The application of parameters for comprehensive smile esthetics by digital smile design programs: A review of literature

Cosmetic dentistry is increasingly becoming an issue of concern to patients who hope to improve their smile. A systematic and comprehensive dentofacial analysis must be performed before commencing esthetic treatment. Several computer software programs have been developed for digital smile design (DSD) to assist clinicians in this process. This article compares DSD programs commonly used in cosmetic dentistry and their ability to assess esthetic parameters. A literature review was performed of current dentofacial aesthetic parameters and clinical applications of computer technology to assess facial, dentogingival and dental esthetics. Eight DSD programs (Photoshop CS6, Keynote, Planmeca Romexis Smile Design, Cerec SW 4.2, Aesthetic Digital Smile Design, Smile Designer Pro, DSD App and VisagiSMile) were compared. Photoshop, Keynote and Aesthetic Digital Smile Design included the largest number of esthetic analysis parameters. Other studied DSD programs presented deficiencies in their ability to analyze facial esthetic parameters but included comprehensive dentogingival and dental esthetic functions. The DSD App, Planmeca Romexis Smile Design, and Cerec SW 4.2 were able to perform 3D analysis; furthermore, Cerec SW 4.2 and PRSD could be used jointly with CAD/CAM. The DSD App and Smile Designer Pro are available as mobile phone applications. It can be concluded that despite the fact that they were not specifically designed for dental diagnosis, Photoshop CS6 and Keynote provide a more comprehensive smile analysis than most specialized DSD programs. However, other program functions should also be considered when deciding which DSD program is applicable to individual clinical setups.