What Can Intraoral Scanners Do?

By David Claridge, CAD/CAM Product Specialist

Long, long ago (during the Gypsum Age), arriving on the silicone and polyether shores of merry England, was the first intraoral impression scanner. It was wheeled ashore behind a dozen horses and handed to a caveman called Claridge. He was the Product Specialist for a unit that shall not be named (unless to say it was tethered to a cumbersome trolley. Claridge drove up and down the country in a special car with ramp access to his little Trojan Horse strapped in the back, and preached to any who would listen about the benefits of digital impressioning.

But the good dentists of the land asked lots of “can it do [fill in the blank]?” questions. These questions are still asked today, but there is a palpable shift that marks the development and adoption of intraoral scanners. So while Claridge was going around gathering ‘can it do’ questions, little hobbits at Carestream Dental were listening to this voice of customer feedback and taking notice. The answers to these questions fell into three categories… “Yes,” “No,” and “Not today.” You see, change happens, and has happened. In those early days, the great majority of replies were either “No” or “Not yet.”

Today, the vast majority of the ‘can it do’ questions I now receive are answered with a resounding “Yes it can!” Can it scan without powder? Can I send my scan anywhere i.e. is it truly open? Is it in HD colour? Can I store digital study models and re-import if I need them? Can I move it from room to room, over several floors? Can it scan implant scan bodies? Can I mark the margins? Can I use it for partial dentures, splints, retainers, aligners, crowns, bridges? Yes! YES!! YES!!! Continue reading

The Secret to Streamlined Implant Cases: The Digital Workflow

Implant placement has become the treatment of choice for completely and partially edentulous patients. With more and more implants being placed, keeping up with demand can be difficult. However, with the ability to make your laboratory workflow more digital, time can be saved to create a more cost-effective, high-quality outcome. 1

Implant-based treatment provides infinite possibilities to practitioners, but it often represents a more time- and cost-intensive solution compared to traditional therapy alternatives with conventional tooth-supported fixed dental prostheses. Reducing the overall clinical treatment and technical production time to achieve a reasonable cost-benefit ratio—in combination with a high-quality outcome—can bring benefits to all concerned. Time is saved by eliminating many of the steps, including pick-ups and chemical-based processes. The delivery of restorations is also quicker and there is less chance of having to provide remakes and returns with a digital workflow.1

Many labs have already started transitioning to a digital workflow, as increased demand, technology advances and the growing shortage of technicians creates an enhanced need for improved productivity. Single digital work steps have begun to infiltrate classical impression-taking procedures, dental master cast fabrication, lost-wax casting techniques and individual finalization of the restoration with hand-layered veneering ceramics. For many years, dentists have taken an impression, sent their prescription off to the laboratory and waited for up to two weeks for a finished restoration to be returned. The restoration could then need further adjustments, despite the best efforts of the dentist and technician. The development of a completely digital workflow has the potential to change the entire process. At first glance, the new systems may seem complicated, but ultimately digital solutions can drastically streamline procedures for both the dentist and lab. Nevertheless, although changes are growing in the field of implant prosthetic treatment, the result of this evolution is a mixed conventional-digital workflow. Continue reading

Using a Digital Workflow to Plan an Implant Case from Start to Finish

Delivering predictable restorative outcomes is essential in implant cases. Through advancements in 3D and CAD/CAM technology, oral surgeons are better able to use a complete digital workflow to plan a case, fabricate a custom abutment, and fabricate and insert the crown.

In the Implant Practice article below, I describe how I treated a patient who presented with a congenitally missing left mandibular second premolar as well as the efficiencies experienced through the use of an integrated digital workflow.

Overall, when compared with conventional dentistry, a digital workflow allows us to complete a case—such as this one—in fewer steps and with enhanced patient comfort and satisfaction in mind.

If Hamlet Had Been a Dentist

To mill or not to mill, that is the question.

In the past, you had two choices once you acquired a digital impression: you could design a restoration and mill it out in your office (CAD-CAM), or you could send the digital impression to a lab just like you used to send a PVS impression.

