J Korean Acad Prosthodont.  2017 Apr;55(2):164-170. 10.4047/jkap.2017.55.2.164.

Use of Digital Smile Design in esthetic restoration in anterior teeth: A case report

• Shin S
• Noh K
• Kwon KR
• Kim HS

• KMID: 2377185
• DOI: http://doi.org/10.4047/jkap.2017.55.2.164

Abstract

When restoring their anterior dentition, patients become more demanding on esthetics compared to posterior region during treatment planning phase. Digital Smile Design (DSD) procedure is performed in presentation software and digital photographs. This can widen diagnostic visualization and aid in transferring information between clinician, patient, and technician. This case presented is that of patient with dissatisfaction of his anterior old restoration. Retreatment procedures were carried out in two different manners: (1) using DSD protocol for diagnosis, smile simulation, communication and fabricating interim and definitive prosthesis by totally digitized workflow. (2) Using diagnostic wax-up for smile design and fabricating restorations by conventional workflow. Comparing two methods, DSD was easier to communicate between the dental team than the diagnostic wax-up method. But the final result obtained failed to meet total esthetic factors. Therefore, to obtain predictable esthetic results, more advanced design tool would be needed, including consideration of various esthetic factors besides successful communications.

Keyword

Esthetic restoration; Digital Smile Design; Treatment planning

MeSH Terms

Dentition
Diagnosis
Esthetics
Humans
Methods
Prostheses and Implants
Retreatment
Tooth*

Figure

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  Fig. 1. Initial intraoral photo.

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  Fig. 2. Facial photo behind the cross.

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  Fig. 3. Transferring the cross to the intraoral image.

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  Fig. 4. Tentative tooth proportion described in the literature.

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  Fig. 5. Tooth outline drawn as guided by ideal proportion.

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  Fig. 6. Tentative tooth shape presented to patient.

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  Fig. 7. Facebow transfer with Kois Dento-Facial Analyzer system.

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  Fig. 8. Diagnostic wax-up.

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  Fig. 9. Transforming the drawings and the lines from 2D image to 3D image by DSD Connect.

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  Fig. 10. Interim restoration by DSD protocol.

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  Fig. 11. Clinical try-in using interim restoration by conventional manner.

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  Fig. 12. Tooth preparation and impression taking.

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  Fig. 13. Transferring initial tooth design to definitive restoration.

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  Fig. 14. Definitive restoration by DSD protocol.

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  Fig. 15. Definitive restoration by conventional manner.

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