| Objective Smile aesthetics is an important part of facial aesthetics,which mainly includes pink aesthetics and white aesthetics.Pink and white aesthetic defects can cause unsightly smiles and facial appearance.Aesthetic crown lengthening and crown restoration are the main ways to solve pink and white aesthetic defects.Digital smile design（DSD）is a digital aesthetic design method,which takes oral aesthetic standards as the basic criteria,and uses computer software to analyze and design visualized on facial and intraoral photos.However,the current DSD is mainly on the two-dimensional plane.The founder of the concept,Christian Coachman and his team,developed three-dimensional DSD（3D-DSD）software,which uses the face as the Guided 3D aesthetic analysis design and accurate design for digital quantification of oral soft and hard tissues.Traditional crown lengthening is mainly based on visual inspection and experience,and the accuracy is poor,while 3D printing crown lengthening guide can guide doctors to accurately remove soft and hard tissues.This study aims to evaluate the clinical effect of 3D digital smile design combined with double positioning crown lengthening guide in anterior esthetic crown lengthening and restoration by pink esthetic score/white esthetic score（PES/WES）assessment and patient satisfaction survey.Methods From September 2019 to November 2020,a total of 20 patients（46 anterior teeth）who needed esthetic crown lengthening and full crown restoration of upper anterior teeth who were treated in Hefei Stomatological Hospital were selected.According to the completely random method,they were divided into the experimental group and control group,with 10 cases in each group,including 4 males and 6 females in the experimental group,with an average age of（29.24±6.17）years,and a total of 24 affected teeth;5 males and 5 females in the control group,with an average age of（29.15±6.46）years,and a total of 22 teeth.The experimental group carried out 3D-DSD,after confirming the plan,3D printed double positioning crown extension guides was used to guide aesthetic crown lengthening,and full crown was repaired 3 months after operation.The control group used traditional aesthetic crown lengthening and full crown restoration.PES/WES evaluation was performed before operation,three months and six months after operation.Visual analogue scales（VAS）were used to evaluate patient satisfaction twice 6 and 7 months after surgery,and the repeatability evaluation of VAS was conducted.The correlation between PES/WES score and overall satisfaction was analyzed 6 months after operation.SPSS 23.0 software package was used for statistical analysis,P<0.05 was considered statistically significant,and the test level was a=0.05.Results A total of 46 teeth were repaired with esthetic crown lengthening and full crown restoration in the two groups,and there were no failure cases.The general data and preoperative PES/WES scores of the two groups were not significantly different（P>0.05）,which were comparable.The PES/WES scores at 3 months and 6 months after operation in both groups were significantly higher than those before operation（P<0.05）.Comparison between the two groups showed that the scores of the experimental group were significantly higher than those of the control group for PES 3 months after operation,PES and WES 6 months after operation,and the difference was statistically significant（P<0.05）.There was no significant difference in WES between the two groups at 3 months after operation（P>0.05）.Satisfaction survey results showed that the intra-group correlation coefficient of the two VAS results was 0.956（P<0.05）,and crown length-to-width ratio,smile curve,personality characteristics,patient participation and overall satisfaction in the experimental group were better than those of the control group（P<0.05）.The results of Spearman correlation analysis showed that PES and WES scores at 6 months after operation were positively correlated with overall satisfaction（rs1=0.905,P<0.001;rs2=0.460,P=0.041）.Conclusion In the treatment of poor double aesthetics of teeth and periodontal soft tissue,compared with traditional anterior teeth aesthetic treatment,3D digital smile design combined with double positioning crown extension guide guides the anterior aesthetic crown lengthening and restorative treatment,which can improve the effect of pink and white aesthetics after treatment,increase the participation of patients,and thus more effectively promote the improvement of patient satisfaction. |
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