Smile Designing, Not A New Thing Anymore

Everyone desires a beautiful, confident smile. A smile design is a process of improving one's smile through one or more cosmetic dentistry procedures such as dental veneers, composite bonding, dental implants, and teeth whitening. When a patient wants to achieve that smile but is hesitant to undergo treatment because they cannot see the treatment outcome, a doctor can use the Digital smile designing (DSD) tool.

Digital smile design allows construction and projects a new smile design by simulating and visualizing the result of the suggested treatment. The DSD concept assists clinicians by improving the aesthetic visualization of the patient's concern, providing comprehension of the possible remedy, and educating and motivating them about the benefits of the treatment, hence increasing case acceptance.

What is Smile Designing?

Smile Design Treatment is a restorative procedure that focuses on improving the smile's appearance through dental veneers or crowns, composite fillings, teeth whitening, and dental implants. This treatment's considerations include alignment and structure of the teeth, facial attractiveness, skin tone, gum tissues, and lips. It is a Cosmetic procedure and is usually chosen by those who want to correct teeth imperfections to get a straighter, whiter, and more beautiful smile.

What is Digital Smile Design (DSD)?

Coachman and Calamita described DSD as a multi-use conceptual tool that can support diagnostic vision, improve communication, and enhance treatment predictability by permitting careful analysis of the patient's facial and dental characteristics that may have gone unnoticed by clinical, photographic, or diagnostic cast-based evaluation procedures.

Digital Smile Design (DSD) is a multifunctional digital instrument with clinically significant benefits. It can improve communication among team members, build predictable systems throughout the therapy phases, boost patients' knowledge and motivation through visualization, and raise the effectiveness of case presentations. Because DSD can improve diagnostic and treatment planning, the work required to apply it is justified. It will make the treatment sequence more rational and straightforward, saving time and resources and lowering treatment costs.

Digital Advancements in Smile designing

Smile design has progressed from physical analog to digital format in the previous two decades, progressing from 2D to 3D. From the days when hand drawing on printed images of patients was utilized for communicating and describing how the eventual result would look, it has now moved to the comprehensive digital picture on DSD software on a computer. This can be readily altered and undone at any moment to get the final design that balances the patients' aesthetic and functional needs.

With advances in digital imaging and 3-d printers, it is now possible to construct a digitalized surgical navigation system with a three-printed CADCAM stent. Post-integrating the digital impression scan data with the CBCT data, ensuring correct implant placement and angulation with minimal invasion and pain.

Advantages and Limitations of Smile Designing

People's perceptions of smiles and how they are designed have changed due to the adoption of new materials and procedures in aesthetic dentistry. The following are the advantages and limitations of Smile Designing.

Advantages

1. Digital imaging and design enable patients to envision the projected final result before treatment begins, improving therapy predictability.
2. The clinician can minimize patients' concerns by digitally displaying the result, inspiring and educating them on the benefits of the treatment.
3. It improves physician diagnosis and treatment plans by providing an aesthetic image of the patient's problem via digital analysis of facial, gingival, and dental characteristics that examine the smile and face objectively and systematically.
4. DSD leads to the customization of smile design by enhancing patient participation in their smile design, resulting in a more aesthetically oriented, humanistic, emotional, and confident smile.
5. The patient is evaluated, provided feedback, and approved of the new smile's final shape, increasing patient happiness Before any treatment operations are conducted. This eliminates the possibility of post-treatment regret, as smile designing is an irreversible treatment.
6. It also aids in evaluating and comparing pre and post-therapy changes. Easy comparisons between pre-and post-treatment images can be made using the digital ruler, sketches, and reference lines.

Limitations

1. Crooked Smile Outbreak: Dentists must be aware of a patient's natural head position when reviewing facial designs. Instead of focusing exclusively on the mouth, the dentist's approach entails doing a correct facial aesthetic analysis while assessing the face. A vertical line drawn through the center of the face directs attention from the point of the nose to the center of the chin, providing a more precise frame of reference in grin design and, as a result, a straighter smile.
2. Excessive Contouring of teeth: If there is little distinction in how light bounces back on different teeth zones, teeth can appear over-contoured. Teeth might appear short and plump, long and thin, or more rectangular and curved depending on how lines and angles are modified. Moving angles outward results in wider-looking teeth, while moving them inward results in narrower-looking teeth. Because dental ceramists must operate within the constraints of preliminary designs, they are compelled to cover the reflecting and deflective zones when building up porcelain, resulting in over-contoured teeth. This infringement can be corrected if dental ceramists are provided with a properly constructed mock-up and utilize the required thickness while creating porcelain veneers.
3. Since the diagnosis and treatment plan relies on photographic and video documentation, there needs to be more clarity that either can distort the reference image or lead to inaccurate diagnosis and planning.
4. 3D software with updates, an intraoral scanner, a 3D printer, and CAD/CAM are required to establish a complete 3D digital workflow, all of which are expensive to maintain.
5. Specific software requires training and handling, which adds to the time and cost.

Future Prospects

Complete 3D digital workflow still needs to be prevalent, but this may change as more clinicians adopt digital scanners, 3D printers, and CAD/CAM, making the need for time-consuming impressions, plaster, and wax obsolete. With software advancements in the coming years, it will be feasible to address facial aesthetics in advanced cases where implants must be implanted by superimposing files from a CT scan or a Cone Beam, as well as 3D files from an oral impression or a facial scan and a photo. There is also the option of introducing a 4D notion in which motion is introduced to the smile design concept. With rapidly expanding technology, a moment may not be far away when a digitally produced smile can be projected through virtual reality glasses to predict the intended smile in actual reality.

Take Away

The ideal smile is what makes the person happy. The concept of digital smile design is a valuable tool for the aesthetic depiction of a patient's problem. It not only assists patients in visualizing their treatment outcomes, but it also improves physician diagnosis and therapy planning. This article summarises advancements, advantages, limitations, and future prospects in smile design. Check out our website to know more about Fundamentals of Smile Designing Video Lectures by Dr. Umesh Palekar, an experienced Prosthodontist and the Dean (Academics) at Pravara Institute of Dental Science and the H.O.D. of the Department of Prosthodontics, Crown, and Bridge, and Dental materials."