The application of parameters for comprehensive smile esthetics by digital smile design programs: A review of literature

Improving the Visualization of Superior Longitudinal Fascicule-2 and Superior Longitudinal Fascicule -3 Using Photoshop Filters

BACKGROUND AND OBJECTIVES

Several studies are currently exploring the anatomical origins of superior longitudinal fascicule (SLF) 2 and SLF-3, which are components of the frontoparietal network. This study aimed to achieve optimum visualization of the anatomical corridors of these fibers using Photoshop filters.

METHODS

Four postmortem brain hemispheres were dissected in accordance with the method proposed by Klingler and Ludwig. Dissections were performed under a surgical microscope (Carl Zeiss AG, Oberkochen, Germany) at 4× and 40× magnification. All dissections were documented at each stage using a professional digital camera (Canon EOS 600D) with a macro 100 mm lens (Canon), ring-flash attachment (Canon), and professional tripod (Manfrotto 808 C4). We aimed to improve the visual quality of the images by avoiding monotone using various the features and filters in Photoshop.

RESULTS

SLF-2 originates from the angular gyrus (Brodmann area [BA] 39) in the right hemisphere and has been observed to project fibers from BA7 and BA19 and toward BA8, 9, 10, and 46. Further, these fibers traverse from the depths of BA40, 2, 3, 1, and 6 as they progress. SLF-2 also projects fibers from the supramarginal gyrus in the left hemisphere. SLF-3 lies between the supramarginal gyrus and the inferior frontal lobe in both the right and left hemispheres.

CONCLUSIONS

The visual descriptions of the dissections were enriched after using Photoshop to avoid monotony. Increasing the visual quality with Photoshop features enable us to gain a better understanding of these pathways. Additionally, it facilitates the comprehension of the symptoms associated with pathology. We hope these results will further aid in reducing the occurrence of postoperative complications.

Integrating digital smile design into restorative Dentistry: A narrative review of the applications and benefits

The primary goal of esthetic treatment is to ensure patient satisfaction and meet their expectations of improving their facial esthetics and smile. However, some patients may have doubts regarding the irreversible nature of the treatment. In such cases, the Digital Smile Designing (DSD) technique can be employed to educate and motivate patients. DSD is a technical tool that allows digital designing and modification of a patient's smile, enabling them to visualize the potential outcomes before the actual treatment begins. This technique facilitates visual communication and patient involvement in the smile design process, leading to predictable treatment results and higher acceptance rates. This article provides an overview of DSD in esthetic dental practice and discusses its applications, advantages, limitations, and future possibilities.

Choice of refractive surgery types for myopia assisted by machine learning based on doctors' surgical selection data

In recent years, corneal refractive surgery has been widely used in clinics as an effective means to restore vision and improve the quality of life. When choosing myopia-refractive surgery, it is necessary to comprehensively consider the differences in equipment and technology as well as the specificity of individual patients, which heavily depend on the experience of ophthalmologists. In our study, we took advantage of machine learning to learn about the experience of ophthalmologists in decision-making and assist them in the choice of corneal refractive surgery in a new case. Our study was based on the clinical data of 7,081 patients who underwent corneal refractive surgery between 2000 and 2017 at the Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Due to the long data period, there were data losses and errors in this dataset. First, we cleaned the data and deleted the samples of key data loss. Then, patients were divided into three groups according to the type of surgery, after which we used SMOTE technology to eliminate imbalance between groups. Six statistical machine learning models, including NBM, RF, AdaBoost, XGBoost, BP neural network, and DBN were selected, and a ten-fold cross-validation and grid search were used to determine the optimal hyperparameters for better performance. When tested on the dataset, the multi-class RF model showed the best performance, with agreement with ophthalmologist decisions as high as 0.8775 and Macro F1 as high as 0.8019. Furthermore, the results of the feature importance analysis based on the SHAP technique were consistent with an ophthalmologist's practical experience. Our research will assist ophthalmologists in choosing appropriate types of refractive surgery and will have beneficial clinical effects.

