Impact of digital prosthodontic planning on dental esthetics: Biometric analysis of esthetic parameters

Statement of problem. Improving dental esthetics is a main objective of prosthodontic treatment. Recently, digital diagnostic waxing has been proposed as an alternative to conventional diagnostic waxing; however, the impact on esthetics has not been evaluated. Purpose. The purpose of this study was to evaluate the impact of diagnostic waxing on biometric esthetic variables and to compare the esthetic outcome achieved by digital waxing with conventional waxing. Material and methods. Three biometric variables were evaluated: perceived frontal proportion (PFP), width/height (W:H) ratio, and symmetry. Maxillary casts of 13 patients were collected. All of them had maxillary anterior teeth that required prosthodontic treatment. Two forms of diagnostic waxing were executed: conventional and digital waxing. Measurements of the esthetic variables were conducted digitally. For the PFP, a frontal image was made and the width of each tooth was measured. Subsequently, the PFP values of the lateral incisor to central incisor and of the canine to central incisor were calculated. In addition, the height and width of each tooth was measured to calculate the W:H ratio. Using the previous measurements, the symmetry between the right and left sides was determined. Results. No consistent or recurrent PFP was detected for any cast. The diagnostic waxing did not alter the PFP of the pretreatment casts. The diagnostic waxing had restored the W:H ratio to what is assumed to be a natural ratio. An improvement in symmetry was detected after the diagnostic waxing and was more prominent after the digital waxing. However, no significant difference was found between the 2 diagnostic waxing methods. Conclusions. The 2 diagnostic waxing methods influenced the esthetic variables of the anterior maxillary teeth and yielded similar outcomes. Digital waxing appears to be a reasonable alternative, but further investigations are needed to ensure its practicality.