Use of SmileFy Smile Design Software as a tool for improved lab communication and 3D interdisciplinary planning:

Crown lengthening and Porcelain Veneers: A Case Report

By: Dr. Sergio Miralles


The 3D smile analysis process is essential for diagnosing, planning, treating, and proposing any dental treatment with aesthetic goals to the patient. Moreover, it facilitates communication between dentists and dental technicians, reducing the number of patient visits and increasing the quality of the workflow of every dental practice. This work aims to present how SmileFy Smile Design Software can assist doctors in delivering more predictable oral-facial outcomes to create more balance, especially in the esthetic zone.

The Case

A young woman in good general health was referred to Dr. Sergio Miralles at the D&S Clinic – Australia, for esthetic rehabilitation. (Fig.1). She was dissatisfied with her smile, specifically with the gaps on the sides and two chipped frontal teeth from when she was eight years old. She was looking to fix the gaps between teeth, restore chipped teeth, and have straighter and whiter teeth.

The first consultation protocol:

A complete examination was performed, including initial teeth measurements, x-rays, clinical videos, photographic documentation, and mouth impressions to be digitized by the dental technician.

The First Appointment Communication:

To improve the communication between the dentist and patient, the SmileFy Smile Simulator was used CHAIRSIDE using the natural teeth templates available in the software over the patient’s facial photo to reference the patient’s new smile proposal to a discussion about treatment possibilities, goals to achieve, number of appointments and timings.  SmileFy uses artificial intelligence to build the smile simulation, facilitating the process and delivering it very fast.  Although the Smile Simulation cannot be used solely as a treatment plan tool, it helps the doctor and patient deliver the first draft of the future smile. (Fig.2A,2B).

The Patients reaction to SmileFy Smile Simulation and its case acceptance:

The smile simulation was really useful for her and a great help for the final case acceptance. Being able to show her that 10 units (rather than 6) would have a much better outcome on her smile regarding her smile’s width and buccal corridors was crucial for her to understand the differences better and start saving for that goal (starting now with 6 veneers but upgrading to 10 as soon as financially feasible). (Fig 3)

3D Analysis & Mockup Design:

After a thorough examination, observation of facial references to guide the patient’s new smile design, and taking the patient’s good periodontal status into consideration, the 3D wax-up design began:

to create a 3D Smile Design a frontal facial smile picture and the intraoral scan of the patient were imported and calibrated into the SmileFy App 

  • The calibrated.STL file was then superimposed on the frontal facial smiling photo   (Fig. 4).
  • And using the recurring esthetic dental (RED) proportion, the facial guided smile frame was designed, and the following were planned using the clinical findings as a reference to the 3D Smile Design (Fig. 5)
  • The original 21( right central incisor)  incisal length was used as a reference.
  • The gaps were closed, and the proportions were improved. using a 3D Natural teeth template available in the software  ( Fig. 6)
  • To increase assertiveness and balance of the oral-facial natural characteristics, the app’s artificial intelligence (AI) technology calibrates the frontal facial picture, which allows the doctors involved in the case to draw a line connecting the glabella, nose bridge, philtrum, and chin to determine the patient’s facial flow (an evaluation of the face to harmony and balance between the facial structures and smile). Using the facial analysis available in the Software (Fig. 7)
  • The cant of the smile was also corrected in the Q1 (gum lifting in Q1, incisal preps in Q1, minimal preps in Q2, correct tilted midline), and the buccal corridor was broadened, adding volume on the premolars on both upper quadrants. (Fig.8A,8B)
  • The cant of the smile was also corrected in the Q1 (gum lifting in Q1, incisal preps in Q1, minimal preps in Q2, correct tilted midline), and the buccal corridor was broadened, adding volume on the premolars on both upper quadrants. (Fig.8A,8B)

The files were exported as 3D print-ready material ( .stl ) and sent to printing. (Fig.10)

Printed Models + in-mouth Smile Trial:

A silicone barrier was fabricated to make a mock-up out of bis-acryl resin for this model. The mock-up was placed onto the patient’s teeth, and when shown to her, she expressed how satisfied she was with the aesthetics as it fulfilled her desires.

The Clinical procedure:

Stage 0: As the treatment remained conservative, teeth whitening was performed before the minimally invasive procedure was initiated.

Stage 1: The diagnostic wax-up was used to guide a laser gingivoplasty on Q1 for better gingival harmonization based on the facially-guided digital design, and the teeth were prepped to receive the final porcelain veneers 

The diagnostic wax-up was then used as a guide to place the provisionals until the next appointment. Fig. 11

Stage 2: After the healing period, the gum & temps were re-checked. A final teeth impression was made for the final adjustment of the final veneers. 

To better collaborate with the dental technician, the following were exported from SmileFy and sent to the dental laboratory: 

  •  All initial pictures
  • 2D Smile simulation image
  • 3D teeth template (shapes overlapped on her teeth) digital files
  • 3D wax-up digital files.

Written instructions in the lab sheet. Final prepped teeth position impression + details to consider to hand-craft the six-layered LiDiSi veneers ( Fig. 11)

Stage 3: The six anterior porcelain veneers were delivered to the dental practice based on the 3D teeth templates and mockup files exported from the 3D smile design created on SmileFy App. The units and the teeth were prepared in accordance with the manufacturer’s instructions, and cementation was performed. The occlusion was evaluated, and polishing was performed. Fig 12A,12B

Stage 4Dr. Heather scheduled a follow-up appointment to perform four composite veneers on the upper premolars. Final pictures were taken.

The case was completed, and the patient was satisfied with the results. The patient received necessary postoperative instructions, and follow-up assessments were made.  Fig. 13

The Patient’s Satisfaction:

“ The patient was really happy with the results and the overall experience. She emphasized how predictable the final result was after seeing the temporaries and the 3d wax-up. She went to New Zealand to celebrate her new smile” – Dr. Sergi Miralles Fig. 14A,14B,14C

The Conclusion:

SmileFy is a world-renowned software available to every dentist wanting to elevate their dental workflows and patients’ experiences. 

With one purpose in mind, the SmileFy App helps doctors worldwide to achieve better outcomes through facially generated smile designs and printable mockups as an essential tool to guide doctors, and dental technicians and, most importantly, to deliver patient maximum smile satisfaction.

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