AU2013100527A4 - Dental restoration - Google Patents

Abstract

C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 A method of creating a dental restoration, involving the following: taking digital images of the face of the patient ('facial photograph'), and the patient's soft and hard dental tissues ('oral photograph'); creation of a physical model of a patient's dentition, prepared for restoration ('prep model'); creation of a three-dimensional digitally scanned virtual model ('scan') of the prep model; taking of a digital image of the completed restoration ('restoration photograph'); application of a digital mapping function to scale and align the scan with the oral and facial photographs using fixed reference points on the patient's oral tissues; creation of a composite display ('composite image') of the scan, oral and facial photographs and restoration photograph to ensure that the restoration work is functionally and aesthetically compatible with the hard and soft tissues of the patient's face. I Clinical. PhotosCiial"o Fullface photos received from Closeup of smile photos received Poo frsoaieaelas Clinician and edited by Clinician from Clinician and edited by an d/or Den talT echn ician usin g Clinician andforDental Technidian newly developed software using newlydevelopedsoftware b etlTcnca ihel

Description

C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 DENTAL RESTORATION FIELD OF THE INVENTION [0001] The present invention relates to dental restoration work and, in particular, to a method of planning, preparing and presenting restoration work. BACKGROUND OF THE INVENTION [0002] A conventional dental restoration procedure involves firstly taking a mould of a patient's oral tissues. This is used to create a physical model which enables the technician to create the material restoration for the patient. Once the restoration has been created, the model is shown to the patient with the restoration in place. This is therefore the first time that the patient and clinician are able to review the appearance of the restoration; under these circumstances, any changes requested by the patient or clinician requires the restorations to be returned to the technician for 're-work', representing a loss of time and resources for the patient, clinician and technician. OBJECT OF THE INVENTION [0003] The present invention seeks to provide an innovative combination of technology and process which allows improved planning, preparation and presentation of restoration work to better match the aesthetics and functionality of a patient's face and smile. It also allows more effective consultation between patient, clinician and technician prior to the placement of physical restoration work, minimising the potential requirement for restorations to be sent back to the ceramist.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -2 SUMMARY OF THE INVENTION [0004] In one broad form, the invention provides an innovative method of creating a dental restoration, involving the following: - taking digital images of the face of the patient ('facial photograph'), and the patient's soft and hard dental tissues ('oral photograph'); - creation of a physical model of a patient's dentition, prepared for restoration ('prep model'); - creation of a three-dimensional digitally scanned virtual model ('scan') of the prep model; - taking of a digital image of the completed restoration ('restoration photograph'); - application of a digital mapping function to scale and align the scan with the oral and facial photographs using fixed reference points on the patient's oral tissues; - creation of a composite display ('composite image') of the scan, oral and facial photographs and restoration photograph to ensure that the restoration work is functionally and aesthetically compatible with the hard and soft tissues of the patient's face. [0005] Preferably, this method involves identifying fixed reference points on the hard tissues in the oral and facial photographs and corresponding reference points on the scan to allow the digital mapping function to accurately superimpose the scan over the oral, facial and restoration photographs. [0006] Preferably, the method includes the ability to remove features of the scan from the composite image to allow presentation of any completed restoration work superimposed over the facial photograph in order to present an image of the aesthetic outcome of the placement of the restoration in the patient's mouth. [0007] Preferably, the method includes the ability to digitally superimpose soft tissues such as lips and gums over the planned or actual restoration work.