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View from the Chairside: Artistic Interpretation and Smile Design

Highlights

  • In the anterior segment, as the number of guiding landmarks to determine restorative tooth anatomy decreases, the need for artistic interpretation to create new landmarks increases.
  • In this presentation, Dr. Paul Belzycki recounts his personal clinical experience in attaining that artistic vision. In his opinion, only so much can be acquired didactically, much of it is a result of trial and error, learned by personally contouring extensive restorations in the provisional phase to ensure the achievement of a mutually agreed upon design with the patient.
  • Once established, that design must be effectively communicated with laboratory to guide that phase in order to avoid unwanted surprises in the final case.

Full Interview (36.40″)

 

 

3 comments

  1. Good presentation.

    Skipped was a conversation about the digital workflow. We are now able to get ptatient understanding and approval before a prep before study models using Digital Smile Design and dentofacial aesthetics. Applications like SmileDesignerPro.com can be used from design to clinical mock-up to laboratory fabrication with high degree of predictability and aesthetics.

    Old tested and true analog techniques are available. But so is the new processes that can be even more dramatically life changing.

    Thank you Dr. Belzycki.

    • On behalf of Dr. Paul Belzycki

      Dear Dan,

      Thanks for taking the time to register a comment.

      As I have stated in all my posts, what follows are my own personal opinions formed over the course of a long career.

      Designing a smile on a computer screen, remains an untested entity. I am fond of saying, “everything looks good on a monitor”. But a computer has no lips, no tongue, no cheeks, does not smile, nor does it eat or speak. A computer has no friends or family by which it is affected.

      By whatever method, “organic modeling” or as you stated, “digital design and manufacturing”, a provisional restoration must be obtained and worn by the patient. An organic being must test-drive an organic restoration. As of yet, no computer can replicate human irrationality and sensibility which is used to judge how something feels or looks. There is a philosophical truism…”Man is the measure of all things.”

      How a restoration is designed and produced is wholly secondary. How it feels in the mouth is a unique visceral event for any one individual. The esthetic evaluation is a complex human psycho-social event. These are the primary criteria by which a restoration is to be judged as successful.

      For that matter, I invest many computer hours designing these posts. All alone, rehearing a dialog, I may delude myself with thoughts of being a dental genius. As stated in the post, speaking to a “virtual audience” in my back-office at the end of a long day’s work is somewhat intimidating and frustrating as I have no clue about how my performance is being received. Giving a lecture to an “organic audience” is where my success will be judged.

      Oasis wants and needs the audience input. My goal is not to claim “do it my way, it is the only one”. It is to start and sustain dialog amongst those of us that are caring and dedicated practitioners of the Art and Science of Dentistry.

      With this in mind, I have a last comment regarding the statement “new processes that can be even more dramatically life changing.”

      I have problems with hyperboles such as “life changing”, or paradigms shifting, or game changing dentistry. Whether crowns are made by Old and True or by a Digital Work Flow, the end result remains the same: Teeth that are harmonious with a patient’s physiological and esthetic demands. Good dentistry will always remain an arduous and exacting endeavour, regardless of the tools we employ.

      I fail to see how any one method becomes more life changing in comparison with any alternate method. I have spent time sitting at a computer, fiddling with the design of a restoration and attempting to generate it on computer. I do this because the computer and lab technologist have little understanding of how restorations impact the soft tissue. We dentists do, or at least should. Whether I trim a restoration by hand or on a screen, I must bring knowledge and experience to bear. I refuse to abdicate control.

      I did marvel at the process, but was not dramatically transformed. Neither are my patients. They are merely grateful that honesty and much effort is invested to earn their trust.

      Thank you again for taking the time to leave your comment.

      Dr. Paul Belzycki

  2. Thank you Paul for an excellent presentation.You should be teaching at the school.Dr McAdam would be proud. I wish the ‘art’ of dentistry was more of an emphasis these days.I think if every dentist did restorations like these..then the RCT’s would last decades longer
    Regards
    Deborah Battrum

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