Learning Smile Design with Nordic Institute of Dental Education

Digital dentistry is maybe the fastest developing field in dentistry. It simplifies the treatment protocols not only in prosthetics but also for example in surgery and orthodontics. As a result of the digitalisation, the client’s role in aesthetic dentistry has become more important as the chairside planning can be done on screen while the client follows.

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Working as a clinician in Tampere and as a PhD student in the University of Turku, I had some previous experience in CAD/CAM technology – computer-aided design and computer-aided manufacturing – both in practice as well as in research projects. However, I wanted to deepen my knowledge with a hands-on course and participated in the Aesthetic Restorations with CAD/CAM course at the Nordic Institute of Dental Education in June 2019.

Before the course, I was looking forward to visiting the Planmeca training center and expected to get a deeper insight into digital dentistry, material selection and aesthetic importance. The course met and exceeded all my expectations completely. I thought it was particularly great that the course was arranged in the building where we could meet people working in the field of designing and marketing of digital devices.

On the course, Dr Wally Renne, one of the course lecturers, taught us an interesting protocol which he uses in his daily clinic consultations. In this workflow, a client comes to the first meeting and talks about the aesthetic changes in their dentition they would like to have. The dentist immediately captures an intraoral scan and clinical images to be able to produce an illustrative treatment plan about the treatment possibilities right away.

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Smile Design case exercise


With these images, the clinician can start the treatment planning with Planmeca Romexis® Smile Design software, while the client waits outside the treatment room or follows the planning procedure. For the smile design, it is only necessary to take a frontal photo in a precise angle to see the smile line and export it to software. Finally, the planned dentition is printed with a 3D printer and fixed to the client’s mouth using the impression of this print and temporary crown material. This way, the planned smile is in the client’s mouth already after a few hours – and during the same meeting.

While we were following Dr Renne’s workflow demonstration, we had the chance to make our own smile design plans. There was also sufficient personal guidance for all of us while we worked. We got many very valuable tips regarding the shapes of the teeth, the smile width, the smile line and preparations. We planned, milled and coloured one anterior crown with good advices on tooth shades and characterisation.

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Staining artwork on a 3D printed dentition


We learnt that smile design is much more than just planning the perfectly shaped crowns, which in some clinics are done by technicians. This kind of working method gives the client the courage to make the decision of the smile they have always dreamed of. With a digital smile design, the clinician can also adjust the plan according to the direct feedback from the client.

The NIDE-experience was as good as it gets: hard work with a committed staff and enthusiastic colleges, networking with people from all over the world and getting the best view of the Finnish capital Helsinki. The course was well planned to meet the needs of specialists in prosthodontics, dental technicians and anyone working in a dental clinic. The theoretical part of the course completed the aesthetic hands-on entirely. I personally enjoyed the groups size, which enabled a lot of discussion, sharing of experiences and personal guidance. We also enjoyed a lovely boat ride and Finnish-style dinner.

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Lecturer Dr. Zach Evans giving guidance on the design


I warmly recommend everyone to attend this course. I found it very helpful for my own research which has an emphasis on zirconia as an implant crown material. In my own studies, I have witnessed that the material choice is very important, but the accuracy of prosthetic crowns depends a lot on the scanning and milling devices, which need to have long-term clinical experience and product development behind them. Planmeca’s new devices from intraoral scanners (Planmeca Emerald™ S) to 3D printers (Planmeca Creo™ C5) and milling machines (Planmeca PlanMill® 30S) are from the best quality and represent the fact that future is now.

Pauliina Moilanen
DDS, PhD candidate
Department of Prosthetic Dentistry and Stomatognathic Physiology