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -3 [0008] Preferably, the method includes presentation of the composite image (less restoration photograph) to a technician during planning and creation of restoration work, to allow the aesthetic appearance of the work to be cross-checked against the outcome during and after the creation of the restoration. [0009] Preferably, the method includes presentation of the composite image to a patient, enabling said patient to approve the restoration work before being fitted. [0010] Preferably, the method includes determining a facial 'centre line' on the patient's facial photograph and then adjusting the facial photograph so that the centre line is vertical. [0011] Preferably, the method includes identifying a 'dental midline' on the oral photograph and overlaying the oral photograph's dental midline and facial photograph's centre line to identify any offset needed to align the three-dimensional scan with the oral and facial photographs during creation of the composite image. [0012] Preferably, the method involves determination of multiple additional fixed reference points on the patient's hard oral tissues to allow for accurate superimposition of the scan and photographs. [0013] Preferably, the method includes the ability to adjust the roll, yaw, pitch and size/scale of the three-dimensional scan, to allow the matching and alignment of the scan with the hard tissue reference points shown in the oral, facial and restoration photographs. [0014] Preferably, the method includes the ability to display selected elements of the scan and restoration photographs at varying opacities to allow accurate alignment and matching of the scan and restoration photograph within the composite image. [0015] Preferably, the method includes the taking of a photograph of completed restoration work and the identification of both a dental midline and the fixed reference points to allow accurate superimposition of the restoration photograph during creation of C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -4 the composite image. [0016] Preferably, the method includes establishing a digitally planned rendering of an ideal restoration and checking the scanned restoration work against the digital rendering to verify the work is consistent with the planned rendering. [0017] In another broad aspect, there is provided a method of producing a dental restoration, including: taking a digital image of a face of the patient, including soft and hard dental tissue; forming a model of a patient's dentition with restoration work; obtaining a scan of the model and restoration work; applying a digital mapping function to align the scan with at least a mouth section of the digital image; presenting a composite display of the image and restoration work to determine if the restoration work matches the hard and soft tissue of the patient's face. [0018] Preferably, the method includes identifying data from the hard tissue in the image and corresponding points in the scan to accurately allow the digital mapping function to superimpose the scan relative to the mouth section of the image. [0019] Preferably, the method includes removing features of the scanned model from the composite display to present only the restoration work in the image of the face, to present the aesthetic outcome expected when the restoration work is in place in the patient's mouth. [0020] Preferably, the method includes digitally superimposing soft tissue such as lips and gums over the restoration work. [0021] Preferably, the method includes presenting the composite display to a technician during formation of the restoration work, to allow the aesthetic appearance of the work to be cross checked against the final outcome. [0022] Preferably, the method includes presenting the composite display to a patient so C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 -5 the patient is able to approve the restoration work before being fitted. [0023] Preferably, the method includes taking a full face image of the patient, determining a facial centre line and adjusting the image so the centre line is vertical. [0024] Preferably, the method includes identifying a dental midline and overlaying the midline and centre line to identify an offset needed to align the model with the image. [0025] Preferably, the method includes adjusting one or more of the roll, yaw, pitch and size of the scanned model to match and align the model with the hard tissue shown in the image. [0026] Preferably, the method includes displaying parts of the model and renovation work at reduced opacity to help visually align and match the model and restoration work with the image. [0027] Preferably, the method includes establishing a digitally planned rendering of an ideal restoration and checking the scanned restoration work against the digital rendering to verify the work is consistent with the planned rendering. BRIEF DESCRIPTION OF THE DRAWINGS [0028] The invention is more fully described by way of non-limiting example only, with reference to the accompanying drawings, in which: Figure 1 is a full-face photo of a patient; Figure 2 is an adjusted upright full-face photo; Figure 3 illustrates a facial midline; Figure 