Duncan Black discusses the benefits of intra oral scanning and how it has transformed – and improved – his practice.
What makes intra oral scanning so beneficial to a practice?
I have been using intra oral scanners in practice for 12 years and I have used Primescan for 14 months. By comparison to the others, it is a leap forward in ease of use and accuracy of scan.
Primescan and intra oral scanning are beneficial in several ways. Firstly, it changes the patient perception of the practice, in that you are embracing the most modern dental technology and ways of constructing dental restorations.
There is an improvement in hygiene, with no more immersing impressions in bleach solution and sending them off to a remote dental lab.
Patients don’t really enjoy traditional impression-taking. A scan with Primescan is fast and accurate. It is efficient and easy for the dentist, and provides much improved patient comfort.
The accuracy of the scan reduces fitting time and reduces the number of remakes. I cannot remember the last time the laboratory asked me for a new impression. This prevents wasted appointments – a plus for both dentist and patient.
It also makes it easy for the practice to embrace other aspects of the ‘digital workflow’, making it easier to access digital smile design, implant planning and digital orthodontics with external suppliers and dental labs.
Also, it is great for patient education, as every patient has a scan and is shown the conditions in their mouth. A picture tells a thousand words! Also, having an accurate colour record of the patient’s dentition prior to treatment provides fantastic medico-legal information.
How has it made a difference to the way you do things?
My treatment workflow is completely different from the way it used to be. Every patient is scanned as part of the examination process. This improves patient involvement in treatment planning and improves informed consent, as we can show patients the issues they have with their dentition in clear colour images.
I use digital planning and digital wax ups in the majority of cases, including in implant planning.
This improves the results of treatment and adds ‘control’ to more complex cases. Often, it allows me to identify potential problems, and offer and show patients the ‘after’ before they start treatment – improving the consent process.
Digital smile design and the use of pulldown stents allows us to use injection techniques for composite bonding. This provides accuracy and a very pleasing aesthetic result for the patient with minimal fuss.
By working with our favourite partner laboratories, we can shorten treatment times considerably. This produces work in a day if needed, rather than 10 days to two weeks.
Scanning has also improved my preparations. I can see the prep incredibly clearly prior to sending it to the laboratory, which allows me a chance to make small modifications.
Bespoke impression
I mainly provide implant dentistry. Primescan is a revelation in comparison to previous scanners I have used due to its depth of focus 20mm and the speed of the scan. Often, when you spend time developing a soft tissue profile for an implant crown with a temporary crown, as soon as you remove the crown for the impression for the permanent crown, the tissue collapses.
With conventional techniques this would mean I would have to create a bespoke impression coping to get accurate transfer to the laboratory. Due to Primescan’s speed and depth of focus this is unnecessary, as it picks up the detail required first time.
If I am ever unhappy with detail, then I can easily review the scan. I can then erase the area I am not happy with, and re-scan.
With previous scanners I have used, sometimes I would take a physical impression, as I knew the scanner would struggle to acquire the information required. This is not needed with the Primescan.
I know it is faster than a conventional impression and very accurate, avoiding the errors that can creep in with conventional impressions.
Due to the accuracy of the fitting of restorations, you tend to change the dentistry you offer. I now offer more inlays/onlays as I know they will fit beautifully every time. The accuracy of digital impressions allows excellent restoration margins and restorations with exact fit first time.
I find that fitting time is reduced and occlusion tends to be ‘spot on’.
How does it improve the patient experience and remove the ‘fear factor’?
Intra oral scanning in dentistry has enormous benefits over traditional impression taking.
Firstly, patients love it! They have no mouthful of impression material, which often makes them gag.
This is particularly good in implant dentistry where we have impression copings as well as the impression material to deal with,. No more struggling with three impression copings, an impression tray, impression material and a screwdriver in a patient’s mouth.
In fact, if for some reason a patient you have taken a digital impression on requires a conventional impression, they always ask ‘Why can’t I get a scan?’
It is an incredible practice builder as patients are amazed by the technology and tell all their friends.
Why do you think digital dentistry improves practice efficiency and profitability?
All of the above. Additionally:
- It is a practice builder
- Fast accurate impressions, reducing impression time, fitting time, and accuracy of fit
- Patients are well informed with digital planning and you deliver what you promise you will
- Reduced remakes and improved patient satisfaction.
Is digital dentistry the future?
Digital dentistry is undoubtably the future. The first machine I used was the 3M Lava Lcos in 2008. You had to powder teeth, and originally implant restorations were not possible. This has all changed: there is now incredible cross arch accuracy, no need for powder, and full arch restorations are now possible.
The integration now between digital planning and digital radiographs supports accurate planning. All of this information gives patients an accurate idea of what we are able to deliver. I cannot work without this level of information now.
The ease of sharing digital impressions with lab partners and planning services such as implants at the touch of a button is completely game changing.
The accuracy of the restorations we can now deliver – with the lack of need for adjustment – I cannot do without.
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