A digital workflow to predict facial aesthetics in patients with maxillofacial trauma with implant retained prostheses

PURPOSE

To introduce a digital workflow for the prediction of facial aesthetics, especially in patients with dentation deformity caused by maxillofacial trauma.

METHODS

Cone-beam computed tomography (CBCT) and three-dimensional facial scans of patients with radiographic prostheses were collected. The aforementioned data were uploaded to ProPlan CMF software and merged to generate a virtual patient with craniofacial hard tissue, realistic facial soft tissue, and remaining dentition. The radiographic prostheses were scanned to form a digital cast, which was fitted with its CBCT image to create the virtual prostheses. Postoperative facial soft tissue was simulated according to the movement of the virtual prostheses. An appropriate virtual diagnostic prosthesis plan was selected by the patient and dentist. Subsequently, prosthetically driven implant guide and restoration were designed and fabricated.

CONCLUSIONS

A virtual patient was successfully constructed. A 4-mm protrusion of the virtual prosthesis was chosen. Subsequently, implant surgery was performed, and dental prostheses were fabricated based on this location. The fusion of the postoperative facial scan and preoperative facial prediction was found to be coincident. This technique can effectively predict facial aesthetic features of patients with maxillofacial trauma, facilitate communication with patients, reduce chairside time, and guide the multidisciplinary design of implant placement and restoration fabrication.

Anterior Upper Teeth Golden Proportion Analysis with Millimetric Templates: An Invention Developed at Londrina State University

In order to achieve aesthetic and harmonious smile results, the use of anterior upper teeth golden proportion concepts represents reliable and scientific based guidelines. However, measuring, recording and analysing teeth and smiles biometric values proves to be a clinical and laboratory routine chalenge, once it is time consuming and demands additional especific math calculus or formulas. The aim of this paper is present an invention, “anterior upper teeth golden proportion millimetric templates,” a set of instruments fabricated in order to achieve precise and fast millimetric measures, once they present predefined geometrical drawings and diagrams. Currently, when planning aesthetic tooth size modifications treatments, tools are used as pachymeters, dry edge compass, or some softwares. Most of times this strategy relies on professional expertise and intuiton, which shows to be limitating factors with the need of trial-and-error training and an accurate critical and artistic sense. Unfortunately, this is not inherent to all professionals, especially undergraduate dental school students. Thus, the templates bring differentials and advantages, being versatile and convenient, allowing countless clinical and laboratory uses, even over a cellphone or a computer screen. An excellent diagnostic aid providing ideal teeth proportions and positioning, increasing the chances of success in dental treatment planning.

Proposal for Introducing a Digital Aesthetic Dentistry Course in Undergraduate Program: Contents and Ways of Administration

Background: Nowadays, digital dentistry is a fundamental skill that dentists need to acquire at this time. The digital workflow has gained acceptance and is widely used in most disciplines of dentistry. For this reason, it might be advisable to include this content in the undergraduate curriculum. The aim of this work was to create a course in digital aesthetic dentistry and evaluate its effectiveness. Methods: Dental students at the University of Verona (from third to sixth year) participated in a 2-h course on photography, digital aesthetic analysis, and digitally planned rehabilitations. Students were randomly divided into two groups, the first group attending the course with video tutorials and the second group attending the traditional class with slides. The students’ ability to perform digital aesthetic analysis and rehabilitation was tested. In addition, a questionnaire was completed to determine student satisfaction with the course and method of delivery. Statistical analysis was performed. Results: The course was highly appreciated, especially by the students who received the video tutorials. Good results were obtained in the performance of digital analysis and rehabilitation, which were better in the first group. Conclusions: Digital aesthetic dentistry was a success in terms of newly acquired skills. From this point of view, the proposal of a course on this subject in the undergraduate curriculum deserves a close evaluation. The video tutorial method seems to be a good way to teach operative digital procedures.