4 illustrates the difference between the facial midline and a dental midline; Figure 5 is a smile image, cropped from the adjusted full-face photo; Figure 6 illustrates reference points, with the dental midline and canine tips; C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -6 Figure 7 is a separately taken original close up smile photo; Figure 8 shows reference points, with the dental midline and canines; Figure 9 shows the two smile photos overlayed, with 50% opacity; Figure 10 shows an adjusted close up smile photo, levelled against facial features; Figure 11 show an ideal smile design; Figure 12 is a scanned model image; Figure 13 shows the model image with hard tissue highlighted; Figure 14 illustrates the scanned model image superimposed on the close up smile photo; Figure 15 is an adjusted model image; Figure 16 illustrates the model image with 50% opacity applied; Figure 17 indicates the model image has an incorrect pitch; Figure 18 indicates the model image has an incorrect roll; Figure 19 indicates the model image has an incorrect yaw; Figure 20 shows the model image at 50% opacity; Figure 21 shows the model image at 100% opacity; Figure 22 illustrates restorations on a model; Figure 23 shows a superimposed image of the restorations at 50% opacity; Figure 24 shows the restorations at 100% opacity; Figure 25 illustrates the restorations against the original smile design; Figure 26 shows the restorations at a pre-glazing stage, at 100% opacity; Figure 27 shows the restorations at 100% opacity with soft tissue overlay; Figure 28 shows completed restorations at 50% opacity; Figure 29 show completed restorations at 100% opacity; Figure 30 shows the complete restorations at 100% opacity with an upper lip overlay; Figure 31 shows completed restorations at 100% opacity with the upper lip overlay and original dentitions; Figure 32 illustrates the restorations in-situ; Figure 33 illustrates a postoperative patient's smile; C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -7 Figure 34 is a flow chart illustrating an overview of the method of the present invention; and Figure 35 is a flow chart illustrating the method in more detail. DETAILED DESCRIPTION OF THE INVENTION [0029] Referring firstly to Figure 34, a flow diagram is shown representing an overview of the method of the present invention. [0030] The method includes taking a full-face digital photo of a patient at step 1 and then a close up image digital image of the face at step 2, showing the patient smiling. Hard dental tissue and soft facial tissue such as gums and lips must be visible in this second image. A physical model of the patient's dentition is created using a mould and the initial restoration work is created using this model. The model and restoration work is then scanned at step 3. [0031] The scan is then subject to a mapping function and various editing processes at step 4, in order to produce a composite display of the image and restoration work that is referenced during completion of the restoration work at step 5. At step 6, the patient is presented with the composite display for approval of the intended restoration work and the restoration work is subsequently fitted in the patient's mouth. [0032] The above method allows a digital comparison of the restoration work with an ideal restoration during manufacture of the restoration work. The method also allows the patient to digitally review the restoration work prior to installation, helping to improve communication between the patient and a clinician in relation to the desired restoration outcome as well as minimising any post-insertion adjustments. [0033] A more detailed description of a method of the invention is described with reference to Figure 35.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 [0034] At step 10 a full face photo of the patient is taken and at step 11 a smile image of the patient's mouth is captured to show hard and soft tissue. At step 12 an ideal facial centre line is determined for both the full face and close-up images. The dental midline is then determined at step 13 for comparison. [0035] At step 14, the cant of the image is determined with respect to the dental midline and tips of the canine teeth. At step 15, the image is adjusted for size and cant to match the facial image and overlayed with the full face photo at 50% opacity to check for alignment. [0036] At step 16, a digitally planned rendering of a smile design with an ideal restoration is produced, over the adjusted digital image. [0037] At step 17, a model of the patient dentition and restoration work is scanned. At step 18, the image of the scanned model is calibrated relative to the digital image of the patient's smile. For that purpose, the scan is overlayed with the close-up image at step 19 and the scan is adjusted to 50% opacity at step 20. At comparison step 21, hard tissue reference points, such as the canine tips, are then