Digital dental treatment planning vs digital procedure planning: how do they compare?

In a classic example, an orthodontist places the patient’s teeth in the position they consider ideal. Once the treatment is finished, they refer it to the prosthodontist who, based on their own planning, determines that the teeth should be in a different position to achieve the best result or be less invasive.

Have you ever experienced a disconnect like this?

In this article, we will look at why ‘big picture’ treatment planning has a place alongside specific procedure planning in your workflow – and what the key differences are between them.

Treatment planning: the ‘big picture’ exploration phase

Treatment planning is the exploration phase that happens right at the beginning. It’s before we know what to do and when, and allows us to explore all the possibilities from an interdisciplinary perspective.

In this phase, we develop the interdisciplinary, comprehensive, facially driven and airway driven plan. This is the 'big picture' that we use to discuss with all the specialists so we can agree and align on the ideal treatment plan, and then explain it to the patient.

At this point, we don't delve into the minute details because they are unnecessary before case acceptance; we just need enough detail to build the ideal treatment plan, align with all the specialists, and create a patient presentation to explain what you believe to be the best option, including an estimate.

For example, at this point you don't need to know if it's 23 aligners or 24, or if the implant is 4 millimeters or 3.7 millimeters. You need to know only that it is two implants, not three, or that you're going to do 10 restorations.

Of course, once you move into the treatment phase after case acceptance, there will be many details to define.

Procedure planning: a deep dive into the details

Once the interdisciplinary treatment plan is done and the patient is on board, we move on to the specific planning for each individual procedure. This is procedure planning. Examples of software for this stage include Invisalign ClinCheck, Simplant and Cerec.

For example, the ortho planning will give us the detailed plan for the ortho treatment with all the necessary information to manufacture the ortho appliances. The surgical procedure planning is the specific detailed plan for whatever surgical procedure we need to do, so we can understand exactly what fixtures we're going to use, what size, what type of procedure will be done, etc.

During the procedure planning phase, you need to plan and manufacture the guides or aligners, you need to guide your preps, but you don’t need to design a smile or integrate the specialities. At this point you don't need to know about airway, about the face or about interdisciplinary connections. This was all determined before case acceptance.

Post-case acceptance is a fragmented procedure plan because the big picture plan already shows us where we want to go. The procedure planning is based on the interdisciplinary planning, so we respect the comprehensive plan as much as possible.

Why do we need the initial treatment planning as well as procedure planning?

The big problem with not doing a proper interdisciplinary exploration pre-case acceptance is that professionals can start doing this when procedure planning. For example, while they are planning implants, they start to realize the other pieces of the puzzle and try to incorporate it into their planning:

It can also mean that clinicians can spend time and resources on unnecessary detailed planning for this phase, since the patient has not yet accepted the treatment.

Secondly, by making the ideal plan at the beginning and involving the specialists in this phase, you avoid misunderstandings or problems when each specialist comes to execute their phase of the treatment. In traditional dentistry, each time the case reaches a specialist, a new planning phase begins from their point of view. This can often result in disagreements when it comes to the previously performed treatments – such as in the example between the orthodontist and prosthodontist highlighted above.

What do we do at the DSD Planning Center and DSD Lab?

We do both interdisciplinary treatment planning and procedure planning.

The DSD Planning Center is a pioneer in the concept of using technology to do the interdisciplinary exploration phase: while many people use digital to do procedure planning, very few use it to do interdisciplinary planning – and this is what the DSD Planning Center does. We are known for treatment planning and for having interdisciplinary experts in addition to the specific disciplinary experts in our team who understand the clinical reality behind the plan. With a specific efficient communication protocol, they make the best decisions together based on each person's experience but on the same project.

Our team will prepare the best plan based on the information received, experience and collective intelligence, but it will always be a suggestion since the last word is always the clinician's.

If you prefer to create and define your own treatment plan, you can still work with us to do the procedure planning, devices and restorations. You as the doctor will make all the treatment plan decisions, and we will follow your plan.

Don’t have access to the DSD Planning Center?

True implementation of the DSD methodology is about collaboration, and this is where the DSD Planning Center and DSD Lab offer value for our clients. Access to the services is only available through our membership options: DSD Provider and DSD Clinic. Find out more below or book your free call to find out how to get started.

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