Conventional and Digital Workflow Planning for Maxillary Teeth Restoration with Porcelain Laminate Veneers: A Clinical Report

Nowadays, media-influenced patients have the desire to "extremely rapidly" alter their teeth to "ideal" and "too bright" ones. Although some esthetically demanding cases need to be thoroughly planned and treated through prolonged phases, other cases can be handled quickly. In such cases, we can witness the impact of many computer software programs for digital smile design that have penetrated clinical practice. This clinical report describes a conventional and digital step-by-step treatment workflow for restoring anterior maxillary teeth with porcelain laminate veneers. Two digital smile design software (GPS and Nemo DSD 3D) were utilized and compared with the conventional workflow. Feldspathic veneers were chosen for their superior optical properties. Case complexity and operator's experience played a significant role in the selection between the conventional and digital workflow. The advanced digital programs, while having many advantages, are not necessarily superior to the traditional technique. The digital smile design programs used in this case demonstrated an effective and predictable workflow. They can achieve comprehensive digital smile design with a satisfactory esthetic outcome, yet the conventional workflow gave conservative and esthetically pleasing results.

Accuracy of Dental Photography: Professional vs. Smartphone's Camera

There is a scant literature on the accuracy of dental photographs captured by Digital Single-Lens Reflex (DSLR) and smartphone cameras. The aim was to compare linear measurements of plaster models photographed with DSLR and smartphone's camera with digital models. Thirty maxillary casts were prepared. Vertical and horizontal reference lines were marked on each tooth, with exception to molars. Then, models were scanned with the TRIOS 3 Basic intraoral dental scanner (control). Six photographs were captured for each model: one using DSLR camera (Canon EOS 700D) and five with smartphone (iPhone X) (distance range 16-32 cm). Teeth heights and widths were measured on scans and photographs. The following conclusions could be drawn: (1) the measurements of teeth by means of DSLR and smartphone cameras (at distances of at least 24 cm) and scan did not differ. (2) The measurements of anterior teeth by means of DSLR and smartphone cameras (at all distances tested) and scan exhibited no difference. For documentational purposes, the distortion is negligeable, and both camera devices can be applied. Dentists can rely on DSLR and smartphone cameras (at distances of at least 24 cm) for smile designs providing comparable and reliable linear measurements.

Artificial Intelligence in Biomedical Applications of Zirconia

Artificial intelligence (AI) is rapidly developed based on computer technology, which can perform tasks that customarily require human intelligence by building intelligent software or machines. As a subfield of AI, machine learning (ML) can learn from the intrinsic statistical patterns and structures in data through algorithms to predict invisible data. With the increasing interest in aesthetics in dentistry, zirconia has drawn lots of attention due to its superior biocompatibility, aesthetically pleasing, high corrosion resistance, good mechanical properties, and absence of reported allergic reactions. The evolution of AI and ML led to the development of novel approaches for the biomedical applications of zirconia in dental devices. AI techniques in zirconia-related research and clinical applications have attracted much attention due to their ability to analyze data and reveal correlations between complex phenomena. The AI applications in the field of zirconia science change according to the application direction of zirconia. Therefore, in this article, we focused on AI in biomedical applications of zirconia in dental devices and AI in zirconia-related applications in dentistry.

Three-Dimensional Evaluation on Cortical Bone During Orthodontic Surgical Treatment

Adult patients' severe malocclusions, especially the skeletal ones, cannot be exclusively solved by the orthodontic treatment and therefore a combined orthodontic-surgical treatment is necessary. Today, numerous software allows to plane and to visualize the final treatment results simulating the best therapeutic option. This is a retrospective experimental study that aims to analyze the changes in the buccal cortical bone in patients undergoing orthodontics surgeries and to evaluate the correlation between the dental movement and the changes in the relative bone cortex. The study sample consists of 32 subjects. By applying the CBCT radiographic examinations, the measurements were made in well-defined points of reference. The 3D study of the dental changes of position and the cortical buccal bone related variation, suggests how the determined orthodontic movement of the dental element does not achieve an easily predictable bone variation. Therefore, it also suggests that there is no direct proportionality relationship between the extent of bone apposition/reabsorption and dental movement.