identified for the purpose of providing data for comparison with the hard tissue represented in the scan. [0038] By comparing the data with corresponding points in the scan, the pitch, roll and yaw of the model shown in the scan can be established, as at steps 22, 23, and 24. The data from these calibration steps is used to determine a mapping function at step 25 that determines the manner in which the image of the scan needs to be manipulated in order to register over and match the size and aspect of the equivalent part of the close-up image. [0039] The scan and image can then be superimposed at step 26 to form a composite display, where the restoration work is shown digitally fitted into the mouth of the patient. The composite image can then be used to compare and assess the restoration work at step 27 to see if it matches the smile design with the ideal restoration or needs further modification.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 -9 [0040] The comparison process might involve a series of steps including removal of soft tissue from the image at step 28, to assist with alignment, adjusting opacity of the images at step 29 and adding soft tissue back to the image at step 30. [0041] Once the restoration is complete, the structural features of the model can be removed at step 31 to leave only the restoration work at 100% opacity in the composite image so the patient can digitally view the completed restoration in situ for approval prior to try in. EXAMPLE [0042] Due to the aesthetic nature and the application of the present invention in the aesthetic zone of a patient's face and the articulator equipment used, Applicant has branded the present invention an 'aesthetic articulator'. With the invention, it is possible to visualise the final aesthetic outcome precisely and accurately, also eliminating possible error that might occur at the try-in / insertion phase in the aesthetic zone. [0043] Referring now to Figures 1 to 33, a smile design can be created using the present invention either by the clinician or the ceramist / technician based on a good set of digital photographs. A full face photo (Figure 1) and close up of a smile photo (Figure 5) can determine the following: Ideal midline (facial midline comes from the full face photo, dental midline comes from the close up smile photo) Ideal length of teeth Ideal proportion Pitch Roll Yaw Fullness of arch - buccal corridor Suitable style (shape) using the facial features Smile line C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 -10 Gum line [0044] The featured images are currently edited by Adobe Photoshop software however it is planned that the aesthetic articulator will incorporate and/or allow for the following functionality: [0045] Step 1: If the full-face photo has a tilt/cant (Figure 1), it needs to be in an upright position (Figure 2). The roll is the only distortion that can be fixed in two-dimensional images. It is ideal to level the maxilla to the temporomandibular joints and cranial base, however, the aesthetic evaluation comes down to the individual ceramist's artistic flair. Since no human being's facial features are perfectly symmetrical, the facial midline should be determined using the whole facial features including the glabella, nose and chin. [0046] Step 2: Ideal facial midline is drawn on the full-face photo (Figure 3). [0047] Step 3: Figure 4 shows the difference between the facial midline and dental midline (i.e. between two upper central teeth). The final position of the midline needs to be determined by both clinicians and technicians after assessing the patient's needs, dental condition and facial features while taking into account the technical/clinical skills of the operators. [0048] Step 4: Ideally, the close up smile photo cropped from the adjusted full-face photo should be used (Figure 5) since there is no tilt/cant being present against the facial features. However, a separately photographed close-up of the smile (Figure 7) can be useful to maintain a clear high resolution image. In order to assess the cant on the separately photographed smile photo, the following features are used as reference points (Figures 6, 8): the dental midline (including the cant); the tips of each of the canine teeth. [0049] Using these 3 reference points, it is possible to level the separately taken smile C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 11 photo against the close-up smile photo from the full face photo-overlaying one photo on top of the other using 50% opacity feature while adjusting the scale/size and cant until those reference points match (Figure 9). Figure 10 shows the levelled individual smile photo without the overlay of the smile photo from the full face. [0050] Figure 11 shows the ideal smile design for this patient, considering their aesthetic concerns and the desire for the final outcome, taking into account the input expertise of the involved