We are constantly being pushed by the dental industry to go digital. If one were to accept and believe all of the hype, it would seem that if we don’t jump on the bandwagon, we are missing out, falling behind and considered a “bad dentist”. Eight years ago, I attended a digital symposium by a major supplier where their president stood up in front of over 500 attendees and emphatically stated that within three years, there would not be a dentist in North America taking conventional impressions. Impression material would vanish as quickly as photographic film. Big statement! Guess what…. dentists are still taking conventional impressions and there are new impression materials coming to the market.
In actual fact taking a conventional impression in many circumstances is more predictable than the most advanced intraoral scanner. I have personally witnessed dental salespeople telling dentists that if they don’t invest in a scanner, they are falling behind the learning curve. They then add that there currently is a promotion on a brand of intraoral scanner. What they often don’t say is that the scanner is being discontinued and being replaced with a new model. Who is the winner here?
Restorations using computer aided design/computer aided manufacturing (CAD/CAM) were introduced to the dental profession approximately thirty years ago. Over the past ten years, CAD/CAM dental technology has been revolutionary as new hardware, software and materials develop. However, if a dentist does not have a strong fundamental knowledge of conventional dental procedures, going digital will add little to their success. Digital cannot make up for poor treatment planning and execution.
In the 1980s, I was a partner in a rock café style restaurant. We were excited to have hired a famous chef who had moved to Montreal from New York City. We believed he was going to put us on the map. He had huge plans and spoke of his celebrated chateaubriand and his ability to create elaborate ice sculptures. The thing was that our clientele really wanted hamburgers! Our famous chef could not make a good burger. Luckily, we had a kitchen helper who could. He also made delicious chicken fingers. He quickly was promoted to head chef. The point is: Why buy into digital if it will not benefit you?
If we compare traditional versus digital treatment planning, I do believe that there are enormous advantages to digital dentistry. However, going digital is a financial commitment and a huge time investment. In my particular situation, I do not have a practice that presently lends itself to in-office milling, nor will the use an intraoral scanner currently replace the use of impression material for large reconstructions and multiple implant cases. There is currently too much room for error. Scanning will definitely benefit our office for smaller cases. But this is not why I believe in going digital! Once one understands the wide range of possibilities that dental softwares provide, such as the capabilities of facial plane analysis, digital articulation and 3D printing, going digital gets really exciting and makes a lot of sense…… for some dentists.
Integrating digital dental technology requires education, investment and commitment. Offices that integrate digital technology can achieve a digital workflow using principles of design, technology, communication, three dimensional optical scanning and CAD/CAM milling and printing. A digital smile design can begin a process of clinician to patient to lab communication leading to advanced clinical diagnosis aided by 3D cone beam computed tomography technologies. The future of dental treatment planning will concentrate on the oral cavity in relation to the patient’s entire face and not just on a specific area involving just a few teeth. Integrating a digital workflow can offer a more complete service to our patients aiding us in the management of complex clinical cases. OH
Dr. Elliot Mechanic practices esthetic dentistry in Montreal, Quebec. He is Oral Health’s editorial board member for esthetics.
