In-Office Digital Dentistry
Cutting-Edge Technologies for Impression Capture, Restorative Design, and Prosthesis Fabrication
THE NEXT DDS
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.
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.
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.
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.
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.
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.