CMYK

Practice Management

Digital Smile Design

Dr. Christian Coachman; Dr. Andrea Ricci; Dr. Marcelo Calamita.
Introduction
The excellence will never be
achieved by chance, but consistently from a systematic approach to diagnosis, communication, treatment planning,
and, eventually, execution. In
order to obtain predictable

and consistent outcomes, the

design of the restorative treatment should be defined at an
early stage. The Digital Smile
Design (DSD) is a multi-use
conceptual tool, simple to use
and with clinically relevant advantages: it can strengthen the
aesthetic diagnostic abilities,
improve the communication between the team
members, create
predictable systems throughout
the
treatment
phases, enhance
the
patients
education
and
motivation, and
increase the effectiveness
of
case
presentation.

Indications
DSD is used for
better - aesthetic
diagnosis, communication, feedback,
patient management, case presentation and education.

The DSD allows a careful aesthetic analysis of the patients

facial and dental features and a
gradual discovery of many critical factors that might have been
overlooked during the clinical,
photographic or study models
evaluation. It also helps the
team to assess and understand
limitations and risk factors such
as asymmetries, disharmonies,
and aesthetic principles violations, adding critical data to the
process of treatment planning1.
Choosing the appropriate technique is easier once the problem
has been identified and the solution clearly visualized.

B. Communication
The main goal of the DSD protocol
is to simplify the communication,
transferring key information from
the patients face to the working
cast, and to the final restoration.
Transferring this information from
the wax-up to the test-drive
phase is achieved through a
mock-up or a provisional restoration2. The design of the definitive
aesthetic restorations should be
developed and tested as soon as
possible, guiding the treatment

2012

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A. Aesthetic Diagnosis

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C. Feedback
The DSD allows a precise re-evaluation of the results obtained in
every phase of the treatment.
This constant double-checking
of information ensures that a
higher quality product will be
delivered from the laboratory
and also provides a great learning tool for the entire interdisciplinary team.

D. Patient
Management
The DSD is an important marketing tool to motivate the patient,
making him/her understand the
issues and treatment options,
compare before and after pictures, and value all the work that
was done.

E. Case Presentation
The DSD makes the treatment
planning presentation more
effective and clear because it
allows patients to see and better understand the combined
multiple factors that are responsible for their oral-facial
issues. It also can be used for
medico legal purposes, registering the improvements that
were achieved and the reasons
for each one of our decisions
during the treatment.

F. Education

Mumbai 2009

5,6,7, October 2012

sequence to a predetermined aesthetic result.

The DSD can increase the impact of the presentations because it adds visual elements
into the slides that will improve the educational aspects
of the lecture. The audience
can understand better the
issues that were previously
highlighted and the presenter
can minimize the use of the laser pointer.

Digital Smile DesignWorkflow

The DSD protocol is performed
by the authors using Keynote
(Apple iwork); however, other
similar software, such as MS
PowerPoint (MS Office 2010)
can also be used with minor adjustments in the technique. Keynote allows simple
manipulation of the digital
images and the addition of
lines, shapes, drawings, and
measurements over the clinical and laboratory images. The
main steps of the DSD can be
learnt and applied very easily.

The IDA Times Mumbai August 2012

Conclusion
The Digital Smile Design is a
practical multi-use tool with
clinically relevant advantages:
it can strengthen aesthetic diagnostic abilities, improve the
communication between team
members, create predictable
systems throughout the treatment phases, enhance the
patients education and motivation, and increase the effectiveness of case presentation.

References
1. Coachman C, Van Dooren
E, Grel G, Landsberg CJ,
Calamita MA, Bichacho N.
Smile Design: from digital
treatment planning to clinical reality. In: Cohen, M.
Interdisciplinary treatment
planning, Vol. II: comprehensive case studies. Hanover Park: Quintessence
Publishing; 2011.
2. Magne P, Belser U. Bonded
porcelain restorations in the
anterior dentition: a biomimetic approach. Carol
Stream: Quintessence Publishing; 2002.

Fig 1: Pre-operative Image.

Diastema was closed using
orthodontic intervention.

Fig
2:
Situation
after
orthodontic correction. Final
teeth outline showing the
relationship between the preop situation and the possible
ideal design.

Fig 3: Digital Ruler Calibration

Fig 4: Post-operative Image

17

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