Online-based software for guiding immediate implantation to replace a tooth with root resorption in the esthetic zone

This case report describes an alternative approach for the planning of immediate implant placement and provisionalization, which uses a new online dental software that predicts the esthetic outcome.

Dentogingival Smile Analysis of Young Adults of Al Qassim Province, Saudi Arabia: A Cross-Sectional Study

Objectives. The present study aims to analyse the smiling components among young adults within Al Qassim region by evaluating typical smile parameters. Methodology. A cross-sectional study was conducted among 324 female and male participants between 18 and 35 years, within Al Qassim Province of Saudi Arabia. The dentogingival macro-aesthetic elements of the smile, the parallelism between the incisal curve and lower lip line, midline, and buccal corridors were determined by using Canon Rebel t7i (Canon, Melville, NY, USA) and evaluated by photo editing software Adobe Photoshop CC2019. The data were analysed using a chi-square test and Spearman’s correlation test for nonparametric data. Results. 62.5% of young adults had no buccal corridors. The nonparallel smile was found in 53.2% of young adults. A high smile line was observed in 33% of participants. 59.3% of young adults lacked a coinciding dental and facial midline. There was a statistically significant difference in the parallelism of the incisal curve and lower lip line as well as in the position of the upper lip line across genders ( $P<0.05$ ). Conclusion. Understanding macro-aesthetic elements of teeth and their interrelation with the surrounding oral structures can be a guide in creating natural and aesthetically pleasing restorative treatment.

Customized composite veneers from a totally digital workflow: A case report

A treatment plan based on the use of a preview software can offer the possibility to rapidly communicate with the patient. Fully digital workflow allows for making several objects at the same time in a precise and cost-efficient manner.

Aesthetic Dentistry, How You Say and How You See: A 500-People Survey on Digital Preview and Color Perception

Purpose

Digital technologies have improved ways to perform aesthetic dentistry in the last few years. The aims of this survey were to investigate the most preferred way to preview the result of an aesthetic dental rehabilitation among a population of dental professionals and laypeople and to compare aesthetic standards of the general population and dentists in terms of the color of teeth for aesthetic dental rehabilitations.

Patients and Methods

A questionnaire was sent to the subjects (dentists and laypeople) during a 1-year period and, together with their demographic data, different ways to preview the result of an aesthetic rehabilitation were submitted, such as digital smile design, dental wax-up and oral explanation. Furthermore, an additional section of the questionnaire investigated the most suitable color for an aesthetic rehabilitation based on the colors of the VITA Scale. Results were statistically analyzed (with Chi-square of independence and Mann–Whitney U-test) highlighting differences of answers based on age groups, educational attainment, gender, and belonging or not to the dental field.

Results

Findings showed that digital smile design (digital preview) is a high-appreciated method for previewing and communicating with patients both by dental professionals and laypeople. Furthermore, lighter colors were found to be more valued by laypeople and significant differences were highlighted between the two populations assessed.

Conclusion

It seems to be viable to use digital preview for dentists and laypeople to improve previewing and communicating ways. It might be advisable to better motivate patients in recognizing aesthetical features and to raise their awareness in preferring more mimetic aesthetic results. Great opportunities are opened up by digital smile design in teaching, learning, and routine practice.

