Embracing the Power of Digital Dentistry
We should no longer be thinking about how any piece of dental technology saves us money, but instead how it increases case acceptance; gets treatment started faster; and makes clinical outcomes more predictable. In my practice, an example of such a technology is exocad’s digital design software.
Why exocad?
DentalCAD from exocad is a robust software platform that gives me greater control and capabilities ranging from planning smile design cases to temporization techniques and final fabrication. More important, the same software can be used for the simple “onesie-twosie” cases, bridges, implant restorations, complex implant restorations, dentures, partials, implant planning surgical guides, and so much more.
Why Insource vs Outsource?
Many will say it’s not worth their time to learn or use software like exocad’s since they have a laboratory that is already doing this for them. I completely understand—that has also been my thinking for a long time with larger cases. My goal is not to diminish our important relationship with labs. The challenge with most lab relationships is that it takes multiple weeks to get the work done, requires time for communication, and removes control from the clinician. However, control and communication are especially important in the planning phase for smile design.
Completing the smile design in-house with exocad allows me to have a greater understanding of the nuances while allowing the patient to be involved in the design process. Most important, it allows me to complete the smile design quickly to get the case started sooner.
Case Presentation
The patient presented needing extractions on teeth Nos. 7 and 10. She expressed interest in improving her whole upper smile, so we opted for a 10-unit restoration spanning teeth Nos. 4 to 13 (Figure 1). We used Smile Creator, a module within the DentalCAD platform, to create a prosthetically feasible esthetic design. In Smile Creator, patient photos are automatically converted to 3D objects and matched to the 3D scans of the teeth, offering a realistic perspective for a restorative treatment plan. Here, we merged the face photo with the smile design and used it to help drive excitement and case acceptance (Figure 2). A model and putty stent were used to transfer the smile design over unprepared teeth to help guide the necessary reduction and desired result (Figures 3, 4).
The final smile design was completed over prepared teeth to create a model for fabrication of a trial smile (Figure 5). Finally, models of the unprepared and prepared smile design were exported from exocad for 3D printing (Figure 6) and the immediate provisionalization (Figures 7, 8). The patient is in her provisional trial smile and is ecstatic with the results and progress of the case so far, especially the opportunity to be more involved in the process thanks to digital technology.
Final Thoughts
The ability to communicate directly with patients about their desires and make adjustments to the smile design with them present is priceless. This ensures ideal outcomes that meet the desires of the patients while also allowing me to determine which patients’ expectations are too high.
The real magic is that the patient can come in for a consult and begin their case as soon as the very next day. This is the power of digital dentistry.
DENTALCAD
DentalCAD is exocad’s open-architecture CAD software platform for experts and beginners alike. With DentalCAD, creating automatic design proposals is simple. Instant anatomic morphing enables efficient adjustments—the anatomy of teeth automatically adjusts in real time for dynamic occlusion—and AI-based detection of facial features makes smile design faster and more accurate.
Dr. Agarwal is a full-time practicing general dentist who deals with the same issues we all face—overhead, difficult patients, ups and downs of private practice, and team management. He doesn’t pretend to have a perfect practice. His practice isn’t a fancy boutique, but a general practice that participates with dental insurance. Despite being contracted with insurance, he’s managed to build a successful practice that is focused on clinical excellence, customer service, and allowing patients to choose optimal dentistry. Dedicated to continuing education, he has studied with many leaders in the fi eld of dentistry but readily admits his best learning has come from the “school of hard knocks.”
