THE DIGITAL STREAM

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.

From the patient’s perspective, dental impressions haven’t traditionally offered the most pleasant experience. The availability of digital intraoral scanners has changed this drastically, providing a much more comfortable alternative. For dentists, intraoral scanners offer many benefits in addition to encouraging patient satisfaction.

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.

Dental injuries are the most common type of facial injury sustained while playing sports, which makes properly designed mouth guards a necessity for injury prevention. In fact, one study estimates that mouth guards prevent approximately 200,000 injuries each year in high school and collegiate football alone. Using a highly accurate digital impression to produce a custom mouth guard promotes stability, proper fit and ease of breathing—and can ultimately help prevent concussions and dentofacial injuries.

In the same way that modern technology has brought us information that’s immediately available, it has also provided instant communication. Considering the very first mobile phone only went on sale to the public a little over 30 years ago (DynaTAC in the US cost almost $4,000 each at the time!), it is astounding to think how far we have come in such a short amount of time.

If you’re using an intraoral scanner to take digital impressions, then you already know their many benefits. However, it’s always good to have a few tricks up your sleeve when using new technology. Often when scanning shiny surfaces, such as a metal restoration, bracket or abutment, you may notice an overly bright area (or “hotspot”) on your scan. Not to worry, in this video I share a few easy tips for scanning reflective surfaces and getting the perfect scan to complete your digital impression.

Intraoral scanning is another way digital workflows are used in dentistry. To create custom abutments with a digital scanner, attach a scan body (compatible with your implant system) and scan like you would a prepped tooth. The digital impression is sent to the lab and the lab software orients the implant fixture according to the scan body position. The lab then designs the final abutment, mills it and can either send a model of the final abutment to fabricate a restoration or mill both crown and abutment digitally.

As an oral surgeon, I do many procedures that require impressions—fabricating surgical guides, creating appliances to correct sleep apnea, etc. I’ve seen great results when using a digital scanner to take impressions in place of conventional impression materials. Not only is the process faster and more efficient, but I’ve noticed that my patients also prefer digital impressions to the potentially gag-inducing polyvinyl or alginate.

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.