Personal Oral Protocol concept

Eric Berger

Mon. 5. August 2024

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In the field of dental prosthetics, digital communication has undergone a major revolution in recent years, transforming how dental technicians interact with dentists, laboratories and patients. Thanks to technological advancements and innovative digital tools, digital communication in dental prosthetics has improved treatment efficiency and the accuracy and quality of the final results. The Personal Oral Protocol (POP) in dental prosthetics employs digital communication tools to personalise prosthetic treatment based on the specific needs of each patient.

This article discusses the POP approach, describing its advantages, the information required and the process, and explores the immediate future of digital communication and developmental trends in the field of dental prosthetics. It is important to note that the POP protocol may vary based on the specific needs of each patient.

Fig. 2: Case example of digital photography expressed in CIELAB colour space values.

Fig. 3: Beginning of layering according to the CIELAB colour space values.

Fig. 4: Results after colorimetric analysis.

Advantages of the POP

Personalisation of treatment
The most obvious advantage of the POP is the personalisation of prosthetic treatment. Each patient has unique needs, aesthetic preferences and objectives regarding their dental prostheses. The POP allows dental professionals to create customised solutions for each individual, taking into account his or her anatomical characteristics, facial morphology and aesthetic preferences.

Improved patient experience
Digital communication has a positive impact on the overall patient experience in dental prosthetics. CAD allows patients to visualise their future smile and actively participate in the aesthetic and functional choices for their prostheses. This involvement strengthens patients’ confidence in the treatment and increases their long term satisfaction.

Better aesthetics
The POP aims to create prostheses that perfectly harmonise with the patient’s appearance and smile. By considering individual facial features, tooth colour and other aesthetic elements, prostheses made using the POP offer a more natural and aesthetic result.

Functional improvement
In addition to aesthetics, the POP takes into account the masticatory and phonetic function of the patient. A customised prosthesis provides better occlusion and articulation, improving masticatory function and the patient’s quality of life.

Optimisation of the design process
The POP uses advanced digital tools such as CAD and 3D printing to facilitate the design and fabrication process of prostheses. This ensures more precise results and reduces manufacturing times.

Adaptability to changes
The POP allows for treatment adjustments based on changes in the patient’s oral health. If adjustments are needed over time, the personalised treatment facilitates modifying the prostheses to meet the patient’s evolving needs.

Fig. 5: Plurality in the choice of intra-oral scanner.

Fig. 6: Shade taking with a spectrophotometer using the Rayplicker Cobra (Borea) or VITA Easy-Shade V (VITA Zahnfabrik).

Fig. 7: Mandibular dynamics in Twim (Modjaw).

Fig. 8: Synchronisation of 2D and 3D images.

Necessary information

Detailed prescription
A precise prescription must be provided by the dentist, clearly describing the patient’s aesthetic expectations and technical specifications for the prosthesis.

Accurate digital impressions
High quality digital impressions of the patient’s oral cavity must be taken to obtain an accurate model of the teeth and gingivae.

Objective colour measurement
A spectrophotometer is used to objectively measure the colour of the patient’s teeth. Unlike visual observation, which can be subject to subjective interpretations, the spectrophotometer provides precise quantitative data, ensuring an accurate match between the colour of the prosthesis and that of the patient’s natural teeth.

Comparison with reference samples
The spectrophotometer compares the measured colour with reference samples, such as standardised shade guides, to find the closest match to the patient’s natural tooth colour. This ensures an accurate match with the colour desired by the patient or prescribed by the dentist.

Intra-oral photographs
Detailed intra-oral photographs of the patient can be useful for the dental technician to better understand the morphology and colour of the patient’s teeth.

Smile line indications
The dentist can indicate the smile line, that is, the alignment and desired position of the edges of the teeth when smiling.

Occlusal dynamics data
Information on occlusion is essential for a prosthesis that integrates perfectly with the teeth.

Materials and techniques
The dentist and dental technician should discuss the materials and techniques to be used.

Use of 3D and 4D smile designers
Smile designers perform a comprehensive aesthetic analysis of the patient’s face, taking into account facial shape, facial features, lips, eye colour and other elements. This holistic approach allows for the design of prostheses that perfectly harmonise with the patient’s overall appearance.

Personalised design
Using CAD tools and 3D printing, smile designers can create digital models of personalised prostheses based on the patients’ aesthetic preferences. These models enable visualisation of the final result before manufacturing, allowing for adjustments if necessary.

