In conversation: intraoral scanning in practice

intraoral scannerMark Barry sits down with Tif Qureshi, Andy Wallace and Daz Singh to discuss their experiences of how working with intraoral scanners has changed their relationship with their lab.

Would you feel that you communicate better with your labs as a result of sending through digital images?

Andy Wallace: It is great to look at your own scans – and of course, you have the ability to modify a prep once you’ve taken it. You take the scan of the prep, look at the analysis and see that you haven’t recorded the margin, or you haven’t taken enough of the occlusal surface but you can go back in, delete it, and take it again in a second.

If you’re doing multiple preps, having to repack all the cord to retake the entire impression messes up your entire day, whereas, if you’re doing that with the scanner it’s a matter of two minutes.

Once you’ve taken your scan, you can annotate the photos to tell the laboratory what you want done on each part. The workflow is just so much smoother, and the communication is so much easier.

I do the odd rehab case, and to be able to get your digital wax up from the laboratory relatively quickly makes communication so easy. It’s so much of a two-way street than the old way of taking the impression, sending it off to the lab, and two weeks later getting a wax up back that you either like or you don’t. That’s a very staccato way of planning a case.

If you’re doing it digitally, the lab can send it you, you can check it on your phone or your iPad, tell them what you like/don’t like and then it’s back to you within the same day or the next day, modified. It’s so much easier.

Do all of the labs that you work with accept intraoral scans?

Tif Qureshi: Absolutely. I think it’s becoming almost like a standard now. There are some ortho systems that don’t even accept impressions any more.

I think the really useful thing – aside from the speed, which is the obvious thing – is the fact that you can analyse your scan before it goes, and keep that as a reference.

You can put together your prescription, submit the scan to the aligner provider and when they send back their treatment set up or 3D proposal, you can see how your scan has been slightly modified. You know how that relates to the patient’s face.

If they’ve perhaps flared the teeth a little bit too much, for example, we can ask them to modify it – it’ll come back, and all of these things are so much faster and so much better.

The back and forth to fine-tune your end result is so much quicker. Even through treatments, if you’re looking to refine things, you’ve always got the same original scan: your comparison position where you know what you’re trying to achieve. I can’t think back to how it was before, if I’m being honest. It makes all the difference, particularly in ortho – it’s just immensely important.

When work comes back from the lab, are you confident that it’s going to fit?

Daz Singh: Yes, very much so. Andy and I have gone on a very similar progress of learning. When I said all my work was going to go digital, he decided he needed to make a similar sort of change in his lab as well to be able to accommodate things like that. What I found was that the work, when you get it back, just fits.

We work with a lab In Chorley. The margins are perfect; the crowns look great. The implant side of stuff is really interesting because now, with the Elos scan bodies that we use, it’s just so simple and straightforward just to be able to take a quick scan and get that sent off.

I’m always amazed when all the work comes back. I love the fits I get back from it. Before, when it was a little bit more manual – I’m not say that things didn’t fit, but these days it literally just drops in very nicely.

This article is taken from a panel discussion – Trios in my practice – between Mark Barry, Tif Qureshi, Andy Wallace and Daz Singh.

Visit to watch the whole conversation.

This article first appeared in Implant Dentistry Today magazine. You can read the latest issue here.

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