Interdisciplinary 3D digital treatment simulation before complex esthetic rehabilitation of orthodontic, orthognathic and prosthetic treatment: workflow establishment and primary evaluation

Longwei Lv,Chunlei Xun,Kwantong Cheung,Wei He,Hongqiang Ye,Lang You,Shimin Wang,Lin Tang,Yongsheng Zhou

doi:10.1186/s12903-022-02070-z

Abstract

BackgroundAn interdisciplinary treatment simulation and smile design before a complex esthetic rehabilitation is important for clinicians’ decision-making and patient motivation. Meanwhile, intervention and interaction are necessary for dental specialists in these complex rehabilitations. However, it is difficult to visualize an interdisciplinary treatment plan by using the conventional method, especially when orthognathic surgery is involved, thus hindering communication between dental specialists. This research aims to establish a 3D digital workflow of interdisciplinary treatment simulation to solve this problem.MethodsAn interdisciplinary 3D digital workflow of simulated treatment plan for complex esthetic rehabilitation was established. Eleven patients were enrolled and illustrated with their treatment plans using 3D treatment simulation, as well as 2D digital smile design (DSD) plus wax-up. Visual analogue scales (VAS) were used to rate the intuitiveness, understanding, and satisfaction or help between the two methods by patients and dental specialists.ResultsAccording to the ratings from the patients, 3D treatment simulation showed obvious advantages in the aspects of intuitiveness (9.7 ± 0.5 vs 6.4 ± 1.4) and treatment understanding (9.1 ± 0.8 vs 6.6 ± 1.5), and the satisfaction rates were also higher (9.0 ± 0.6 vs 7.1 ± 1.8). Dental specialists regarded the 3D digital plans as more intuitive (8.9 ± 0.8 vs 5.9 ± 1.0) and useful to understand the plans from the other specialists (8.9 ± 0.7 vs 6.1 ± 1.0) and helpful to their own treatment plans (8.7 ± 0.9 vs 5.9 ± 1.4).ConclusionsThe interdisciplinary 3D digital treatment simulation helps both patients and dental specialists to improve treatment understanding, and facilitates dental specialists for decision-making before complex esthetic rehabilitation.Trial registrationThis study was registered in the National Clinical Trials Registry under the identification number MR-11-20-002862. This is an observational study in which we did not assign the intervention.

Highlights

An interdisciplinary treatment simulation and smile design before a complex esthetic rehabilitation is important for clinicians’ decision-making and patient motivation
According to the ratings from the patients, 3D digital simulated treatment plan showed obvious advantages in the aspects of intuitiveness and understanding of the treatment plan, and the satisfaction rates were higher than digital smile design (DSD) plus conventional wax-up
As for ratings from dental specialists, 3D digital simulated treatment plan was superior in the aspects of intuitiveness and understanding of the treatment plan

Summary

Introduction

An interdisciplinary treatment simulation and smile design before a complex esthetic rehabilitation is important for clinicians’ decision-making and patient motivation. Complex oral-maxillofacial esthetic defects, which can be caused by various reasons such as genetic factors, growth and development factors, trauma, often lead to multiple problems ranging from tooth and dentition defects, malocclusion, to maxillofacial deformities [1,2,3,4]. As for these complex cases, the most challenging phase of their treatment is comprehensive diagnosis, planning and decisionmaking by the interdisciplinary team before the whole treatment starts [5, 6]. This 2D method is inevitably influenced by the angulation of photograph taking, affecting its accuracy [10]

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