Digital Dentures: What You Need To Know
Gary M. Radz, DDS
The introduction of digital dentures to dentistry has opened up the door for more dentists to provide this service to an ever-growing population of potential patients. Additionally, the reduction in number of visits required can potentially reduce the costs to patients.
Exciting technological advancements have changed clinical denture technique and laboratory technology in an area of dentistry that has not seen change in many decades.
There are still some misconceptions about digital dentures, the biggest being that the dentist needs to use a digital impression scanning system to capture the patients’ impression. In reality, digital impression scanning systems cannot capture the required information accurately enough for denture fabrication. The soft tissue dynamics present in a patient’s oral cavity cannot be adequately recorded with current intraoral digital impression technology.
Traditional impression techniques are required to perform the border-molding component of the denture impression. Additionally, the vertical dimension and the bite relationship can be determined with variations of traditional techniques. With digital denture techniques, the need for a custom tray is eliminated and the vertical dimension and occlusal plane can now be captured accurately at the first appointment rather than multiple.
The “digital” part comes into play in the lab. The traditional impression taken in the dental office is now digitally scanned in the dental lab using a 3D scanner. Then, using new software, multiple anatomical landmarks are identified to assist in the virtual fabrication of the try-in denture. The software can now conceptualize the ideal arch shape and occlusal plane as well as the tooth shape and size based on the data from the scan as well as the information provided by the clinician.
The try-in denture is created digitally in a printed model, which replaces the traditional wax try-in. The clinician can now refine the occlusion, adjust flanges, modify the post dam as needed, and make notations for tooth positional changes. The try-in can even be relined with conventional impression material.
Any modifications are scanned and merged with the original scan to facilitate the fabrication of the final denture. The final delivery is no different than traditional delivery techniques of the past.
The benefit of digital dentures to both the patient and the dentist is that so much information can be gathered digitally that it will reduce the number of patient visits and increase the accuracy of the final prosthetic appliance. The reduction of chairtime and visits is helpful is terms of convenience and finances..
From a personal perspective I have done very few full dentures in my office in the past 20 years. The variability in the technique process and the need for multiple appointments were frustrating. Being a more traditional crown and bridge dentist, the variability involved when dealing with soft tissue born prosthetics was challenging. Additionally, I found that the fee I needed to charge based on demand and a satisfactory final prosthesis made it prohibitive to many patients. With digital denture technology and techniques, we are now able to provide an excellent final result at a fee that is acceptable to the practice and more patients. It has been an exciting addition to our practice mix, opening up a demographic that we have ignored for many years.
About the Author
Dr. Gary Radz maintains a private practice in downtown Denver, Colorado. He is a faculty member of the University of Colorado School of Dental Medicine.