Digital planning protocol for functional and esthetic prosthetic treatment

The aim of the present study was to present the different stages of prosthetic treatment planning involved in the design of an esthetic smile and the improvement of masticatory function using CAD/CAM technology.

The patient underwent the following tests and procedures: CBCT (CS 9300; Carestream), intraoral scans and occlusal detection (CS 3600; Carestream), a photographic portrait session (Nikon D610; Nikon), a face scan (Bellus 3D FaceApp; iPhone XS, Apple), and registration of individual temporomandibular joint (TMJ) angles and mandibular movements with a Zebris for Ceramill device (Amman Girrbach). All the data were transferred to Ceramill Mind software (Amman Girrbach) where they were integrated. The face scan and photographs were superimposed on the CBCT scans. Scans of the dental arches were combined with the CBCT scans. On this CBCT base, the position of the condyles in the articular fossae was determined. A Virtual Artex CR virtual articulator (Amann Girrbach) was attached to the 3D object. Individual TMJ angles and mandibular movements were then introduced.

A virtual patient was created in the Ceramill Mind software. The optimal shape and position of each tooth were designed into the program. The wax-up was printed using a 3D printer and a temporary mock-up, and final restorations were made for the patient. At the same time, the esthetics of the smile was improved, and a harmonious central occlusion and articulation were obtained on virtual models and in the patient's oral cavity.

The presented digital planning protocol allows the working out of an optimal solution in complicated patient cases from both the functional and esthetic points of view. (Int J Comput Dent 2023;26(1):61-0; doi: 10.3290/j.ijcd.b2599445).