The Digital Integrated Workflow in the Aesthetic Management of the Smile: A Case Report

The aesthetic treatment for anterior teeth requires a series of clinical and technical evaluations to obtain a predictable result, following a well-defined operating sequence. Today, the clinical–technical team can use different digital tools in the different steps of the workflow. A preventive assessment, the knowledge of limits, and the possibilities of surgical and prosthetic procedures allow to use these devices. Sharing goals of the treatment with the patient according to their expectations and needs is the key point of the treatment plan. Setting a defined treatment plan avoids invasive procedures. In this clinical case report, a 27-year-old patient affected by Class II div 2 malocclusion with deep bite was treated with a full digital workflow. Previewing the aesthetics was through dedicated software, which shows operators and patients the objectives of the therapy and guides the dental technician in the first phase of the work. The use of digital flows in the prosthetic phases reduces the working time. In this case, it shows the impact of a digital workflow on peri-prosthetic therapy for the aesthetic rehabilitation of the upper central incisors in a young adult.

DSDapp use for multidisciplinary esthetic planning

OBJECTIVES

Digital smile design (DSD) is useful in planning multidisciplinary esthetic treatments. However, DSD requires clinician training and skill to ensure its effective use. The Digital smile design application (DSDapp) was recently developed, to facilitate such planning. The objective of this study was to illustrate the use of the DSDapp for esthetic planning in a clinical case that included periodontal plastic surgery and ceramic laminate veneers.

CLINICAL CONSIDERATIONS

An intraoral digital scan was performed, and a photograph was obtained using an iPad (frontal facial full smile). The images were analyzed using the DSDapp. All reference lines were inserted, and dental shapes predetermined by the app were superimposed on the photographs. A digital diagnostic wax-up was performed considering the plan created in the DSDapp. After 3D printing the wax-up, a mock-up transferred the planning to the oral cavity. Following this, the patient was referred to a periodontist for the periodontal plastic surgery. After the healing period, the teeth were prepared for computer-aided design/computer-aided modeling lithium disilicate ceramic laminate veneers.

CONCLUSIONS

DSDapp use accelerated the initial planning steps. Smile planning can be performed during the clinical session with the patient's active participation. In addition, the DSDapp facilitated better communication within the multidisciplinary team.

CLINICAL SIGNIFICANCE

The DSDapp relies more on intuition than on skill and training to execute the treatment plan. The DSDapp provides immediate feedback to the patient, offering greater predictability and helps monitor the planning through all the clinical stages.

Automated integration of facial and intra-oral images of anterior teeth

BACKGROUND AND OBJECTIVE

Digital smile design is the technique that dentists use to analyze, design, and visualize therapeutic results on a computing workstation prior to actual treatment. Despite it being a crucial step in digital smile design, the process of labeling and integrating the information in facial and intra-oral images is laborious. Therefore, this study aims to develop an automated photo integrating system to facilitate this process.

METHODS

The teeth in intra-oral images were distinguished by their curvature and finely segmented using an active contour model. The facial keypoints were detected by a sophisticated facial landmark detector algorithm; these keypoints were then overlaid on the corresponding intra-oral image by extracting the contour of the teeth in the facial and intra-oral photographs. With this system, the tooth width-to-height ratios, smile line, and facial midline were automatically marked in the intra-oral image. The accuracy of the proposed segmentation algorithm was evaluated by applying it to 50 images with 274 maxillary anterior teeth.

RESULTS

The proposed algorithm recognized 96.0% (263/274) of teeth in our selected image set. The results were then compared to those obtained by applying manual segmentation to the remaining 263 recognized teeth. With a 95% confidence interval, a Jaccard index of 0.928 ± 0.081, average distance of 0.128 ± 0.109 mm, and Hausdorff distance between the results and ground truth of 0.461 ± 0.495 mm were achieved.

CONCLUSIONS

The results of this study show that the proposed automated system can eliminate the need for dentists to employ a laborious image integration process. It also has the potential for broad applicability in the field of dentistry.