dental professionals (i.e. treating clinicians and technicians). In this case, the treatment plan is to proceed with ceramic veneers on teeth 1.5 (right second premolar) and 1.3 (right canine), and ceramic crowns from teeth 1.2 (right lateral incisor) to 2.2 (left lateral incisor), for a total of 7 units. [0051] In order to mount the 3D scanned model on the close up smile photo (Figure 10), the aesthetic articulator software is utilised. Currently, 2D photographs are prepared by using a Zirkon Zahn tripod while adjusting the position of the model incrementally in order to mimic the 3D effects - a very time consuming process (Figure 12). [0052] There is already existing CAD technology to provide 3D model scanning, and the scanned virtual model needs to be uploaded then positioned on the 2D photograph precisely using the hard-tissue information reference points. Note that soft tissues (such as facial features, gums or lips) are not reliable reference points for accurate mounting. [0053] Figure 13 highlights the hard tissue information on a prepped model. Though the prepped area (coloured in blue) is still hard tissue information, these are now unreliable reference points to mount the model, as they have lost their original shapes. The unprepared/untouched hard tissues (including existing restorations, coloured here in red) provide the most accurate hard tissue information, and will therefore be used as reference points. The dental midline is also a useful reference point, although it is invisible on a prepped model. Its position can be manually marked using the lower dentition in occluded position (good hard tissue information) as a reference point.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 12 [0054] Here are the steps of model mounting using the aesthetic articulator. [0055] Step 1: The prepped model is scanned in 3D, and then uploaded on the close-up smile photo (Figure 14). [0056] Step 2: The model is resized to match the size of the maxilla seen in the close-up smile photo (Figure 15). [0057] Step 3: 50% opacity (in a range of 0-100%) is applied to make the model 50% translucent so that the original position of the hard tissue can be visible through the model (Figure 16). [0058] Step 4: When the model of dental arch is tilting up or down in comparison to the reference points, the 'pitch' is not correct and needs to be adjusted accordingly (Figure 17). [0059] Step 5: Now the 'pitch' seems roughly correct, but one side is higher than the other in comparison to the reference point means the 'roll' is not right, so it needs to be adjusted accordingly (Figure 18). [0060] Step 6: When the dental midline is lined up and one side of buccal corridor seems wider than the other against the reference points, means the 'yaw' is incorrect so it needs to be adjusted accordingly. [0061] Step 7: Figure 20 and Figure 21 show the model, mounted to the exact position seen in the close up smile photo. Once this process is completed, the position of the model needs to be secured or recorded within the 3D scanner providing a special reference for the position within 3D, so that the model can go back to the exact position at any later time during the manufacturing process. [0062] The feature should include the ability to change the colour of models.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 13 [0063] Once the model is mounted on the aesthetic articulator, the restorations can be assessed at any stage of the manufacturing process. [0064] Figure 22 shows the restorations at the 'biscuit bake' stage on the model then mounted on the aesthetic articulator to ensure accurate alignment (Figures 23, 24). [0065] The restorations can also be assessed against the original smile design (Figure 11), examining the length, shape, midline and the position of the buccal corridor (Figure 25). [0066] The system will include being able to cut out the hard tissue (teeth/restorations) and/or eliminate the soft tissue (i.e. stone model) for better assessment of the gingival level (Figure 25). [0067] Figure 26 shows the completed restorations at the pre-glazing stage. [0068] The system includes a function that allows a soft tissue (upper lip) overlay on the mounted restorations, in order to examine the lip-line against the restorations (Figure 27). [0069] Figures 28-31 show the completed restorations on the aesthetic articulator. [0070] The feature should include being able to eliminate the image of the stone model, apart from the restorations (Figure 31), thereby showing the original dentition (i.e. 1.6, right upper molar; 2.3, left upper canine; and 2.6, the left upper molar). [0071] Note: the aesthetic articulator cannot yet be used for assessing the colour of restorations. [0072] Completed restorations are shown in situ in the photos taken two weeks post-op (Figure 32 and Figure 33). These photos confirm the accuracy of the restorations completed on the aesthetic articulator.

