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The Use of Digital Smile Design in everyday Orthodontics

The Use of Digital Smile Design in everyday  Orthodontics

by Dr. Kamsiah G Haider BDS, MDSc
Dec 13, 2017


As technology continues to evolve we now have the advantage of digital smile design workflows in our everyday dentistry. Through photography, video and impression scanners we can perform similar procedures using digital smile design protocols. We have been exposed to many great interdisciplinary examples of digital smile design cases that involve full mouth restorative. However, we can use these protocols to also execute traditional orthodontics as well.
The following is a clinical case of an orthodontic procedure that many general practitioners might perform on a regular basis. It was planned using a Digital Smile Design (DSD) protocol to educate patient on how the movement going to be during traditional orthodontics  .
DSD protocol may be used for other cosmetic dental case which we have discussed extensively in our website , blog, FB , Instagram and twitter cases involving restorative dentistry, periodontics, implantology , aligners, orthognathic cases . By using the digital workflows , clinical cases are predictable and easier to explain to our patients and  implement with the help of an experienced lab in Digital Smile Design Technology . 

All-on-4® using guided surgery

by Dr. Kamsiah G Haider BDS, MDSc

Nov 26, 2017


All-on-4® using guided surgery 


The All-on-4® treatment concept was developed in the 1990s as a way to best restore the full arches of the upper and lower jaws. The procedure uses only four implants to secure all teeth in place, hence the name “All-on-4.”

CBCT guided implant planning and surgery is a facially driven treatment plan. It first involves planning an ideal dental restoration for a patient; this may be a complete denture or, for a partially edentulous patient, a digital diagnostic wax-up of the planned restorations.

This virtual treatment plan is then sent to a laboratory (in this case the DSD lab in Madrid) for fabrication of an appliance that is used at the time of surgery to accurately place the implants in their planned position(s). Most larger implant manufacturers offer guided surgery-specific instrumentation for flapless implant placement. When desired and indicated, techniques and armamentarium are available for extractions, bone reduction, immediate implant placement, and immediate loading, all of which are commonly used in the All-on-4 protocol.

At surgery, the surgical guide was properly positioned and stabilized using stabilization pins. Implant-specific instrumentation was used to place the four planned implants to full depth and accurate direction using guided-surgery techniques with implant mounts .

Guided surgery and dental CAD/CAM are complementary technologies that can make the surgical and restorative phases of implant therapy more efficient and predictable.



The use of CT-guided surgery to perform the All-on-4 procedure is a combination of technologies that is still not very in common practice.  We @drkamsiah prefer the combination  of these two techniques, together with the digital smile design concept to improve the aesthetic outcome as well.