DentaltownUK May 2017 - 64

Steps can be taken however to overcome
these potential risks. Firstly, before showing the patient an image, it is important to
explain that this is an image created on a
computer to give us an idea of how the
patient could look if dentistry was carried
out. Indeed, sometimes the images do look
artificial and so we do not want the patient
to be put off treatment because they do not
like the artificial image.
A disclaimer can be printed under every
image to the same effect. In addition, it is
important that the person doing the imaging or showing it to the patient has some
understanding of what is possible. For
instance, if there is a large jaw discrepancy
that can only be corrected with orthognathic surgery, this may be simple to simulate on a computer but the reality of the
procedure is much more complicated.
This needs to be communicated to the
patient sensibly so that there are no false
expectations. Imaging is not the treatment
plan per se, the dentistry still needs to be
diagnosed and planned appropriately, taking biology and function into account.
The software that I have found the easiest to use in practice for 2-D imaging is
Smile Imaging (smileimaging.co.uk). This
program is very user-friendly and full
training is provided so that team members
such as treatment co-ordinators can easily
be trained to set up the imaging. All the
changes I have mentioned above can be
made, saved and 'befores' and 'afters'
organised for easy discussion and communication with patients.
Dental 2-D imaging can be outsourced
to companies that will accept an emailed
photograph with some simple instructions
and will return a before-and-after for a fee.
E.g., SmileVision.

MAY 2017 // dentaltownuk.com

Thirdly, images can be manipulated
within keynote or using photo software.
This is generally less intuitive and needs
more understanding of the nondental software by the operator but is also effective.
The 2-D images, if accompanied by an
.STL file from a digital impression or a
model scan, can also be converted to 3-D
and this can also be outsourced, for example to the DSD Planning Centre in Madrid.
This is definitely the future for dentistry.
Software such as Nemotech can be used
to design the case in 2-D and 3-D. The
future also holds other advances which will
make this process simpler for the user. For
example, the work being done by Disney
where teeth are constructed from simple
photographs or video will likely eventually
impact the image-capture capabilities of
dentistry.
In summary, dental imaging is a very
useful tool to be able to demonstrate to the
patient in photographic form the potential
outcome of changing elements of the smile.
This is most powerful when used with the
full face. Although smiles can be designed
digitally-e.g., following the DSD protocol by Christian Coachman and team-it
is not always possible to take these to the
mouth in the first instance.
Trial smiles can be designed digitally
and photographed and videoed in the
mouth to produce 3-D images for some
patients.
For non-additive cases-e.g., perio
where teeth have drifted forward, or to
demonstrate simple things like colour
change or bonding before going to the
mouth-2-D dental imaging with for
example 'Smile Imaging' is a simple, effective way to initiate further discussion and
can be used to increase case acceptance. ■

http://smileimaging.co.uk http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK May 2017