I will try to briefly describe the concept of Dental Architecture©. It is not a specific technology but rather a philosophy concerning the patient, the dentist, the dental technician, professional ethics and quality. Imagine you want to build a house. What would be your first step? Most probably you would not rush to buy bricks or furniture. Everything begins with an idea. Or, to be more precise, with MA. With an empty space from which your idea originates. In other words, it all starts with your unique vision. What has this got to do with dentistry? I think that architecture is an ultimate expression of unity between visuals and functionality. I see direct links between those two concepts. I would describe Dental Architecture© as a concept based on interrelation between components of a complex structure that includes various logical, functional, physical and programme structures.
Plot of land
Diagnosis (pictures, models)
The first thing that the two concepts share is “components of a complex structure”. Do you see the relation between such elements as the patient and the client, which is an equivalent notion in architecture. Or between the plot of land and its equivalent in Dental Architecture©, i. e. the oral cavity. In collecting and combining information about the restoration to be performed, we should take into account the baseline situation (point of reference) which is called landscaping in architecture.
These are the composite elements of Dental Architecture© which are indispensible for achieving the optimal end result. The patient, the oral cavity and its current state are all important pieces of information. Obtaining and recording it is a rather easy task.
Another element of Dental Architecture© philosophy is, in my opinion, a crucial one, and at the same time a very abstract one. It is expectations of the patient. Every individual who seeks medical care comes to a doctor’s office with a specific complaint. At the same time he/she have specific expectations. In the beginning these are not very clear, unless the patient has a picture from his/her own youth or a celebrity’s picture ☺
However, I believe it from these expectations that the IDEA can be identified. At this stage, it is important to be delicate and sensitive in one’s attitude as much as possible to be able to hear the patient’s expectations.
One interview is sometimes not enough to achieve this because you may need further clarification.
For this purpose we have an ideal tool called a diagnostic wax-up. Architects call it a sketch. It is a rough draft, an idea at its infant stage. An idea originating from the information collected up to the present moment. At this stage, you can change every aspect of the idea, brainstorm, and talk about individual patient’s likes or dislikes.
It is called a MA, a gap between the idea and its expression. When performing a diagnostic wax-up, some practical questions may arise both for the dentist and the patient. It is the first tangible thing that may be analyzed not only in a visual sense but also in terms of functionality.
The wax-up procedure requires a great deal of knowledge ranging from the anatomy of the oral cavity and tooth to biomechanics and function.
It gives the patient an accurate preview of the final result, and the dentist has the opportunity to assess the actual situation and to plan further actions.
We have nothing but great admiration for the inventor of the dental mock-up. Who knows, maybe this idea was also inspired by architecture It is the visualization of my dental work, a transformation from the abstract idea to a tangible result. The mock-up allows you to make everything fit in its place. The patient receives a tool which offers a feel and look of the final result. The mock-up is a prototype of what the permanent restoration will look like. It will be used as a template for fabricating the actual denture which will be an identical copy of the mock-up.
Being aware of all this, the patient can express any desired changes and preferences. Taking this into consideration, I can make some correction to the wax-up but not the permanent denture (“I am trying to imagine what it would be like to increase six 0.3 –0.5 thick glass ceramic veneers in length by 1 mm ”)
It is very important to perform a thorough oral cavity examination and to plan possible interventions prior to the prosthetic procedure. Implantation or gummy smile correction will deliver impeccable results if we know what specific steps should be taken.
What follows are practical steps which are called a design in architecture and I myself call it a treatment plan.
All ideas, comments, expectations, technological and, of course, budget considerations are documented in the paperwork.
As Oriental wisdom says “…the journey is more important than the destination…”. It does not apply to my work. I must have a clear goal and know how to achieve it. The mock-up is my goal, and the treatment plan is a path toward this goal. Both are of equal importance.
From my practical experience, all work performed up to the creation of the treatment plan ensures several crucial aspects:
simplicity of structure
permanent denture that works right from the first try-in.
Once we have decided on our next steps, the DENSTIST and the DENTAL TECHNICIAN become a team of contractors which proceeds to implement their ideas.
Here, professionalism and coordination of actions are of utmost importance. Actions can be coordinated using modern digital technology. We use the www.Trinyte.com platform.
What professionalism implies is another question. Not everyone can become an architect but most of us can be a good contractor. This requires a great deal of knowledge, attention to detail, good equipment and materials.
It is very important to work as a team and to have your own style of working. I know the dentists I work with very well and I do my best to assist them whenever possible and so do they.
Of course, the simplest solution would be to always work as a team of two, one dentist working hand-in-hand with one dental technician. But after some time this would limit our professional growth because it would slow down the flow of ideas. There would be no need to grow professionally and suggest something new because “we can always leave it the way it is”.
The more professional the teams are, the more advanced and non-invasive treatment technology can be offered to the patient.