Use of DSDApp as a treatment planning tool for Invisalign Aligners and Porcelain Veneers
Case Report by:
DR. Alysson Resende, DDS
DR. Felipe Saliba, DDS
DR. Diogo Alves, DDS
A 30 year-old female patient sought dental treatment at AR Odontologia, a DSD Clinic located in Belo Horizonte, Brazil complaining about her dissatisfaction with the harmony of her smile and posterior crossbite. (Fig. 1).
An examination and full mouth radiographs revealed no cavities and no evidence of any endodontic or periodontal pathology. There were no signs or symptoms of temporomandibular joint disorder. On the posterior left side a cross-bite was observed and the dental midline slightly shifted to her left side (Fig. 2A, 2B).
Initial photo (note posterior left crossbite + disharmony of smile)
Retracted lateral picture showing posterior crossbite
Retracted frontal showing dental midline slightly shifted to the patient’s left side
A correct oral hygiene instruction was performed followed by digitalization of the upper and lower arch of the patient (Fig. 3). After scanning, one frontal facial smiling photo was taken of the patient to simulate the smile with DSDApp (Fig. 4).
Upper and lower arch
Intraoral scan .STL file
Frontal Facial Smile Picture
DSDApp Smile Simulation
The app calibrated the patient’s picture following the facial flow concept (Fig. 5) and a smile (selected from one of the natural smile donator libraries [Jan Hajto F07] by the doctor) was then superimposed on the patient’s picture. The patient was shown the smile simulation case presentation with before and after photos using DSDApp. Once shown the transformation, she was immediately appreciative and instantly approved the case (Fig. 6A, 6B).
2D Smile Simulation Before and After
Auto Calibration + Facial Flow concept applied
2D Smile Simulation Before and After Slider
DSDApp 3D Smile Design
To create a 3D Smile Design, the upper intra-oral scan (.STL file) was calibrated into the App (Fig. 7) and a frontal facial smiling photo and a digital impression (.STL file) of the patient were reconciled (Fig. 8). The facial guided smile frame was created by using the recurring aesthetic dental (RED) proportion, (width and length ratio proportion), arch curve, teeth proportion, and design and the same smile donator [Jan Hajto F07] was used for 3D Smile Design (Fig. 9) which was then converted to a 3D project for digital teeth mounting (Fig. 10A, 10B). To fine-tune the project, digital waxing was applied to get better accuracy of the future smile (Fig. 11A, 11B).