The Elmwood Dental Digital Smile Design Process

The restorative process developed at Elmwood Dental in partnership with Hybridge Digital Laboratory uses todays most current computer aided smile design and manufacturing technology and blends artistic design and technology to create authentic, beautiful smile makeovers.

Step 1: Digital Imaging Capture

Step 1: Digital Imaging Capture

Before any diagnosis and treatment plan can be started, digital images must be captured in order to have enough information to complete a thorough analysis. A series of digital photographs, a complete full mouth 3D optical scan utilizing a 3 Shape Trios 4 scanner, and a CBCT radiographic scan are captured. These images are recorded during the 30 minute “Intake Appointment”. Also at this appointment, a detailed questionnaire will be filled out by the patient rating various aspects of their dental esthetics and dental health.

Digital Photographs

3D Optical Scan

Radiographic CT Scan

Step 2: Initial Conversation

Step 2: Initial Conversation

The Initial conversation is an opportunity for the dental provider to learn as much about the patient’s dental condition, dental complaints and treatment goals as possible. Typically a 60 minute appointment, this consultation can be done virtually, and recorded for the patient for future reference. With important input by the patient, and a thorough diagnosis by the Elmwood Dental provider, the proposal of a customized treatment plan will be generated that satisfies the treatment goals.

Arch Scan

Treatment Goals Questionnaire

Step 3: Preliminary Smile Analysis

Step 3: Preliminary Smile Analysis

During the Initial conversation, the many determinants of the patient’s smile are evaluated in relation to the specific dental complaints of the patient. These “Smile Determinants” are aspects of every smile, in combination, that determine the general esthetics of the smile. The most obvious is color, but many others become important when analyzing one’s smile, and determining what needs to change in order to satisfy the patient’s objectives. Lip position, symmetry, and the proportions of the teeth all become important to the restoration of a smile.

Smile Determinants

  1. Color
  2. Tooth Length
  3. Midline
  4. Symmetry
  5. Occlusion - Bite
  6. Proportions
  7. Lip Position

Smile Analysis

Step 4: Smile Design & Simulation

Step 4: Smile Design & Simulation

Smile Design and Simulation is generated using the digital information captured, and loaded into our powerful smile design software. This emerging simulation technology is powered by Artificial Intelligence. The facial recognition algorithms plot the key landmarks of the face, allowing the Elmwood Dental Provider the ability to customize a new smile simulation consistent with the patient’s objectives.

Step 5: Treatment Plan

Step 5: Treatment Plan

Upon completing the evaluation and analysis phase, a comprehensive treatment plan will be developed that can accomplish as many of the treatment goals as possible.  In order to satisfy the objectives, the Elmwood Dental provider must determine which dental procedures will be required to accomplish those goals.  To name a few they are, tooth whitening, composite bonding, porcelain veneers, ceramic crowns, orthodontics and dental implants. 

Step 6: Appointment Sequencing

Step 6: Appointment Sequencing

An important component of the Elmwood Dental Smile Design Process, is the exacting treatment sequencing that creates a written plan, outlining the order of appointments, their time commitment, and timeline to completion of treatment. Before any patient should commit to treatment, a defined sequence and time line should be established in order to minimize incorrect expectations.

01

APPOINTMENT

1 Hour: Initial Records & Digital Capture (wait 1 week)
02

APPOINTMENT

2 Hours: Zoom Whitening (wait 2 weeks)
03

APPOINTMENT

3 Hours: Veneer & Crown Preparation & Provisionals (wait 1 week)
04

APPOINTMENT

1.5 Hours: Final Insertion & Delivery (wait 3 weeks)
05

APPOINTMENT

1 Hour: Final Photos & Follow-up

Step 7: Smile Preparation & Provisionals

Step 7: Smile Preparation & Provisionals

The term “preparation” refers to the modification of a tooth in order to prepare it to receive a restoration of some kind. Typically there is a need to remove some of the outer tooth enamel in order to replace it with a ceramic or composite tooth colored alternative. This holds true for both a ceramic crown, and a porcelain veneer. Both examples above ultimately allow for the cementation of the restoration over the newly shaped or prepared tooth.

Once the tooth is prepared, a provisional (temporary) veneer or crown is made to be worn until the final (definitive) restorations are fabricated. Usually made of plastic, these “Provisionals” protect the tooth, and also allow the Elmwood Dental Provider and the patient to evaluate the shape, color and contours of the Provisionals as a preview of what the final smile could look like.

Step 8: Final Smile Analysis & Design

Step 8: Final Smile Analysis & Design

Final Smile Analysis is completed approximately one week after the Preparation and Provisionals appointment. The patient has had an opportunity to wear the provisional restorations long enough that anything that isn’t exactly right about how they look and feel can be critiqued and further designed to the patient’s liking. An optical scan of the Provisionals is completed, and that digital 3D model is used as the “Situation Scan”. The Elmwood Dental technician will design the final restoration based on the final design, factoring in small changes in shape and also color as needed.

Step 9: Restoration & Delivery

Step 9: Restoration & Delivery

The final ceramic crowns or veneers are then permanently cemented/bonded to the underlying teeth. Once cemented, the restorations are firmly attached, and should provide many years of function and beauty.