Technology That Gives Us Reason to Smile
Dentistry is a constantly advancing field thanks to the forward thinking of manufacturers and clinicians alike. Here, we take a look at some of the technologies that get better and better every year, and should be a consideration for every dental practice.
It’s safe to say that any dentist who’s been in practice for a number of years has witnessed significant transformations in technology. This constant evolution can be seen in every corner of the practice, and it impacts just about everything the dental team does every day—or better yet, everything the team no longer has to do, thanks to streamlined products and processes. There are the obvious advancements—the sleek technology such as sophisticated imaging systems and software, CAD/CAM equipment, 3D printers, lasers, and all of the other products that continue to emerge, enabling shorter treatment times and better patient experiences. There are the behind-the-scenes workhorses, such as the practice management software that keeps the practice running smoothly and the patient communication systems that help to fill the schedule. And then there are the restorative materials—such as universal adhesives, chameleon-like composites, and bioactive materials—that have advanced dramatically in the past few decades and offer the capability to do more with less. Here, we take a look at a few of the technologies that have continued to evolve—to the point where they should be a consideration for every practice.
The Digital Entry Point
Every dental professional has his or her favorite—that investment they made that literally changed the practice. And in many cases, it’s the investment in a digital intraoral scanner, which serves as the entry point to any number of digital workflows.
For Lawrence Brent, DMD, owner of Brent Dental Arts in Cranbury, NJ, the 3Shape TRIOS intraoral scanner has made all the difference in his practice. “Taking digital impressions with TRIOS has hugely improved the quality of my restorative work,” he shared. “I can see so much more in the scans, and my preps have gotten better after 30 years in practice. Digital bite registrations are much more accurate, to the point where most of my restorations require no adjustments.”
Plus, Dr. Brent continued, there’s no need to retake an impression—he can just rescan an area as needed if more detail is required. “After 5 years of scanning, TRIOS has proven to be a huge time-saver at delivery appointments. The days of spending 15 to 20 minutes adjusting occlusion are history, and the patient ‘wow’ factor is almost worth the investment alone.”
The latest-generation scanner from 3Shape, TRIOS 4, comes as a flexible wired and wireless solution, with increased battery life of more than 30%. With its instant-heat technology, the scanner is ready to capture an impression in seconds, and combined with the enhanced battery life, the scanner can be
used with more patients on a single charge.
The Planmeca Emerald S—which has scanning speeds twice as fast as its predecessor, new diagnostic capabilities, and improved usability—has had a major impact on the digital treatment workfl ow for Dr. David Edelson, who provides a high volume of restorative treatment to patients in his Plainville, CT, practice. Among his favorite aspects are its portability and usability. “It’s very lightweight and small—plus the SlimLine tip gives you better accessibility to tight spaces,” he said.
Although he fabricates most restorations in-house, Planmeca’s open architecture makes it easy to send digital scans out to a lab for milling restorations and creating custom implant abutments. “In an implant case, I can quickly and easily send digital scan bodies, an impression post, and a scan post to the lab so they can build the abutment,” Dr. Edelson shared, adding that the result is accurate, single-visit restorations that fit extremely well.
“Portability is also a big benefit over some other scanners I’ve used. Its USB setup means you can have the software plugged into all your computers and
easily walk from operatory to operatory with the scanner, without having to pull a cart around with you,” said Dr. Edelson.
The iTero Element 5D Plus imaging system from Align Technology simultaneously records 3D models, intraoral photos, and near-infrared images (NIRI) to aid in caries detection above the gingiva. This trifecta of imaging capabilities has helped Dr. Jennifer Bell’s dental team increase efficiency during appointments in their Raleigh, NC, practices.
“They can capture intraoral photos and NIRI images all at once, instead of taking individual images and spending a lot more time capturing a lot less information,” said Dr. Bell.
