Ashish Parmar discusses the digital opportunities that come with an intraoral scanner.
My practice, Smile Design by Ash, was set up as a private squat 10 years ago. It now attracts patients from all over the UK, as well as internationally.
I have a special interest in cosmetic dentistry, advanced restorative cases, implants, lasers, fibre/composite dentistry and dentures. That’s why I’ve become increasingly involved with digital dentistry, which all started with the purchase of my first intraoral scanner.
Hearing about the benefits of digital scanners, around four years ago I decided to look at the models available.
I finally settled on the 3shape Trios, which is an ideal starting point for anyone new to digital dentistry. I liked the simplicity of the scanner and chose the cart model to make it easy to move between our three treatment rooms. This way, it could be used by any of our dentists as required.
The benefits of intraoral scanning
For myself and my clinical team, the Trios has opened up a range of new treatment opportunities. It has made the patient journey more efficient and comfortable in three distinct ways:
In today’s practices, digital scans are a key part of the initial consultation with a new patient. This greatly improves patient communication and aids the patient’s understanding of the treatment I am recommending.
The beauty of a digital scan is the manoeuvrability of the images on the screen; this tool can be used to highlight problem areas and to show patients the inside of their own mouth. Probably for the first time – in ways X-rays or 2D photographs simply cannot do.
As an Invisalign provider, the use of digital impressions and 3D computer imaging is essential. This is where we rely on Trios the most.
Clear, almost invisible braces and retainers for orthodontic treatment is a huge growth area in dentistry. It can lead to uptake of other cosmetic treatments, such as whitening or veneers. In the current climate, it also offers a minimally invasive and non-aerosol generating approach to alignment.
I now often use digital impressions for my crown and bridge work. An important benefit of digital scanning is checking the interocclusal clearance – the space between the prepared tooth and the opposing tooth, to verify the required thickness of the crown.
I can also look for undercuts, which can sometimes mean the crown or bridge will not fit properly. Using the undercut measuring tool within the Trios software, I can analyse where the undercut is and go back and make minor modifications to the specific area. I can then look on screen at my margins to ensure they are finished properly, as well as checking the colour and shade mapping of the prepared tooth.
Digital occlusal analysis
Almost every dental procedure has an impact on the occlusion. While a digital scan can show where the forces and contact areas are in the mouth, they can’t measure the actual force.
I’m passionate about occlusion and I use the T-Scan software from Tekscan that provides a dynamic occlusal measurement to reveal the occlusal forces on individual teeth and the timing of the occlusal contacts. Equipped with the digital bite force data and in conjunction with articulating papers, I can be specific and make small, precise adjustments with greater accuracy than ever before.
The place for analogue
I do not exclusively use digital impressions for every case. For instance, I prefer to use a conventional analogue impression for subgingival preparation. I use a two-step putty-wash technique where the compression pressure pushes the impression paste sub gingivally to give very fine detail, which is not as easy to achieve with a digital impression. I routinely use retraction cords.
The type of impression you choose is ultimately dependent on the clinical case and the digital capabilities of your laboratory. Even today, I still take analogue impressions for my smile makeover cases where I believe this will lead to a better outcome or I’m advised it is the right option by my laboratory technician.
There are so many advantages to moving to digital dentistry and in my opinion, it is definitely the way forward.
For patients, an intraoral scanner offers more comfort and faster treatment. The new technology impresses them. For GDPs, the technology provides a digital treatment record – it’s an ideal way to check the standard of your own work and greatly improves overall communication with your lab, as well as your patients.
The digital workflow has certainly revolutionised my dentistry: the predictability is there, I know the occlusion is going to be right and there is far less margin for error.
Digital technology is getting better and more affordable all the time and is now an essential part of helping to build a practice that sets you ahead of the competition and prepares you for the future.
This article first appeared in Dentistry magazine. You can view the latest issue of the magazine here.
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