Technology That Earns Its Place

After 32 years in private practice, Dr. Maria Van Huffel has seen dental technology evolve from amalgam and conventional impressions to digital scanning, chairside milling, CBCT, guided implant placement, and 3D printing. Of all those changes, one technology stands out.

“The scanner really, for me, changed my practice in the greatest way,” she said.

Digital scanning eliminated one of the most uncomfortable parts of dentistry for many of her patients while also making her own workflows more efficient. What started with scanning for crowns and bridges has expanded to nearly everything she does, including full-arch cases, clear aligners, implant treatment, and same-day dentistry.

Dr. Van Huffel has also built much of her digital workflow around the Dentsply Sirona ecosystem, including Primescan—and, now, Primescan 2—CBCT, CEREC, and implant-related technologies. That integrated approach has become increasingly important as her practice has expanded—and as her son, Dr. David Van Huffel, has joined her in practice, creating a new need for technology that can support multiple clinicians.

At this year’s DS World in Las Vegas, Dr. Van Huffel met with DPS to discuss how technology has changed the way she practices and where she sees it taking implant dentistry next.

What technology has had the biggest impact on the way you deliver care?

I think the most pivotal change in my practice came about when I started scanning. Patients carry so much fear with them into the dental office, and for so many people, not having to fear the impression was life-changing. It really changed their dental experience. They just didn't dread it.

For a long time, we were just scanning for crowns and bridges so we didn't have to do the 5-minute polyvinyl siloxane impression. Now we’re really at a point where we scan for almost everything. We're not even taking alginates very much either. We scan because we're able to print those models.

I actually purchased a CBCT first because my panorex died, and I decided to go with 3D technology. My next purchase was a scanner and a mill at the same time. I chose to do it with the Dentsply Sirona ecosystem intentionally. As much as I use technology and love AI for a lot of practical purposes, I don't always understand how things work together. Keeping it all within the same ecosystem takes that pressure off me. It's all meant to work seamlessly, and in my experience, it has.

How has scanning changed the way you work?

So many different things have been affected by it. Primarily, it's the patient. They're no longer fearful of the impression, so they're much more likely to come in and ask for things they always wanted to have done but had been putting off.

I've been doing same-day dentistry for more than a decade, and that has been a significant change for the patient. But it's also changed things for me. I didn't like doing impressions either.

The other big advantage is that if you have one little bubble on the margin of an impression, you have to take the entire impression over. Now I can cut out just that one little piece and redo it, and it's done.

As the scanner technology has advanced, it has become easier and easier to capture the image. I purchased my Primescan specifically to do SureSmile because I was faced with doing full-arch scans, and Primescan was so good at doing that. My desire to do different procedures and more procedures has really driven my taking advantage of the technology.

How has digital technology changed your approach to implant placement?

I started placing implants around 2018, and I'm a little risk-averse, so for me, it was fully guided from the very first one. I had the technology, and that's what really led me into starting with implant placement. I had the CBCT and the scanner, and at that point we were milling our surgical guides. Now we 3D-print them.

When I'm placing my own implants, the variance in position is 0.3 mm with the Dentsply Sirona/SICAT workflow. It's so precise that it's really a pleasure restoring implants with an integrated system that gives me exactly what I ask for each time.

Before fabricating my own implant restorations in-office with Atlantis custom abutments, I was using labs to fabricate my restorations and working with UCLA and stock abutments. It was a very different experience. There was much less nuance and less patient-specific control, particularly when you had angulation problems with an implant someone else had placed. Now, using my CBCT and CEREC scans to plan my fully guided surgeries, I know where the crown is going to be, where the anatomical landmarks and caution areas are, and I can make a really good decision about where I want to place the implant.

What would you tell dentists who are beginning to incorporate implants into their practices?

No. 1 is precision. When you don't have a tremendous amount of experience, you want to know that you're using a system that's giving you the best belt and suspenders—covering all of those things so there's as little variability as possible. When you're taking a CBCT and an intraoral 3D scan and stitching them together, you have all of the information. You know where your crown is going to be, and it's a restoratively driven process. You know where your anatomical landmarks and caution areas are. There's just so much information that you can make a really good decision about where you want to place that implant.

If you don’t have a 3D printer, you can send the case to a lab to print the surgical guide. But eventually, you definitely want to have that printer and be able to make your own guides.

How do you decide whether a new technology is worth adding to the practice?

I do love a gadget, but these are very big investments. I really try to make the decision based on my needs at the time. How is this going to make my patients’ experience better? How is it going to make my stress less? Is it going to increase the number of things I'm able to do in-house?

With the printer, for example, I can make occlusal guards pretty much the same day if we need to. I can reprint a provisional or an immediate denture. That gives me control over the timing.

The Primescan 2 came out last year, but I only bought one today. The reason is that I just didn't need it until now. My son is now in the practice with me, and there are times when we all want the scanner, so it now made sense from a business standpoint.

Looking ahead, where do you see the next opportunities for technology in implant dentistry?

I don't think we'll ever be at the end of the road. I'm regularly amazed and surprised at the things dentistry comes up with that make it a better experience for the patient, a better experience for the doctor, and solve problems we never even knew we had.

I don't know if the next advances will be in surface technology, more shapes and sizes, or materials that help with integration and treatment after surgery. Maintenance of implants is still going to be something that's changing and improving, particularly as patients keep their implants longer and live longer.

I also think we'll see improvements in implant abutment technology and restorative materials so we're able to give patients healthy, functioning, esthetic, comfortable restorations that last longer and stay healthier into the future. And then, when there are problems, we'll have better technology to treat those, too.