Digital Smile Design-An innovative tool in aesthetic dentistry

A fundamental objective of an aesthetic treatment is the patient's satisfaction and that the outcome of the treatment should meet the patient's expectation of enhancing his/her facial aesthetics and smile. A patient constantly doubting the end result of the treatment, which is an irreversible procedure, can be motivated and educated through Digital Smile Designing (DSD) technique. DSD is a technical tool which is used to design and modify the smile of patients digitally and help them to visualize it beforehand by creating and presenting a digital mockup of their new smile design before the treatment physically starts. It helps in visual communication and involvement of the patients in their own smile design process, thus ensuring predictable treatment outcome and increasing case acceptance. This article reviews the aspects of digital smile designing in aesthetic dental practice pertaining to its use, advantages, limitations and future prospects.

Periodontal evaluation using a non-invasive imaging method (ultrasonography)

The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90–100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment.

Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence.

Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.

DENTAL CARIES PROGNOSIS BY NEURAL NETWORK COMPUTER TECHNOLOGIES

Computer technologies are widely implemented in clinical dental practice. The use of computer neural network programs in predicting dental caries as the most common dental disease is quite relevant. The aim – to study the effectiveness of using the “CariesPro” computer program developed using neural network technologies in the individual prediction of dental caries in persons of all ages. Materials and methods. We examined 73 persons aged 6–7, 12–15 and 35–44 years, in which the intensity of dental caries was determined taking into account the number of cavities, the hygiene condition of the oral cavity, the structural and functional acid resistance of the enamel of the teeth according to the enamel resistance test and its functional component. The data were added to a neural based computer software program “CariesPro” designed to predict dental caries. After 1 year, a second examination was performed and the dental caries obtained were compared with the individually predicted computer program. Results. The highest intensity of dental caries was found in persons aged 35–44 – 6.69±0.38, in children 6–7 and 12–15 years it was 3.85±0.27 and 2.15±0.24, respectively (p <0.05). After 1 year, the corresponding intensity indices for persons of these age categories were 8.92±0.52; 6.27±0.35 and 4.23±0.2. The growth rates of caries intensity were, respectively, 2.23±0.25; 2.42±0.15 and 2.09±0.15. After comparing the re-survey data with the computer-programmed estimate, the probable number of carious cavities was found to be 61 true and 12 false predictions from the entire sample, the prediction accuracy of the constructed and trained neural network was 83.56 %. Conclusion. The “CariesPro” computer program, developed using neural network technologies, allows to predict the number of carious lesions in a year with a probability of 83.56 %.

Perception of Buccal Corridor Space on Smile Aesthetics among Specialty Dentist and Layperson

Objectives

The aim of this study was to assess and compare the perception of smiles with and without buccal corridor spaces (BCSs) among prosthodontists, orthodontists and laypersons on smile aesthetics.

Materials and Methods

Smiling photographs of subjects with wide BCSs were collected and digitally manipulated to eliminate the BCSs. Digitally altered and unaltered photographs were placed together and assessed for aesthetic appeal using visual analog scale of one to ten by prosthodontists, orthodontists, and laypersons. One-way analysis of variance (ANOVA) and two-way ANOVA were applied to evaluate the collected data using the Statistical Package for the Social Sciences (SPSS 22), Epi Info 6.0, and GraphPad Prism, version 6.0.

Results

The total mean value scores of smiles with BCSs were significantly higher than those of smiles without BCSs (P < 0.001). Orthodontists and prosthodontists significantly appreciated BCSs and graded the smiles with BCSs to be much more attractive (P > 0.005). Laypersons rated the smiles with BCSs with greater mean values, but the difference in mean values of smiles with and without BCSs was not significant (P < 0.005). No significant difference was found between the perceptions of prosthodontists and orthodontists.

Conclusion

The results of this study reveal that the smiles with BCSs were notably more desirable than the smiles without BCSs. Laypersons, orthodontists, and prosthodontists evaluated smiles differently. The smiles with BCSs were appraised much more pleasing by prosthodontists and orthodontists. Laypersons could not significantly appreciate BCSs, but rated smiles with BCSs as more acceptable.

Digital dentistry: The new state of the art - Is it disruptive or destructive?

