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A method is presented for obtaining a virtual 4-dimensional patient that replicates the intended esthetic treatment. The process involves facial and intraoral scanning to acquire records and software manipulation to enable a virtual waxing of the smile. Once the digital design is complete, patient information can be merged to generate an animated video of the projected rehabilitation, displaying movement and smile dynamics. This strategy provides a noninvasive and reliable diagnostic tool for predicting clinical outcomes.

Os avanços nas técnicas de digitalização permitem o registro e a integração das estruturas ósseas, dentárias e faciais. A tomografia computadorizada e os escaneamentos intraoral, laboratorial e extraoral da face fornecem dados aplicáveis do diagnóstico ao tratamento e fomentam a atual renovação da terapêutica odontológica. Nesse âmbito, atribuiu-se a esta revisão sistemática o objetivo de avaliar se as referidas tecnologias tridimensionais podem ser associadas para aquisição do paciente virtual, com a finalidade de planejamento digital otimizado. A coleta da evidência foi realizada sem restrição de tempo e língua e detalhada estratégia de busca foi aplicada às bases de dados Cochrane, PubMed e Web of Science, resultando na amostra total de 1.267 artigos. Pesquisas adicionais foram efetuadas no Google Acadêmico e as listas de referências dos artigos selecionados foram analisadas na procura por estudos compatíveis com os critérios de elegibilidade. Após duas fases de seleção, conduzidas por revisores independentes, 23 artigos foram incluídos para análise descritiva. Os trabalhos foram submetidos à análise do risco de viés individual através das ferramentas do Instituto Joanna Briggs e a certeza da evidência cumulativa geral foi avaliada pelo instrumento GRADE. O padrão do conteúdo científico reunido indica que o efeito estimado por esta pesquisa é potencialmente próximo ao real. A revisão revelou que a associação das tecnologias é efetiva para a completa geração do paciente virtual. Para o propósito de planejamento digital, os protocolos demonstraram otimização e viabilidade clínica, com desfechos caracterizados pela acurácia, previsibilidade, tempo e custos minimizados. Trabalhos acerca desse tema estão em desenvolvimento e espera-se que a evidência futura corrobore e amplie os achados desta pesquisa sistematizada. Advances in digitization techniques enable the integration of bone, dental and facial records. Computed tomography and intraoral, laboratory and extraoral face scans provide applicable data from diagnosis to treatment, contributing to the renovation of dental practice. In this context, the objective of this systematic review was to assess whether the aforementioned three-dimensional technologies could be associated to acquire the virtual patient, with the aim of optimized digital planning. Evidence collection was carried out on the Cochrane, PubMed and Web of Science databases. The detailed search strategy had no time and language restrictions and rendered a total sample of 1,267 articles. Additional searches were performed on Google Scholar and the reference lists of the elected articles were inspected to identify studies in accordance with eligibility criteria. Two selection phases were conducted by independent reviewers and 23 articles were included for descriptive analysis. The individual risk of bias was evaluated by Joanna Briggs Institutes tools and the certainty of cumulative evidence was determined by the GRADE instrument. The standard of this investigation indicates that the estimated effect is potentially close to reality. The review detected that the association of technologies is effective to generate a complete virtual patient. The analyzed protocols revealed clinical feasibility and digital planning optimization, since the outcomes demonstrated accuracy, predictability, and minimized time and costs. Scientific works regarding this theme are under development and it is expected that future evidence will corroborate and expand the findings of this systematic research.

Objective The aim of this report is to present an interdisciplinary approach with novel concepts to virtually plan and achieve esthetics and function. Clinical considerations Despite the advancements in the digital workflow applied to restorative dentistry, the final outcomes are commonly not similar to initial planning. To overcome this major limitation, three concepts are proposed: guided dentistry, digital quality control and "copy-paste" dentistry. Guided dentistry consists of simulations in 3D software and also includes the manufacture of guides/appliances to assist dentists in all clinical steps. Digital quality control involves the use of intraoral scanners and 3D software to compare the real outcomes with the pre-operative simulations after every procedure. "Copy-paste" dentistry is a consequence of the previous two concepts. Using the capacity of the software to overlap files, the original project can be maintained and adapted to achieve results more comparable with the initial design. The proposed method associates facially driven treatment planning and periodontal and restorative procedures to perform the patient's dental rehabilitation. Conclusion Through a guided workflow and digital control of clinical steps, the final outcomes obtained were equivalent and closer to the initial design. Clinical significance In interdisciplinary cases, the treatment plan needs to address individual requirements and to coordinate sequential clinical stages. It is challenging to meet these demands in a conventional process. The proposed concepts engage technological resources to orientate the procedures and to provide assessment in each step. This approach enables the development of a complete and accurate functional-esthetic rehabilitation. Ultimately, the technique presented is reproducible and the results reflect the established plan.