Patient involvement
Smile designers actively involve patients in the design process by consulting them on their aesthetic preferences and considering their specific wishes. This collaborative approach gives patients a sense of control over their treatment and confidence in their new smile.

Patient’s smile simulations before treatment
Smile designers use advanced software to simulate the appear ance of the smile after prosthetic treatment. These simulations allow the patient to see the potential result before making a definitive decision, thereby increasing treatment compliance.

Communication between the dentist and dental technician
Smile designers act as mediators between the dentist and dental technician, communicating essential information for the prosthesis realisation. This effective communication ensures that the patient’s aesthetic expectations are met.

Optimisation of function and aesthetics
Smile designers aim to balance masticatory function with the aesthetics of the smile. They ensure that prostheses are not only beautiful but also functional and comfortable for the patient.

Fig. 9: Smile design in inLab CAD SW 22.0 (Dentsply Sirona).

Fig. 10: Mandibular dynamics in inLab CAD SW 22.0.

Fig. 11: Complete prosthetic simulation.

Chronological process

Precise data collection
The POP begins with the precise collection of patient data, including digital dental impressions, intra-oral and extra-oral photographs, and information about the patient’s aesthetic preferences and specific needs. This digital data provides a comprehensive basis for the design of the prosthesis.

In-depth case analysis
The digital data collected is thoroughly analysed by the dental professionals. They use specially developed CAD software for the POP, allowing them to visualise the data in 3D and gain a detailed understanding of the patient case.

Precise and personalised design
Using digital data and advanced digital tools, the dental technician creates a customised prosthesis for the patient. They can precisely adjust the shape, size, colour and occlusion of the prosthesis based on the patient’s individual characteristics and aesthetic preferences.

Fig. 12: 2D, 3D and 4D imaging combined in DentalCAD 3.1 Rijeka (exocad).

Simulation and patient validation
Once the initial design has been completed, a digital simulation can be performed to show the patient what the final result is expected to look like. This allows the patient to validate the design and give approval before the physical fabrication of the prosthesis.

Precise fabrication using 3D printing
The optimised digital data is used to guide the 3D-printing process of the prosthesis. This technology allows for the manufacture of prostheses with high precision, providing a perfect fit and better aesthetics.

Follow-up and prosthesis adaptability
Digital data is also useful for patient follow up and prosthesis adaptability over time. If adjustments are necessary, digital data allows the dental professional to quickly make the required modifications.

Patient data back-up
The POP allows for the back up of the patient’s digital data, making it easier to create replacement prostheses if needed. The data can be used as a reference for future prosthetic interventions.

Fig. 13: Face scan in exocad 3.1 Rijeka.

The immediate future: Collaborative telecommunication—POP 2.0

Digital communication facilitates collaboration between dental technicians, dentists and laboratories. Digital files of prostheses can be instantly shared via secure platforms, allowing the different actors involved in the process to work synchronously and efficiently, even if they are geographically distant.

Developmental trends

Real-time communication
Collaborative telecommunication enables real time exchange, meaning participants can communicate instantly through messaging or voice or video calls. This real-time communication fosters quick problem solving and informed decision making, leading to better coordination in planning and executing prosthetic treatments.

Asynchronous communication
In addition to real time communication, collaborative telecommunication facilitates asynchronous communication. This allows users to share information and collaborate at their own pace.

File and document sharing
Collaborative telecommunication tools allow for easy sharing of files and other digital resources. This enables members to work together on projects, review documents and access relevant information.

Online collaboration tools
Collaborative telecommunication often includes online collaboration tools, such as project management platforms, virtual whiteboards and shared storage spaces, which facilitate activity coordination and information visualisation.

Multiplatform accessibility
Collaborative telecommunication solutions are generally accessible on various platforms, including desktop computers, mobile devices and tablets, allowing users to collaborate anytime and anywhere.

Security and privacy
Collaborative telecommunication prioritises the security and confidentiality of data exchanged between users. Security measures are often put in place to protect sensitive information.

Fig. 14: Use of augmented reality in the dental laboratory.

Fig. 15: Final CIELAB colour space check of a prosthesis.

Summary

In summary, the POP optimises the employment of digital data in dental prosthetics, allowing for precise data collection, personalised and accurate design, patient validation, high-quality 3D-printing-based fabrication, and long-term follow-up and prosthesis adaptability. By closely collaborating and providing comprehensive information, the dentist and dental technician can improve the quality, efficiency and overall satisfaction of prosthetic treatments for patients.