C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 14 [0073] As may be appreciated from the above, the present invention eliminates the guesswork in the many elements of smile design, providing an accurate result in the complex area of restorative dentistry. [0074] The aesthetic articulator can be used on aesthetically demanding cases, especially in prosthodontics. The aesthetic articulator is a digital articulator with soft tissue information in the aesthetic zone. [0075] In an ideal scenario, the manufacturer (dental technician or ceramist) of dental prostheses can see how their restorations (including substructure) would look against the soft tissue (gums, lips and face) prior to the dispatch to the clinician (client). This is an extremely valuable ability during manufacturing, whether working on a single tooth or a large smile makeover case. [0076] An articulator is currently a physical apparatus which only records the hard tissue information such as facial indices (e.g. through the use of a facebow), which helps level the maxilla on a cranial (hard tissue) basis in order to achieve aesthetics. However, current articulators cannot record the effects of soft tissues (gums, lips and face) that ultimately determine the style, shape, position and length of teeth, all of which are needed to achieve the ultimate aesthetics. [0077] In the ceramics industry, there is a significant amount of pressure to 'get things right' without any errors under very tight timeframes, leaving little time for remaking procedures during the manufacturing process. The aesthetic articulator will allow a greater opportunity for the work to be done right the first time, which is ultimately what all dental professionals and patients prefer. [0078] It should be pointed out that the aesthetic articulator may also be used by the clinician who has ordered work to be done from a dental technician or laboratory. Not only can the clinician use the aesthetic articulator to ensure quality control on received C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 - 15 laboratory work prior to insertion into patient's mouth, but they can also directly benefit through its use at the case planning stage. The aesthetic articulator-mounted restoration is the most accurate image available to be shown to the patient, when compared to images developed using existing computer imaging dental software. The aesthetic articulator provides clinicians with the opportunity for a higher level of communication between themselves, the dental technician and the patient. [0079] Two of the key elements that the aesthetic articulator assists with during the manufacturing process are the retention of planned images for the duration of the manufacturing timeframe, and the ability to superimpose parts of the manufacturing process onto the image of the prosthesis at various stages, to enable placement of the right elements. [0080] Dentistry is fast becoming more advanced, but even with this progress, dental technology is still some way from being able to visually check the development of individually manufactured prostheses with the natural dentition and its surroundings, without the need for the patient to be present. [0081] This invention redefines the standard of care protocol, extending it from chair side procedures through to all products and services provided to the patient. [0082] The name 'aesthetic articulator' can be used in relation to the software supporting the methodology of the invention. The CAD model scanner to be used with the model and restoration work can be manufactured by a conventional dental supplier using existing technology/equipment. The supporting software includes features similar to those available through the Adobe Photoshop suite. [0083] Using current-generation computer software and scanning devices already on the market, the prep model can be scanned as a three-dimensional object rather than a two dimensional photograph. This enables the user to correctly position the model and more easily create a positional match with the hard tissue seen in the smile photos (or the C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 16 retracted intra-oral photos). Without this three-dimensional scanning ability, the procedure takes much time and technical skill in the use of existing devices such as digital cameras, specialised dental tripods and the use of 'Adobe Photoshop' or equivalent software. [0084] Software design also allows incorporation of details such as the scope of the frame, colour variations and the amount of elements within each image such as gums, teeth, other restorations and lips. It also enables the measurements and dimensions of oral elements, and the uploading and manipulation/storage of images etc. [0085] The scanning component is already on the market and this aspect of the invention can be achieved with current available and well-understood technology already in the market place.

