Dimitar Filtchev

Assoc.Prof.Dr. Dimitar Filtchev, Bulgaria Dr. Dimitar Filtchev obtained his degree in Dental Medicine from the Faculty of Dental Medicine in Sofia, in 1998. In 2000 he was appointed Assistant Professor at the Department of Prosthetic Dentistry at the same Faculty and from 2008 is a Senior physician at the same department. In 2003 he acquired a postgraduate specialization in Prosthetic Dentistry. In 2012 he completed his doctoral thesis on the following topic: “Arrangement of artificial teeth for implant-supported and non-implant supported overdentures”. Co-founder of the Laser Dental Center and the Implant Center at the Medical University in Sofia. Specialization in Prosthodontics, Faculty of Dentistry – Munster, Germany . Visited a number of practical and theoretical courses in Implantology, Orthodontics and Esthetic Dentistry by leading dental professionals like Prof. Nitzan Bichacho, Dr. Mauro Fradeani, Prof. Angelo Putignano, Dr. Henry Salama, Dr. Maurice Salama, Prof. Michelle Jabbour, Prof. Andre Saadoun and many others. Since 1998 he has been running a successful private practice in Sofia, focused on Implantology and Esthetic Dentistry. Dr. Filtchev has more then 50 publications in scientific journals, many scientific presentations at international dental congresses, numerous participations as an invited speaker at national and international congresses.
Assoc.Prof.Dr. Dimitar Filtchev, Bulgaria Dr. Dimitar Filtchev obtained his degree in Dental Medicine from the Faculty of Dental Medicine in Sofia, in 1998. In 2000 he was appointed Assistant Professor at the Department of Prosthetic Dentistry at the same Faculty and from 2008 is a Senior physician at the same department. In 2003 he acquired a postgraduate specialization in Prosthetic Dentistry. In 2012 he completed his doctoral thesis on the following topic: “Arrangement of artificial teeth for implant-supported and non-implant supported overdentures”. Co-founder of the Laser Dental Center and the Implant Center at the Medical University in Sofia. Specialization in Prosthodontics, Faculty of Dentistry – Munster, Germany . Visited a number of practical and theoretical courses in Implantology, Orthodontics and Esthetic Dentistry by leading dental professionals like Prof. Nitzan Bichacho, Dr. Mauro Fradeani, Prof. Angelo Putignano, Dr. Henry Salama, Dr. Maurice Salama, Prof. Michelle Jabbour, Prof. Andre Saadoun and many others. Since 1998 he has been running a successful private practice in Sofia, focused on Implantology and Esthetic Dentistry. Dr. Filtchev has more then 50 publications in scientific journals, many scientific presentations at international dental congresses, numerous participations as an invited speaker at national and international congresses.

EVENTS BY THIS MEMBER

ARTICLES PUBLISHED BY THIS AUTHOR

Nowadays the people’s demand and level of information has driven the clinicians to a certain questioning about customization, especially about planning, according to the individual psychological characteristics, that if ignored, may lead to dissatisfaction, even though all the classical rules which tend to establish standards are being used.

In aesthetic dentistry are used concepts, techniques, and materials by which dentists could establish new smiles with minimally invasive approaches and maximum natural effect on the restorations and in the same time to restore the mastication and phonetics, for a better quality of life.

Besides the aesthetic rules established throughout time, the emotional expression of the treatment, represented by the shapes and lines constituent of a smile, should also be taken into consideration of creating a customized and personalized treatment planning.

The concept of “visagism” may help dentists to do restorations that correspond not only to the aesthetic but also to the psychological features of the created image which affects the emotions, identity, behaviour and confidence of the patient. On the other side these factors affect the way the patients react to the definite treatment. [3]

These concepts recently have been applied in software such as “VisagiSmile” which can help clinicians to change the smile design.

Digital Planning

For achieving an optimal aesthetic result from a dental treatment, we

need to create a suitable smile design that should create a perception which has to fulfill the aesthetic expectations. [1] [2] It is also important that the teeth proportions to be correctly diagnosed and designed before an irreversible restorative dental procedure to be done. [4]

To create a personalised smile design we need to use the “visagism” concept.[3]

Excellent quality DSD (Digital Smile Design) software products exist on the market, such as DSD 2D, Smile Designer Pro, Planmeca Romexis® Smile Design [5][6][7]. However these solutions do not apply the visagism concept which produces a smile design in relation to the facial type and personality of the patient which is perceived as more harmonious.

Visagism applied in aesthetic dentistry is associated with assessment of the facial type, which involves subjective judgment, time consuming personality test and also complex calculations of the teeth configuration. The numerical results were then visualized as a teeth design which served for the patient, for the dentist and for the dental laboratory.

VisagiSMile is a software that automates the process of creating dental visagism case. VisagiSMile is a multiplatform web application for aesthetic dentistry which does not require installation, but only a simple registration process to get started. All cases and data are stored on a server to allow dentists to work on different devices and platforms – computers, tablets and smartphones. The research on the Visagism concept is an ongoing process which constantly changes the requirements for the software

Two main photographs were needed: one full-face with maximal smile and visible dentition and the other photograph of the upper jaw with retracted lips and black contrasting tool.

The photograph in full-face with maximal smile and visible dentition uploaded in “Visagismile” software were automatically placed behind the facial frame. By marking the landmark points on the image, the software analyzed the face structure and classiFied the face as strong, dynamic, sensitive and calm representing in percentages. 

Immediate implant placement in extraction wounds has been performed for more than 20 years. According to a number of authors the success rate is comparable to that of delayed implant placement. The reduced treatment time has huge benefits both for the dentist and for the patient, and the predictability of this method is comparable to the protocols for delayed and early implantation. 

On the other hand, immediate implant loading also has many advantages for the patient like immediate function, good aesthetics and improved self-esteem. Many studies support the excellent outcomes that immediate loading can provide. Massimo Del Fabbro et al. conducted a study on 2000 implants, placed and immediately loaded in the aesthetic zone. They reported a success rate of around 97.60% after a period of 10 years. 

Nowadays the implant treatment in the aesthetic zone is made accordingly the anatomical and aesthetic rules. The golden standard is to place the implant  2-3mm from the CEJ of the adjacent teeth. There is number of criteria for the deciding the design of the future restoration and smile and to determinate the vertical position of the implant. Guided surgery is increasing its popularity, giving the clinician very good VL, MD positioning and giving the right torque. 

 

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