Digital workflow of orthodontic-prosthodontic multidisciplinary treatment (OPMT) plan can be developed and applied in complicated reahibilitations, in order to enhance the efficiency of communication dentist- patient. A digital workflow can demonstrate final treatment outcome and makes treatment easier, rapid and more accurate. 100 patients with the needs of OPMT to solve their complicated problems (dental agenesis, premature loss of tooth, dental-alveolar discrepancy, cranio-facial syndromes, skeletal deformities) will be recruited in this study. No restrictions related to age, gender, malocclusion will be applied in the selection criteria. Panoramic radiograph, Cephalogram and Cone Beam Computer Tomography (CBCT) will be requested to each patient, digital measurements/analysis will be performed on them. Digital models of patients¿ both dental arches and soft tissues will be captured using intra oral scanner and analyzed too by software. Prosthodontic and orthodontic treatment plan will be carried out for each patient. Virtual-setups will be performed using orthodontic analyze system and imported to prosthodontic design system to finalize the digital wax-up models (DWM). DWM will be exported and printed into resin diagnostic models which would be utilized in the prosthetic treatment process. Virtual setups will be used to fabricate clear aligners. Anatomical variables like 3Dcephalometric data,alveolar width and height, occlusal vertical dimension will be analyzed by descriptive statistic, while time of treatment (orthodontic and prosthetic), costs and efficiency will be compared to average data available in literature by T-student test. OPMT in complex cases requires long times and high economic costs but with new digital technologies working time is reduced with fewer appointments and easier management of the patients.
Preprosthetic orthodontics gain importance both for aesthetics and functionality. It is an interdisciplinary approach that can be considered as a point of view of the production of more durable and durable restorations of high aesthetics.
It is not surprising that the orthodontist and prosthodontist collaboration may be more important when correction of primary orthodontic anomalies and prostitution needs separately affect part of the population. The costs and timing of dental treatment discourage access to dental and private hospitals in Italy and in other countries where social difficulties are more present. The tendency is to renounce therapies or to settle for low quality services offered in some realities with a strongly negative impact on social health. In the field of oral health there is a lot of interest in the potential offered by the latest technologies. New technologies can make therapies faster and, in some passages, even less invasive and more effective, as long as pre-prosthetic orthodontic procedures are planned and performed on the basis of correct diagnosis and established biological and biomechanical principles. Innovation finds its expression in Diagnosis, Orthodontics, reconstructive and implant surgery and in the prosthetic field. Digital dentistry aims to integrate new technologies into a daily workflow with the aim of improving the patient's treatment plan, in an optimization path in all its areas of interest, from diagnosis to therapeutic finalization, passing through new communication possibilities and active confrontation with the patient, always respecting the "Historical" knowledge and the scientific SIDENCE. "Digital" intervenes in the diagnostic phase, with oral radiology methods such as the new generation of TAC CBCT 3D, able to allow high image quality, and to be able to align through matching processes with the results obtained from intraoral scanning and photographic documentation . The performance of these technologies allows the clinician to perform three-dimensional reconstructions of the patient's maxillofacial structures, with the possibility of carrying out therapeutic projects and multidisciplinary and complex treatment plans simultaneously (Orthodontic, Surgical, Reconstructive, Implant, Prosthetic Therapy). The new possibilities of representation of what has been "acquired", of the resulting digital analysis and therapeutic design, become a new performing dentistry-dental-patient-diagnostic tool. Improve the standard of care that an odontologist can provide, through more in-depth diagnosis and controlled, codified and above all repeatable and predictable production procedures. This also leads to high possibilities for individualizing treatment, associated with a significant reduction in operating time and cost control. A series of clinical cases in which the result of digital dental activity proves to be effective in the diagnosis, evaluation, aesthetic-functional validation, replication and therapeutic optimization phases, will be a confirmation of how, in Dentistry, digital can be considered a "DISCIPLINE" at the service of others. These systems produce products of a quality comparable to those produced manually in a simpler, faster, cheaper and, above all, more predictable. Moreover this happens with less environmental impact since they require less energy without producing processing waste. Important societal objectives will be those of sensitizing the population through the dissemination of scientifically correct information. For this reason it is already planned the international realization of scientific research and dissemination activities in the field of digital dentistry. The global economic condition that pushes towards the search for simpler solutions and a reduction in costs will make this process even more accelerated in the immediate future. From the clinical point of view the interventions will be simplified and minimally invasive with high predictability of the results, a better follow-up and compliance by the patient.