentially, appears to be like a film. This procedure is carried out as far as the superimposition of the images processed during the first analytical aesthetic phaseuptotherelatedfunctionalmodelsinserted into the oral cavity before the definitive restora- tion. _From the analogue phase of the model, we move on to the digital phase to produce the prosthesis with CAD/CAM procedures (these images can be further analysed in the virtual planning phase; Figs. 22a & b). _In the case of particular work procedures in which software-assisted implantology techniques are used, one may also have at one’s disposal a sec- ond model in PMMA, diagnostic or surgical guides especially for implant structures, etc. _The final step in the implementation of ADSD in the CAD/CAM protocol is the placement of the de- finitiverestorationintheoralcavity(Figs.23a&b). The outcome of the multidisciplinary approach should confirm the predictability concerning the aesthetic and bio-cosmetic integration of the prosthesis. _Conclusion Thedetailedanalysisofthesmileanditsproject, indispensable for the formulation of an aesthetic clinical diagnosis, is a fundamental part of the del- icate approach to the patient, the true protagonist of aesthetic dentistry. Today, the operator has at hisorherdisposalnewnon-invasivemeansoffor- mulating the treatment plan; digital dentistry and image-editing software are now part of a dentist’s armamentarium. Furthermore, the entire treating teambeingadvancedintheuseofinstrumentsand technologies for diagnosis and communication makes an excellent marketing tool for dental services. ADSD is a simple and economical way of offering the patient a predictable plan that can be visualised immediately or at least at the second appointment to demonstrate the aesthetic and functional changes possible with treatment with the aid of corresponding models. It is also a tool for transmitting all the information necessary to the entire treating team in the multidisciplinary approach. Let us hope that a new professional figure may soon establish himself or herself in the world of dentistry, the smile designer, a new way to communicate._ Editorial note: This is the second of a two-part article based on a paper presented by Dr Valerio Bini to the 15th International Congress of Aesthetic Medicine in MilaninOctober2013duringthesessiontitled“Aesthetic dental surgery of the lower third of the face”. Part I of the articleappearedin cosmeticdentistry 1/2015. Dr Valerio Bini,DDS,graduated from the University of Genoa in Italy.He is a specialist in prosthodontics and aesthetic dentistry. He has presented papers at international conferences on aesthetic dentistry and aesthetic medicine,and is the author of many articles published in national and international journals. Dr Bini is a member of the European Society of Cosmetic Dentistry,a fellow of Società Italiana di Estetica Dentale (Italian society of aesthetic dentistry). Dr Bini may be contacted at info@studio-bini.com. cosmeticdentistry _about the author