The dental team can utilize a variety of iTero software modules to help patients visualize their oral conditions. For example, Dr. Bell can create an Occlusogram to illustrate patients’ periodontal concerns, such as crowding and malalignment; toggle over to intraoral and NIRI images to validate radiographic fi ndings; or use TimeLapse technology to compare current and historical scans and determine if a particular condition is improving or worsening. “It’s all really integrated into the treatment discussion that we have with patients. We are able to give them a full view of their oral conditions using a 3D rendering of their mouths, which is a unique experience for most patients because they’ve never really encountered that type of diagnostic conversation before.”
Dr. Joshua Howard, who practices in Dover, NH, first began using an intraoral scanner in 2005, choosing Dentsply Sirona technology then and upgrading
over the years as the company released new innovations. Today, he uses Primescan, which he said is the company’s best and fastest intraoral scanner. Primescan allows for easy capturing and quicker processing of more data in higher resolution, transmitting exactly the data needed and displaying 3D-scan models immediately. It also enables seamless and open data transfers—to in-house software, a lab, or other partners such as clear aligner providers. Primescan is the starting point of Dr. Howard’s in-house CAD/ CAM restorations as well as his lab workflow, and services such as clear aligner treatment with SureSmile aligners.
When it comes to sending digital scans to the lab, Dr. Howard said that Primescan makes the process very simple. “It’s great if we’re doing large cosmetic cases because we can send along pictures digitally, and since we’re scanning it, we know right away that the fit is not going to be an issue—it’s going to fit right every single time,” he said.
Dr. Howard also appreciates that Primescan is user-friendly with what he described as a short learning curve, enabling easy delegation to the team.
The QuickScan IOS from Denterprise International is a “brilliant entry-level scanner,” according to Dr. Isaac Tawil, who practices in Brooklyn, NY. He said he appreciates the system’s speed and accuracy, as well as its ergonomic design.
“The handpiece is slender, making it easy to hold when rotating from occlusal to palatal and buccal surfaces—almost the opposite of typical handpieces,
which are wider and heavier. I can get my fingers all the way around the QuickScan. That makes it easier to do a full-arch scan in one pass. I see no reason why I could not capture all surfaces for practically any typical case.”
Dr. Tawil also lauded the QuickScan’s intuitive workflow. “The user interface has been simplifi ed, dropdown menus are self-evident, and the workflow is intuitive. On screen, the impression renders in full color, monochrome, and meshwork. It is open architecture, so scans can be exported in STL and PLY file formats to any lab with CAD/CAM software or to any open-treatment planning and design software.”
Seeing Is Believing
CBCT imaging takes what many dentists are used to—a fog of digital information compressed into a 2D image—and allows visualization of exquisite anatomy details that allow for better diagnosis.
The latest imaging system from Dentsply Sirona is Axeos, a versatile 3D/2D unit with a full range of functions for practices that offer
a broad array of treatment services. The unit has a 5-cm volume designed for local findings, such as endodontic issues or single implants, as well as an 8-cm volume for lower and upper jaw dentition, which can be used for planning multiple implants. The 11-cm volume is for complete dentition, including wisdom teeth, and the 17- cm volume for temporomandibular joints and the cranial base.
The volume sizes are key for Kirsten Andrews, DDS, of Johnson Family Dentistry in Devils Lake, ND, who upgraded to Axeos from an older system. For example, she uses a smaller volume size when analyzing an image for a possible root canal or to extract a tooth, or the largest volume size for a sleep apnea case or to evaluate TMJ.
Since getting Axeos over a year ago, Dr. Andrews has seen tremendous benefits, especially when it comes to implants. “I found myself actually squinting at images before I began using Axeos—the images are so much more crisp and clear now,” she added.
For the past 15 years, PreXion has been developing dental 3D imaging systems on the cutting-edge of CBCT technology, thanks to a diligent manufacturing process and seemingly endless research and development. Dr. Jon Julian, now a lecturer on the use of technology in dentistry, was drawn to PreXion when he first began looking at CBCT systems over a decade ago, impressed with its diagnostic clarity and ease of use. The technology would transform his practice.
“I kept discovering things I wouldn’t see previously—things that neither I nor the patient knew they had. It didn’t take long for me to figure out that I better take a cone beam scan on every patient—not just those who needed an implant. By doing so, I have an opportunity to diagnose anything going on in the entire mouth,” Dr. Julian said.