Claims (25)

1. A method of creating a dental restoration, involving the following: taking digital images of the face of the patient ('facial photograph'), and the patient's soft and hard dental tissues ('oral photograph'); creation of a physical model of a patient's dentition, prepared for restoration ('prep model'); creation of a three-dimensional digitally scanned virtual model ('scan') of the prep model; taking of a digital image of the completed restoration ('restoration photograph'); application of a digital mapping function to scale and align the scan with the oral and facial photographs using fixed reference points on the patient's oral tissues; creation of a composite display ('composite image') of the scan, oral and facial photographs and restoration photograph to ensure that the restoration work is functionally and aesthetically compatible with the hard and soft tissues of the patient's face.

2. The method of claim 1, further including identifying fixed reference points on the hard tissues in the oral and facial photographs and corresponding reference points on the scan to allow the digital mapping function to accurately superimpose the scan over the oral, facial and restoration photographs.

3. The method of claim 1, wherein the method includes the ability to remove features of the scan from the composite image to allow presentation of any completed restoration work superimposed over the facial photograph in order to present an image of the aesthetic outcome of the placement of the restoration in the patient's mouth.

4. The method of claim 1, wherein the method includes the ability to digitally superimpose soft tissues such as lips and gums over the planned or actual restoration work. C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 - 18

5. The method of claim 1, wherein the method includes presentation of the composite image (less restoration photograph) to a technician during planning and creation of restoration work, to allow the aesthetic appearance of the work to be cross-checked against the outcome during and after the creation of the restoration.

6. The method of claim 1, wherein the method includes presentation of the composite image to a patient, enabling said patient to approve the restoration work before being fitted.

7. The method of claim 1, wherein the method includes determining a facial 'centre line' on the patient's facial photograph and then adjusting the facial photograph so that the centre line is vertical.

8. The method of claim 1, wherein the method includes identifying a 'dental midline' on the oral photograph and overlaying the oral photograph's dental midline and facial photograph's centre line to identify any offset needed to align the three-dimensional scan with the oral and facial photographs during creation of the composite image.

9. The method of claim 1, wherein the method involves determination of multiple additional fixed reference points on the patient's hard oral tissues to allow for accurate superimposition of the scan and photographs.

10. The method of claim 1, wherein the method includes the ability to adjust the roll, yaw, pitch and size/scale of the three-dimensional scan, to allow the matching and alignment of the scan with the hard tissue reference points shown in the oral, facial and restoration photographs.

11. The method of claim 1, wherein the method includes the ability to display selected elements of the scan and restoration photographs at varying opacities to allow accurate alignment and matching of the scan and restoration photograph within the composite image. C:\NRPortbl\DCC\CAB\93033 II.DOC-14/02/2013 - 19

12. The method of claim 1, wherein the method includes the taking of a photograph of completed restoration work and the identification of both a dental midline and the fixed reference points to allow accurate superimposition of the restoration photograph during creation of the composite image.

13. The method of claim 1, wherein the method includes establishing a digitally planned rendering of an ideal restoration and checking the scanned restoration work against the digital rendering to verify the work is consistent with the planned rendering.

14. A method of producing a dental restoration, including: taking a digital image of a face of the patient, including soft and hard dental tissue; forming a model of a patient's dentition with restoration work; obtaining a scan of the model and restoration work; applying a digital mapping function to align the scan with at least a mouth section of the digital image; presenting a composite display of the image and restoration work to determine if the restoration work matches the hard and soft tissue of the patient's face.

15. The method of claim 14, wherein the method includes identifying data from the hard tissue in the image and corresponding points in the scan to accurately allow the digital mapping function to superimpose the scan relative to the mouth section of the image.

16. The method of claim 14, wherein the method includes removing features of the scanned model from the composite display to present only the restoration work in the image of the face, to present the aesthetic outcome expected when the restoration work is in place in the patient's mouth.

17. The method of claim 14, wherein the method includes digitally superimposing soft tissue such as lips and gums over the restoration work. C:\NRPortbl\DCC\CAB\493033 II.DOC-14/02/2013 - 20

18. The method of claim 14, wherein the method includes presenting the composite display to a technician during formation of the restoration work, to allow the aesthetic appearance of the work to be cross checked against the final outcome.

19. The method of claim 14, wherein the method includes presenting the composite display to a patient so the patient is able to approve the restoration work before being fitted.

20. The method of claim 14, wherein the method includes taking a full face image of the patient, determining a facial centre line and adjusting the image so the centre line is vertical.

21. The method of claim 14, wherein the method includes identifying a dental midline and overlaying the midline and centre line to identify an offset needed to align the model with the image.

22. The method of claim 14, wherein the method includes adjusting one or more of the roll, yaw, pitch and size of the scanned model to match and align the model with the hard tissue shown in the image.

23. The method of claim 14, wherein the method includes displaying parts of the model and renovation work at reduced opacity to help visually align and match the model and restoration work with the image.

24. The method of claim 14, wherein the method includes establishing a digitally planned rendering of an ideal restoration and checking the scanned restoration work against the digital rendering to verify the work is consistent with the planned rendering.

25. A method, substantially as described with reference to the drawings and/or examples.