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In-Office Digital Dentistry

Cutting-Edge Technologies for Impression Capture, Restorative Design, and Prosthesis Fabrication

Computerized data capture has evolved significantly throughout the past two decades, resulting in improved transfer of critical information. Initial iterations of digital systems have paved the way for contemporary modes of impression capture that enable enhanced communication with remote laboratories, as well as novel chairside systems designed to capture the patient’s information and allow the general practitioner to immediately fabricate a long-term, aesthetic restoration for same-day delivery. Patient benefits (Table 1), in conjunction with ease of use and applicability, have caused this technology to become a vital component of cutting-edge care, improving the predictability and precision of treatment.

Digital Impression Capture

Conventional forays into digital impressioning utilized data captured from digital CAD/CAM systems as a precursor to restorative fabrication. Novel versions provide independent impression capture using still images or continuous video streaming captured using a handheld device. These images can then be used to improve information transfer and communication between the laboratory and clinician. Using such systems, clinicians and technicians can view impression data and communicate directly, in real time, and can refer to the same image as projected on a computer screen. Preparation designs can be immediately altered during the initial appointment, which will save valuable time traditionally spent shipping models and recalling patients to revise preparation designs.

Image Acquisition

Digital impressioning and CAD/CAM systems use different methods to acquire the computerized imaging used to transfer critical data for subsequent restoration fabrication. By incorporating multiple images captured from different aspects, these systems can then combine the captured data to depict the existing intraoral environment (Figure 1). While application of powder is necessary for some systems to register the morphology of the teeth and/or surrounding tissues, this step can generally be performed quickly and easily; the powder can be easily removed using water immediately following completion of the data-capture process. Once the image is captured and reviewed by the clinician, it can be stored in the system for chairside fabrication, or digitally transmitted to the dental laboratory for use.

Restorative Design

Using digitized formats, clinicians can now design chairside restorations that would traditionally require laboratory fabrication. Proprietary software programs can be used to ensure development of an accurately fitting, proportional, and functional restoration that can then be stained, layered, and fired during the same preparation appointment.  Alternatively, systems designed to provide digital impression capture can then be used to transmit the digital image to the laboratory where the model can be milled for subsequent creation of a CAD/CAM or traditional porcelain restoration. By transforming the image created by the proprietary software into a physical model, complex cases can be carefully evaluated in the laboratory as needed prior to definitive porcelain layering.

Conclusion

For both the dental technician and the clinician, digital impression and CAD/CAM systems provide a variety of improvements over traditional restorative methods. Patients can now be awarded significant time savings by being able to receive immediate, chairside restoration when indicated. With both in-office CAD/CAM systems and chairside scanning systems, clinicians can deliver restorations with improved accuracy, longevity and fit.

Tables

Table 1: Patient Benefits Using Digital Chairside Dentistry

*Single visit restorations.

*Reduction in time required for prosthesis fabrication and preparation modifications.

*Improved marginal fit.

*Increased restorative accuracy.

*Natural aesthetics.

*Enhanced comfort.

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