“We use the Planmeca Viso G7 every day in our practice. From panos to 3D imaging, it really does it all. In fact, it’s the best imaging system we’ve ever had in our office,” said Dr. Thorup.
Planmeca Viso G7 was designed with innovative features to help eliminate factors that degrade image quality. That includes the Planmeca CALM movement correction algorithm, which cancels the effects caused by patient movement—saving time and guarding patients from unnecessary exposures. And with the integrated Planmeca ProFace feature, clinicians can merge a realistic 3D face photo with a CBCT image in a single scan, as a way to build a more complete patient profile and orient the patient to where the problem area is in relation to the face. This not only aids in preoperative planning and postoperative comparisons, but can help motivate the patient to move forward with treatment. Another key feature is the option to capture the area of interest with precision using the system’s live patient positioning and unlimited fi eld-of-view sizes.
Something to Smile About
When it comes to cosmetic treatment, procedures such as implant restorations, crown-and-bridge work, and veneers are all critical. However, more and more dentists have added clear aligners to their roster of services, finding it to be a great way to meet more of their patients’ esthetic demands in-house while providing a new revenue stream.
Over the years, Dr. Brent has had his ups and downs with clear aligner providers. He has worked with a variety of companies but was frustrated with issues such as mandatory case minimums, long response times for new cases, and the number of refi nements. Not one to give up on finding the right solution for his patients, Dr. Brent began working with Dentsply Sirona’s SureSmile Aligner. The full-service aligner platform accepts digital scans from any device and gives clinicians the option to work with the SureSmile Digital Lab to design and fabricate the aligners—or digitally design their own treatment plans.
“SureSmile seems to be a very good product with exceptional support and training,” he said. “My last case was approved and in my office in less than 5 business days. I am doing more of this treatment because my patients want it, and I’m happy to have found a vendor that gives me clinical confidence in their product.” Dr. Irene Renieris, who practices in Chicago, IL, has had a similar experience with clear aligners, and like Dr. Brent, is enjoying success with SureSmile. “I love the personal touch I have with my rep, and getting questions answered quickly is another reason they’re now my go-to aligner company,” she said. “Also, the turnaround time to receive the aligners is so much quicker than with my previous service.”
For many dentists, Reveal Clear Aligners from Henry Schein Orthodontics have been the answer. Dr. Eric Veenstra of Midland Park, NJ, had used a
prominent brand for years, but felt his general dentistry practice was getting pushed aside by the company, which started to have customer relationship issues and tray delivery delays. After checking out other aligners, and being a practice that already purchased supplies from Henry Schein, he decided to try their clear aligner, Reveal. "We realy liked it," he said. "And my patients have been very happy with it." With Reveal, Henry Schein Orthodontics provides a service that's easy for general dentists to implement and a product that’s clear, comfortable, and effective. The aligners are engineered to provide greater clarity and guaranteed not to discolor or cloud over time. The silky, smooth trays fi t securely along the gingival margin for maximum patient comfort. A precision fit with the proprietary ClearWear aligner material ensures that teeth will move as quickly and comfortably as possible.
ClearCorrect offers simplicity for dentists and patients. After submitting photos, x-rays, and digital impressions from nearly any intraoral scanner, ClearCorrect maps out a 3D model of the patient’s teeth and creates a web-based treatment plan that can be managed online or shared with patients 24/7.
Dr. Maria Jackson recently built a new practice in Forney, TX, where she offers a wide range of dentistry to her patients, including a great deal of orthodontics because it allows her to take a conservative approach to dentistry by fi rst moving teeth into their proper position. She sends a 3Shape TRIOS digital scan to ClearCorrect and receives a virtual mock-up of the treatment plan, which she then shares with the patient for motivation to move forward. Dr. Jackson has found her patients love the aligners as much as she does. “I’m defi nitely a big fan of the material ClearCorrect uses, especially the latest material they came out with, ClearQuartz. My patients will say, ‘Oh, this is super clear,’ or ‘I can barely tell that I’m wearing an aligner.’ I tell them, ‘That’s great, just wear it—that’s all I care about!’”
