Digital Communication Enhances Dentist/Lab Collaboration - CAD/CAM RESTORATIONS

Author : Dental Product Shopper
Published Date 06/03/2011
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Experts agree that communication is essential to the success of any long-term relationship, whether it?s a husband and wife, best friends, or dentist and lab. Communication can be verbal, it can be handwritten, and in recent years it has gone digital. Given our demanding schedules, it?s no surprise we continue to find new and creative ways to communicate with each other.

Digital pictures are now regularly used to provide insight into tooth shade, occlusion, and smile line. But when it comes to margin placement, preparation reduction, and articulation, pictures alone are not sufficient.

The Digital Impression Twist

Traditionally, the largest amount of information communicated between a dentist and lab has been via the impression. Digital impression systems (eg, 3M ESPE?s Lava Chairside Oral Scanner C.O.S., Sirona?s BlueCam, and Cadent?s iTero) provide a new twist and new opportunities for communication. Intraoral scanning allows the dentist to see far more than ever before, and the virtual model becomes a powerful communication tool. The ability to magnify the image on the monitor allows scrutiny of detail, which is not possible in the mouth or in a traditional impression. In cases of deep margins or unusual anatomy, the dentist can alert the lab or even annotate where the margin should be marked.

Any time an ambiguous area can be clarified at the beginning of the case, efficiency will be enhanced. Streamlining the communication between dentist and lab involves providing complete and accurate information that eliminates many of the questions or uncertainties that could otherwise arise.

Digital Workflow Efficiency

The digital workflow provided by digital impressions promotes the dentist and lab working together. For example, after the scan and prescription are complete using Lava C.O.S., the case is sent electronically, and the dentist has almost immediate confirmation that the data transfer has occurred. Within an hour or 2, the lab receives the case?all with no need to schedule shipping or track lost cases. Dentists and labs that work with digital impressions have the opportunity to learn together, further enhancing their relationship. As the technology evolves, they will have to rely on each other more than ever.

For labs with CAD software, or those who have partnered with a milling center, cases can often be scanned and imported into the CAD system for designing substructures, over-press patterns, provisionals, and even full-contour restorations.

Collaborate in Real Time

There are a number of screen sharing programs that can been used for everything from webinars to corporate presentations. They make it very easy to invite others to view the computer screen of a host computer. These programs are a fantastic tool for laboratories, dentists, and even milling centers to collaborate real-time. Whether it?s margins, framework design, or full-contour designs, the laboratory and dentist are only a few mouse clicks away.

The Dentist Said?

Incorporating digital impressions into our practice was a leap into the unknown, but quickly became a part of the daily workflow. Knowing how our lab would handle these cases was just as critical as having our dental assistants on board. In the office, the assistants complete the electronic prescription and can scan the opposing arch and bite. Scanning cases involving 1 or 2 units is straightforward and predictable, requiring less time than traditional impressions. But the area in which this technology really shines is multiple-unit cases. Knowing that the lab will receive all of the detail necessary to complete the case accurately is very satisfying. As I prepare a patient?s teeth and manage the soft tissue, I now ?think like a scanner,? working toward the goal of delivering complete and accurate data. The Lava C.O.S. we use in our office has become an invaluable tool in providing my patients the best care possible.

The level of collaboration with my laboratory and its milling center has risen to a new level because we can now review cases electronically. When an issue or question arises, what used to take days to accomplish by sending models back and forth, we can now resolve quickly, usually via a screen shot and an e-mail.

The Milling Center Said?

When it comes to digital impressions, we are, more often than not, the middleman between the dentist and laboratory. In 80% of Lava C.O.S. cases, we are designing a substructure or full-contour restoration for the dentist?s laboratory. For the rest of the cases, we are marking margins so that a model can be made for the lab to fabricate a restoration using traditional methods and materials.

For CAD-based restorations, screen-sharing technology has helped us learn laboratory-specific design preferences without sending cases back and forth. We?ve also found it is a great tool to ease the concerns of a laboratory that is just getting into digital workflow. If there is a challenging case that requires consultation with the dentist, it can be done online with everyone participating in the discussion.

Dr. Lori Brown is a co-owner of Enspire Dental, a general dental practice located in Ann Arbor, Michigan. She is an Associate Editor for The Dental Advisor. Chris Brown is the Business Manager of Apex Dental Milling, a CAD/CAM milling center located in Ann Arbor, Michigan. He is a Technical Consultant for The Dental Advisor and frequent lecturer on CAD/CAM technologies. Having been married for over 20 years, with 2 teenage children and 2 businesses to run, they have come to rely heavily on technology to manage their busy personal and professional lives.