OBJECTIVE

Summarizing the new state of the art of digital dentistry, opens exploration of the type and extent of innovations and technological advances that have impacted - and improved - dentistry. The objective is to describe advances and innovations, the breadth of their impact, disruptions and advantages they produce, and opportunities created for material scientists.

METHODS

On-line data bases, web searches, and discussions with industry experts, clinicians, and dental researchers informed the content. Emphasis for inclusion was on most recent publications along with innovations presented at trade shows, in press releases, and discovered through discussions leading to web searches for new products.

RESULTS

Digital dentistry has caused disruption on many fronts, bringing new techniques, systems, and interactions that have improved dentistry. Innovation has spurred opportunities for material scientists' future research.

SIGNIFICANCE

With disruptions intrinsic in digital dentistry's new state of the art, patient experience has improved. More restoration options are available delivering longer lifetimes, and better esthetics. Fresh approaches are bringing greater efficiency and accuracy, capitalizing on the interest, capabilities, and skills of those involved. New ways for effective and efficient inter-professional and clinician-patient interactions have evolved. Data can be more efficiently mined for forensic and epidemiological uses. Students have fresh ways of learning. New, often unexpected, partnerships have formed bringing further disruption - and novel advantages. Yes, digital dentistry has been disruptive, but the abundance of positive outcomes argues strongly that it has not been destructive.

Benefits of Digital Smile Design (DSD) in the conception of a complex orthodontic treatment plan: A case report-proof of concept

INTRODUCTION

Digital Smile Design (DSD) is a systematic protocol based on specific photographs and software analysis that is used worldwide. DSD aims to assist the practitioner in creating and planning a course of treatment, especially in a multidisciplinary approach, and provides a virtual simulation of the final result. Additionally, it is a tool that enables communication and discussion between all the dental team, including the dental laboratory, and also with the patient. Although widely described and used in prosthetic rehabilitation, this tool remains only anecdotally used in the world of orthodontics. The objective of this proof of concept was to describe the application of the Digital Smile Design protocol in the diagnosis of orthodontic treatment.

MATERIALS AND METHODS

A teenage patient was referred to our university clinic by a private orthodontic practitioner for a second opinion on the treatment at that time. The patient had a self-ligating orthodontic appliance. According to the history of the case and the oral situation at that moment, the patient required an accurately calculated plan for orthodontic tooth movement that would permit the achievement of future rehabilitation. Therefore, the decision was taken to use a DSD protocol to potentially complete the classic orthodontic examination.

RESULTS

From the classic orthodontic examination, the patient presented a molar class I, midline deviations, the #21 and #23 were missing, #12 was conoid (microdontic) and, finally, #22 was in the position of #21. From the DSD results, three different views simulated the final results and therefore provided additional and relevant information, such as the correct position of the upper midline and the correct position of #12, #13, #22 and #23.

CONCLUSION

This proof of concept showed the clinical relevance of the Digital Smile Design protocol as a new tool for complex orthodontic treatment planning, especially in a multidisciplinary approach. Further publications will be necessary in order to define a specific DSD protocol for orthodontic treatment.

Dental Restorative Digital Workflow: Digital Smile Design from Aesthetic to Function

Breakthroughs in technology have not been possible without influencing the medical sciences. Dentistry and dental materials have been fully involved in the technological and information technology evolution, so much so that they have revolutionized dental techniques. In this study, we want to create the first collection of articles on the use of digital techniques and software, such as Digital Smile Design. The aim is to collect all of the results regarding the use of this software, and to highlight the fields of use. Twenty-four articles have been included in the review, and the latter describes the use of Digital Smile Design and, in particular, the field of use. The study intends to be present which dental fields use "digitization". Progress in this field is constant, and will be of increasing interest to dentistry by proposing a speed of treatment planning and a reliability of results. The digital workflow allows for rehabilitations that are reliable both from an aesthetic and functional point of view, as demonstrated in the review. From this study, the current field of use of Digital Smile Design techniques in the various branches of medicine and dentistry have emerged, as well as information about its reliability.