Digital Smile Design: A New Face of Dentistry

Jason Olitsky, DMD, AAACD

The Digital Smile Design Concept (DSD) presents the world with a new face of dentistry—more human, emotional, and artistic, but also more efficient and precise through digital technology. DSD is a dental treatment-planning tool for interdisciplinary esthetic dentistry to improve diagnostic vision, strengthen communication, and enhance predictability throughout the course of treatment.

I attended a lecture by Christian Coachman, one of the founders of Digital Smile Design along with Livio Yoshinaga, at the AACD several years ago that introduced a powerful new concept to improve the smile design process. He presented cases with an enhanced photographic protocol that used slide presentation software and cloud sharing to artistically simplify smile design, treatment planning, and interdisciplinary communication. As an avid smile designer, I immediately integrated this new concept into daily practice. DSD as a protocol makes so much sense. It logically organizes cases in presentation software, such as Keynote and PowerPoint, and uses cloud sharing such as Dropbox. While the protocol streamlines our artistic design presentation process, the photography and video make it come alive.

While the DSD protocol in no way mandates high level skills with a DSLR or postproduction software, the richer and more vibrant the documentation, the better the presentation. Enhanced photography and video has the ability to differentiate a clinician and attract patients who are drawn to the emotional content of our presentations. The technique is captured on a mobile device such as a phone or tablet, but truly gets our attention with high definition video and eye popping images.

DSD integrates more video into our designing process to help us better treatment plan and connect emotionally with our patients. An image is a poor static reproduction of the dynamic relationships of the face, lips, and teeth. This dynamic documentation of the smile allows esthetic treatment planning from a facial perspective; improves communication with the patient, technician, and specialists; and increases the predictability of the treatment. While video improves case acceptance, integrating technology generates efficient and predictable clinical procedures.

Clinicians can go from 2D to 3D with a conventional wax-up, which is my current method, or a digital wax-up. In a digital wax-up, a 2D project is linked to 3D software programs. By using the 2D/3D Connect concept software (Hack Dental Software, https://hackdental.software), one can overlap and calibrate 2D images over well known 3D CAD/CAM software programs, such as CEREC (Dentsply Sirona, www.sirona.com). Using software that already has the 2D/3D concept imbedded is also an option to develop the 3D smile design project following the facially generated 2D smile frame (NemoDSD 2D/3D, Nemotec, www.nemotec.com).

The final 3D file can be exported to a printing machine to generate a physical model of the new design. This model, whether fabricated by conventional means or digitally, can be used to fabricate a matrix for a mock-up, preparation guides, crown lengthening, or implant placements. The software can be overlapped with orthodontic software such as Invisalign (Align Technology Inc, www.aligntech.com) to guide the orthodontist in the digital set-up, as well as CBCT files and guided surgery software programs to allow for implant planning related to the facially guided 3D design.

DSD is a revolutionary movement from traditional smile design. This is the future of smile design and all its glory. I would recommend picking up a computer, a camera, and engaging your right brain.

About the Author

Jason Olitsky, DMD, AAACD, maintains a private practice with his wife, Colleen Olitsky, DMD, in Ponte Vedra Beach, Florida.