The Future of Digital Scanning is Here
Parag R. Kachalia, DDS
Digital restorative dentistry has been around for over 30 years, however the adoption of digital technology over the first 25 years was relatively low. By technology standards, digital dentistry has only recently moved from those individuals that live on the bleeding edge and are considered the innovators to those that are considered early adopters. There are many reasons for this relatively slow adoption, but three key areas tend to stand out. These are accuracy, cost, and the fear of buying too early. One significant change that addresses all of these issues is that digital dentistry is no longer an all or none phenomenon. In the past, to be considered a digital restorative dentist, a clinician had to purchase a complete system that included both digital scanning and restoration fabrication. For many clinicians this was the appropriate choice, as they wanted to move a significant portion of their laboratory processes in house. However, others had no desire to create restorations, but rather wanted to capture digital impressions and partner with their laboratory. Today, practitioners have many choices and they can individually decide where they would like to enter the digital highway. The first step for many will be to simply acquire a digital scanner that will allow intraoral impressioning and this article will help practitioners navigate the nuances of the various systems available today.
One of the primary fears surrounding digital scanning has been that the results may not be as accurate as traditional impression material and practitioners are concerned that their restorations may not fit as well as they did using traditional techniques. Numerous studies have been conducted over the last 5 years and digital scanning has repeatedly proven to be at least as accurate as traditional impressioning. In fact the data sets that are generated by digital scanners today are so robust that single-unit restorations can be predictably fabricated without the need to generate a physical model. Many restorations today can be designed using a 100% digital workflow and the inaccuracies of traditional gypsum-based models can be overcome. Numerous clinicians have reported that delivery times or restorations have decreased by nearly 20% when restorations have been fabricated based on a digital scan.
This high level of accuracy associated with digital scanners has been present for more than 5 years and while accuracy continues to improve, many manufacturers have also focused their efforts on improving scanning efficiency and the physical size of the camera. In the early days of digital scanning, workflows were more complicated and wand sizes were fairly bulky. The bulky wand size sometimes did not allow access into patients’ mouths with smaller openings. In addition, to capture an accurate digital scan, clinicians would need to place the scanner on the dentition and take numerous individual images that were stitched together to form a model. This process was cumbersome and did not necessarily make the process faster than traditional impressioning.
Today, manufacturers have started to produce scanners with much smaller intraoral wands and very fast image capture rates. In some cases, the wand size is now similar to intraoral cameras and one can easily navigate dentitions of all sizes. To attain improved scanning efficiency, yet maintain accuracy, some manufacturers have chosen to use high resolution contrast powders or sprays and other manufacturers have chosen to use robust optics that do not require any type of contrast solution. The benefit of contrast solutions is that the accuracy can stay high while keeping overall system costs more affordable. In systems that require no contrast solution, workflow can be streamlined while maintaining high accuracy. Additionally, many of these systems output a color image of the patient’s dentition, which can be helpful in terms of patient education and treatment planning.
The digital scanning marketplace has improved tremendously over the last decade and practitioners today have the opportunity to pick the system that is appropriate for their practice. Furthermore, many of the systems that are available today have an open architecture platform, so clinicians can choose to grow their digital scanners into complete office solutions over time. By investing in an open architecture system, clinicians can choose to pair the best products across multiple manufacturers versus a closed architecture world where only technologies within a given manufacturer’s offerings can be paired. Clinicians should also be comfortable knowing that the hardware aspect of digital scanning is very good today and that many of the changes that will occur will be more software related. The big benefit of software advances is that it allows an investment in a scanner to evolve over time, so that a purchase today is not outdated tomorrow.
Digital scanning is no longer a future technology, but rather a technology that has matured greatly and works very well today.
About the Author
Parag R. Kachalia, DDS
Vice Chair of Preclinical Education, Technology, and Research
Department of Integrated Reconstructive Dental Sciences
University of the Pacific
Arthur A. Dugoni School of Dentistry
San Francisco, California
San Ramon, California