The problem was that the machines that did these things could only do one or the other—not both—and they did not work together. As a dentist, you would need to decide which system you wanted and then, once you bought it for many thousands of dollars, you were stuck with that choice.

There are rather good arguments for each solution. On the other hand, the best solution is to do both—which is exactly what the newer systems allow you to do. Continue reading

A Brief History of CAD/CAM

Though computer-aided design/computer-aided manufacturing (CAD/CAM) for dentistry has been available for the past 25-30 years, it’s only been within the past decade that the technology has moved from the lab to chairside. Much like radiovisiography technology, dental CAD/CAM technology got its start in Europe in the 1970s and 1980s. However, early versions of CAD/CAM systems were so cumbersome and complicated that they were considered more of a hindrance to practice workflow than an advantage, and were mostly confined to laboratories. Fortunately, advances in the technology over the past few years have made CAD/CAM a more viable option for dentists looking to do restorations in-house. Continue reading

It’s About the People

(This is an updated version of an article I published in 2009)

It’s not about the machine, it’s about the people. But sometimes the machine can make all the difference.

It is easy to see technology just as machines and networks but I have always believed the real significance, the real value of technology comes when we use it to improve the human condition. Dr. Tony Romanazzi, a dentist from Glens Falls, New York in the Hudson River Valley, told me a lovely story that demonstrates this idea perfectly.

Dr. Romanazzi was asked by a long time patient if he would see a relative of hers, a special needs patient we will call Jimmy. Jimmy was a mentally handicapped man in his fifties who functioned about on the level of a two or three year old. That is he could say a few words and get around the house but could not really care for himself. Jimmy had been complaining that his teeth hurt. His care givers had tried to find him some help but so far no one had been able to do much. Continue reading

CAD/CAM Technology: Is it Worth the Investment? (Chart)

Like all technology these days, from phones to computers, equipment in the field of dentistry is changing faster than ever before. And, just like an early adopter with the latest smartphone, the task falls to doctors in discerning which cutting-edge technology is worth the investment for their practice now and which they can afford to wait on.

Computer-aided design/computer-aided manufacturing (CAD/CAM) is one such technology that has made its way into the industry and piqued the interest of dentists—but has them asking if the investment is worth it. CAD/CAM systems allow users to scan, design, mill and place a crown in a single appointment, and it’s changing the way dentists handle restorations. Immediate benefits include the convenience of working entirely in-house; streamlined workflow with tools that work together seamlessly; and, of course, single-appointment restoration for patients. Continue reading

How Do You Choose the Right Intraoral Scanner for your Practice?

All digital scanners will produce a clinically acceptable image, but they are not all the same. The scanner is the device that actually captures an impression of the tooth. It is sometimes called the impression wand or the camera.

Whatever you call it, like most other every high tech device, impression image capture systems have come a long way in recent years. Developments in photo, video and laser 3D technology have made digital impressions extremely accurate. If we assume clinically acceptable image quality, what features should dentists look for when choosing a scanner? Continue reading

CAD/CAM: Why Bring the Entire Restoration Process In-House?

I’ve been a big advocate for computer-aided restoration/computer-aided manufacturing (CAD/CAM) restorations for a number of years; in fact, I have used several systems in my office during my quest to find the perfect solution for my needs. The reason for these efforts is due to the many benefits that performing restorations onsite has extended to my office, including:

  • improved patient care;
  • reduced lab and impression costs;
  • increased revenue;
  • the ability to have fun and be more creative in my practice!

Continue reading

Developing Systems, Software and Services for Dental Professionals

Having practiced dentistry, I understand how important imaging products are when interacting with patients, diagnosing a problem, and developing the right treatment plan. I also know how frustrating it is when you’re forced to adapt to technology and make significant changes to your workflow rather than have your systems complement the way you practice. That’s why I am so dedicated to ensure that we are providing technology that is beneficial to you and furthers our industry as a whole. Continue reading