Digital Smile Design (DSD) is a technology for planning aesthetic restorations of anterior teeth based on the use of a computer program for individual simulation of the intended result of treatment. It has been further developed and can be used to plan both the aesthetic and functional parts of the dentition.
This method has been placed under the heading of diagnostics, because it can often be a part of the diagnostic measures. At the same time, it can be assigned to any area of dentistry that deals with aesthetics.
Characteristics of Digital Smile Design (DSD) Technology
Digital Smile Design technology was introduced in 2007 and is designed to optimize communication between the dentist and the patient and the dental laboratory. Digital Smile Design is the use of photographs of the patient and the creation of a virtual model of the future restoration on their basis. The patient’s wishes are taken into account in the modeling process and the patient can follow the process on the computer screen. When working, the program is based on the features of facial expressions and the structure of the maxillary system of a particular person, so the planning result is strictly individualized and highly accurate.
Our specialists use similar technology to model DSD, taking into account the functional and anatomical features of patients.
For DSD we use software from various manufacturers (software) Digital Smile System, Planmeca Romexis Smile Design and others, the range is constantly expanding. They can be used not only to simulate the desired appearance of the patient, but also to create a detailed plan of all dental procedures necessary to achieve the final result. The peculiarity of Digital Smile Design technology is the direct participation of the patient in the planning of future restorations and the creation of his/her smile.
It should be noted that the existing modeling programs are divided into two classes – the first allow for rapid external modeling of the smile, the second – also allows working out the functional part (such as ExoCad, Nemo, etc.). Specialist workload on the DSD modeling with the second class programs is incomparably higher, so they are used only in certain clinical situations where high aesthetics are required or in complicated cases where many teeth are missing.
Benefits of Digital Smile Design (DSD)
The introduction of digital smile design technology in aesthetic and prosthetic dentistry facilitates the work of the dentist, and DSD has its advantages for the patient.
Main advantages of Digital Smile Design (DSD) technology in dental treatment planning:
- High degree of adaptation. DSD programs, within the limits of their functionality allow to take into account any individual features of the patient, the quality of the result remains high regardless of the condition and proportions of teeth. Built-in tooth and smile libraries make it possible to satisfy various aesthetic needs.
- Versatility. The technology allows performing a variety of tasks associated with diagnosis and modeling, serves as a link in communication between the dentist, the patient and the dental laboratory.
- Versatility. The software is capable of designing restorations of varying complexity, it is possible to work with the complete absence of teeth on the jaw.
- The speed of reception of result. The preliminary result of modeling – the future appearance of teeth will be obtained in just a few minutes, ie during a consultation. The result of functional modeling in one or two days.
- Affordability. Digital smile design does not require complex and cumbersome equipment, only a camera and a computer with software. Time to make corrections. Functional modeling will require a 3D face scanner, however, this class of equipment is quickly becoming more accessible.
- Accuracy. Calculations resulting from the simulation guarantee a harmonious combination of size and shape of teeth with facial features, while preserving the natural functionality of the dentition.
- Involvement of the patient in the process. One of the main advantages. The patient is directly involved in the creation and discussion of the treatment plan, thanks to the capabilities of the software, he can be sure that his wishes regarding his appearance will be heard and correctly interpreted by the dentist.
- Visibility. Even before the restorative work is begun, the patient can see their new smile and form realistic expectations for the treatment result.
- A good level of communication. The task created by the dentist and the patient is visualized and transferred to the dental laboratory, so misunderstandings on the part of the dental technician are avoided.
- Compatible with CAD/CAM systems. Data from the software is exportable to any CAD/CAM system that is used to make restorations. Based on a smile design created using the DSD technology, taking into account the functional alignment of the teeth, navigation patterns are made, and the implants are placed.
- Predictable treatment results. Restorations made using Digital Smile Design technology precisely meet the wishes of the patient, the result of treatment is never disappointing.
Thus, the same features of the technology allow for different benefits for both patient and doctor.
Steps in the Digital Smile Design (DSD) procedure
During the consultation with the dentist, when the treatment plan is made and the work begins, the dentist examines the oral cavity, identifies any contraindications, i.e. follows the standard procedure.
If one of the requirements is the installation of new frontal teeth on the same day, note that restorations are not allowed if there is inflammation of the gums, tartar, or tooth decay.
When planning an extended treatment (expected to last more than two to three days), Digital Smile Design is a good option to start as one of the first steps of the job.
Stages of Digital Smile Design:
- Photo session. The doctor takes a series of pictures that clearly show the patient’s face and smile from different angles. Intraoral pictures are also taken.
- Determining the patient’s wishes. The patient explains to the doctor what changes he would like to make, how he sees his future smile, while discussing the color of enamel, shape and size of the teeth. The doctor helps the patient to determine the best option in terms of aesthetics and functionality, explains what features the shape of the teeth adds to the face.
- When planning a functional simulation, impressions are taken of the patient’s jaw and diagnostic models are made before the virtual modeling, and it is good if the doctor obtains a stereo lithographic image of the patient’s face and head using a 3D scanner.
- Virtual modeling. Digital images are sent for processing: the software analyzes the features of the patient’s bite, the shape of teeth, the position of the lips when smiling, and determines the relationship between the teeth and lips. The patient is offered several options for a new smile, and the dentist helps him choose the best one in terms of aesthetics and functionality. If the patient wishes, the dentist can adjust the size and shape of the teeth and their color. As a result, the patient’s face with the new smile is displayed on the screen, and if it meets his or her expectations, the model is sent to a dental laboratory.
- This step is performed during functional modeling. Each step is coordinated with the patient. The program makes a three-dimensional combination of 3D images of the patient, 3D diagnostic models, models of future teeth, and ideally, a CT image of the patient. New teeth are placed in the simulation program, according to the anatomic features of the patient, are matched, then the new teeth “subtract” the surface of the diagnostic models, and this result is displayed on a 3D printer for “trying on a smile” in the mouth.
- Wax modeling is analogous to step 5, which is performed in the laboratory. Based on the virtual model, the dental technician makes a wax model of the teeth.
- Evaluation of the model in the mouth. The model of the future restoration is tested in the mouth using a silicone key and Mock-up technique. This allows the patient to give a realistic assessment of the expected outcome and the doctor defines the parameters of phonetics, aesthetics and functionality of the restoration.
- Fabrication of the permanent restoration. Data obtained during the incarnation of DSD, are transferred to the CAD / CAM module, which produces the restoration: these can be crowns, veneers, ultranaries, bridges. Also, the results of modeling are used in bone grafting and implantation.
- Fitting the finished restoration. Fixation of prostheses or microprostheses in the oral cavity. Patients usually have no questions about the appearance and color of their new teeth, because the restoration fully meets all their wishes.
Digital Smile Design technology is a guarantee of complete communication between the patient and dentist, as well as the certainty that the entire process of dental restoration goes strictly according to plan. Digital Smile Design for the patient is an opportunity to see the final result in advance, make adjustments to the treatment plan and end up with a smile that is 100% in line with your expectations.