The Digital patient - Zirkonzhan

Real jaw movements and face morphing on the digital patient: production of functional restorations in only two chairside appointments

Example of a full-digital workflow based on the production of a demo mock-up. The tools for patient diagnostics as well as the design automations used allow for a precise functionalisation of the prosthetics in the digital world, providing patients with customised restorations in only two chairside appointments.

The latest technologies and software innovations in terms of patient data acquisition permit the production of functionalised and aesthetic restorations in considerably shorter times. Through a demo case of a mock-up, this article describes a workflow based on Zirkonzahn’s patient diagnostics tools and design automations allowing for the manufacture of precise, individual dental prostheses in only two chairside appointments. A comparison between the produced demo mock-up and the natural teeth is also displayed, to show the mockup’s high level of customisation and natural effect achieved with the workflow.

First chairside appointment During the first appointment with the patient, the practitioner records the patient’s data and oral situation by taking 2D pictures of the face as well as digital impressions through the intraoral scanner.

After the visit, the dentist sends the recorded data to the dental technician, who creates a virtual patient folder in the archive software, saving and storing all patient information for future usage. Based on the 2D pictures and intraoral scans, the dental technician designs a first set-up by means of the Smile Creator module included in the Zirkonzahn.Modellier software, in order to create a preview of the potential new smile.

With the Smile Creator, the dental technician can design the tooth setup based on the natural teeth of the patient, or use the virtual libraries of natural tooth sets available in the software. In addition, the dental technician can apply different tooth sizes, display the teeth in a realistic dentine colour, as well as integrate different reference lines into the 2D pictures for better tooth alignment (e.g. the smile line). The completed setup can then be exported as a 2D or 3D file and saved in the software for future designs.

TOP: Impression-taking with the intraoral scanner BOTTOM: Registration of patient data into the archive software

Second chairside appointment During the second appointment, the dentist and the dental technician show the digital smile preview to the patient. If the patient is satisfied with the aesthetic result, the dentist continues the treatment according to the restoration type. This demo case for the creation of a mockup shows the workflow generally used for treating complex cases on implants. In such situations, the dentist employs the following patient diagnostics tools:

• The PlaneSystem® (MDT Udo Plaster), which records the patient’s occlusal plane and oral situation in Natural Head Position

• The Plane Analyser II, which detects the patient’s real mandibular movements for a detailed and customised functionalisation of the prosthetics

• The Face Hunter 3D facial scanner, for a photorealistic digitalisation of the patient’s face

Such technologies permit the 1:1 reproduction of the patient physiognomy and oral situation into the virtual world with no loss of precious information. In this way, the techno-clinical team can continue the workflow with no need for further chairside appointments to perform functional and aesthetic checks. This is possible thanks to the integration of the recorded information into the Zirkonzahn.Modifier design software. By means of a specific software function (“Real Movement”), the dental technician can display with accuracy all mandibular movements recorded with the Plane Analyser II (opening, closing, protrusion, retrusion and laterotrusive movements), achieving an optimal functionalisation of the design. Subsequently, with another automation (“Face Morphing”) the functional movements can be associated with the patient physiognomy in order to simulate several facial expressions (e.g. smiling) and evaluate the restoration in terms of aesthetics. Movements can also be imported into the virtual articulator, which is adjusted automatically in relation to the case, for a possible switch to the analogue workflow with milled or printed models.

At this point, the dental technician sends the dentist a PDF file including all information concerning the design as well as the software-generated functional movements. After the dentist’s final approval, the dental technician proceeds with the manufacture of the prosthetics.

Delivery to the patient The patient goes to the dental practice to receive the restoration. No functional or aesthetic changes need to be applied, since all checks were performed on the digital patient by means of the Real Movement and Face Morphing functions.

For more information: W: www.zirkonzahn.com

T: +39 0474 066 660

E: info@zirkonzahn.com

TOP ROW: Creation of a first set-up displaying tooth size, colour and shape 2ND ROW (L): Capture of the oral situation with the PlaneSystem® 2ND ROW (R): Capture of the mandibular movements with the Plane Analyser II 3RD ROW (L): Photo-realistic 3D digitisation of the patient’s face with the Face Hunter facial scanner 3RD ROW (R): Matching of all data, for a 3D virtual reproduction of the patient’s oral situation and physiognomy 4TH ROW (L): 3D display and analysis of jaw movements recorded with the Plane Analyser II (“Real Movement”) 4TH ROW (R): Simulation of facial expressions (“Face Morphing”) 5TH ROW: Natural smile vs smile with the mock-up.