# Creating a Digital Twin of a Patient Using Face Scans and Intraoral Scans
## Introduction
[0] We get a good accurate alignment of a face scan with the mod denture record system to the intraoral scan. So let me show you this case really quick. We have our intraoral scans brought in at the proper vertical because our software from our scanner merged it to our record tray system right here. And so you could see those are in alignment.
[24] Now if your scanner software did not pin the upper and the lower jaw like this shining elite did to the edentulous arch scans, you could use a similar technique to manually align the jaws to the upper, index and the lower index of the modern true record system and have them be at the proper vertical. So let me go ahead now and show you how once these are all aligned. And, again, this came right from the scan software all the way like this.
## Bringing in a Face Scan
[52] How do you bring in a face scan? Well, first, you need to do a retracted face scan and a smile face scan, and you first bring in the retracted. So in Exocad, in expert mode, go to tools, add remove mesh. To bring in the face scan, we're gonna go to face scan, and we're gonna hit load. And we're gonna find that face scan.
[86] And we hit no or yes. It doesn't matter because they've not been aligned. And so then I left click on the face scan and drag it. I hold control and left click to rotate it, and what you want to do is get these two separate and distinct models aligned in space kinda side by side. So if you right click the screen, the blank of the screen, rotate both objects together like this.
## Aligning the Face Scan
[113] If you left click the face, you move the face. If you control left click the face, you rotate the face. And so the first thing I like to do is ignore the face and get my tray system here looking straight at me, and then I come over to the face and get it to be side by side like that. And so now what I'm gonna do is hit align meshes, and this part's a little bit tricky. We're gonna click common spots between the face scan starting first on the face scan and then going to the intraoral scan between our tray system and our scan on the face.
[152] And so the clarity of the face scan, sometimes it struggles, with picking up all the details of the tray depending on what face scanner you have. You could also look at little details in the putty which is super helpful to find little areas that might help index, for example, up here to here. And then what we're gonna do is after we have about five or six different distinct points, I like to do the four corners of the box up here at least.
## Performing the Alignment
[193] Is then we go to matching exclude selected parts, and we put our brush size on maximum, and we are gonna paint this area here, and then we're gonna paint this area here. And then what we need to do is hit invert. And now it's only gonna consider these areas, okay, when it does the alignment, the areas that are not shaded blue. So then we hit perform alignment, best fit match, and it's only gonna take into consideration the triangles that we painted.
[237] And there we have a good alignment. I could already tell because it's got this kind of leopard pattern. So if I hit the checkbox on matching exclude selected parts, it now lets me do show distances, and we could see we have a pretty good match as indicated by the leopard pattern of colors on the face scan, and then we click okay.
## Finalizing the Alignment
[254] So now I have properly aligned my retracted face scan to my tray, which is already aligned to my arches at the proper vertical. Okay. So now I'm gonna bring in another face scan which is the smile. So this is optional but it's sometimes nice to have a smile so I'm gonna hit load and I'm gonna load the smile face scan. I'm gonna hit no. And then I'm gonna, again, control click left click, and I'm gonna get the faces to be side by side.
[285] And now I pick common spots between the two, like maybe this freckle. Here I'm gonna go to align meshes. Freckle here and a freckle here, spot here, and you know find about 10 spots. Always start on the new mesh that you brought in, which is the smile face scan, and go to the retracted. So the arrows are pointing in the direction this is gonna move. It's gonna move this over to here.
## Completing the Process
[310] Find things that like the corners of the mouth would not be good because there's no common data here, but the canthus of the eye is very good. Anything that you see that might be similar. K. And this is where, like, the quality of the face scan really matters. Okay. So now that I got a few spots here, I got seven, I'm gonna get a few more little spots. That's looking pretty good. I like to get one like on the bridge of the nose, the glabella area, and I got one right here.
[344] Now we're gonna do the same trick where we go to matching exclude selected parts, and now I'm gonna paint kind of a square or something around the forehead and the eyes because those should be very similar between a retracted and a smile photo depending on, you know, the patient's forehead creases and things like that. But those shouldn't be too distorted. And then down to the bridge of the nose like this, that's helpful.
[380] We hold control or shift, sorry, to erase anything that got on her lips like that. Okay. So that's kind of the areas I want the algorithm to focus. So I'm gonna hit invert. So now it's only gonna look at the areas that are not blue. Then I hit, like we did before, perform alignment, Best fit match. And it's gonna take this area and the forehead and nose, glabella, canthus of the eyes into consideration.
## Conclusion
[419] This is also very graphics card intensive. It's looking at millions and millions of different data points trying to find a good match. Okay. So then we could uncheck that. We could, hit show distances, and we wanna see this kind of leopard pattern on the forehead, and we wanna see some colors on this tip of the tray here. We're gonna click okay. So now we have all of that aligned in space, and so what we need to now do is click okay here to save our alignment.
[458] Now we need to get the smile shot to where I'm gonna right click and hit edit face scan. I'm gonna we got two face scans, a retracted and a smile. I'm gonna turn off my retracted and now I'm just going to circle the lip outline of the patient's smile. You cannot connect these dots you don't want to and you're gonna hit delete. Okay. And I'm also going to circle, I'm gonna look down like this.
[503] Let me see from the side maybe. Let me turn off this tray, and I'm gonna circle the little aberrations from that tray right there, just like that. That. Okay. I'm gonna click okay. So now I have the patient's jaws merged to my tray, and then now I can start my wax up and I can see where my teeth are in the patient's head and I can start to go ahead and do my sculpting and waxing in exocad. So that's how we create a digital twin of the patient.
[525] And again, you could do face scans with your phone, with the cologne pro app, you could use the medismile from shining, you could use the ray face, you could use the Vectra, you could use the pro version of the Miraco. There's a lot of cool face scanners and they change constantly. This is just one way to do a digital twin of your patient so that you could now start sculpting the teeth and look at where the teeth are and go ahead and create your best, match to the patient's smile.
[555] And then for try in, you have a little bit less stress of going in of where the midline is, where the incisal edge is, and things like that. I hope this merging helps. It's very advanced topic in Exocad. We have multiple different videos on this exact thing that you could watch and get better with your merging techniques.
