This past year brought about great strides in CAD/CAM dentistry as well as in communication between dentists and laboratories. In some cases, the technological strides that came about in these two areas were directly related to one another, while in others, improved communications between the lab and the doc were designed to produce better care for the patient for cases that have nothing to do with computer-assisted designing and milling of restorations.

Any way you look at it, 2008 was a big year in terms of developments that will greatly affect the way you practice dentistry in 2009 and beyond.

In the January and February issues of Dental Products Report, we published a two-part survey report on Dentist/Lab Communications, while the April survey report was based on our readers’ responses to a CAD/CAM survey.

Here’s a quick look back at some of the key statistics and comments, as well as a sneak peak ahead in these exciting areas of dentistry.

Lab/DDS Communication

What we found when we asked you and your labs what is being used for communication was most of the respondents continue to use tried-and-true communication tools like shade guides (96%), study models (90%) and shade tabs (67%), but that according to Dr. Michael DiTolla, director of Clinical Education and Research at Glidewell Laboratories, more doctors also should be taking advantage of shade-matching devices and digital photographs than currently are (see “Shade guides at top...”, page 36). At the beginning of 2008, 56% of our readers were using digital photographs and 11% were using a computerized shade analysis. Since then, a couple of manufacturers have introduced new shade-matching devices, giving dentists even more choices when looking to add the helpful tool to their practice.

“With today’s technology, it’s almost like our technician has seen the patient in real life if we’ve selected the shade with the (Vident) Easyshade (vident.com) and sent some digital photographs along with that information,” Dr. DiTolla said when reviewing the survey last January. “If you have a study model and you have pictures with those shade tabs in place from a couple different angles, it really is almost better.”

Dr. DiTolla expects more dentists to take advantage of shade-matching devices. But just as significant, he maintains, is the importance of taking good digital photographs, a responsibility staff members can easily master and manage, which allows the doctor more time to concentrate on patient care. These images can be helpful when taken prior to treatment, after treatment and during treatment of adjacent teeth with shade tabs in place. At times, it’s even helpful to take pictures of a temporary in place. Dr. DiTolla believes “there’s no such thing as e-mailing too many digital photographs to a laboratory.”

The speed and ease of sending digital images and other information via e-mail has made life a lot easier for both doctors and labs. According to the survey, 21% of GPs use the Internet to communicate with their labs, and of those, 95% are sending digital photographs and 31% send e-mail notifications of case progress.

We also learned that 20% of the GPs maintain an in-office laboratory, and that quality of work was the top criteria (92%) listed when we asked you what’s important when choosing a lab. Good communication (51%), fee schedule (41%) and reputation (34%) also are important factors when selecting a lab.

CAD/CAM

The rapid inclusion of computer-driven technology both chairside and in the laboratory is enabling today’s GPs to more accurately diagnose and treat patients. It also is changing the way the technicians fabricate crowns, bridges, and implants. These factors, combined with the expanding number of available restorative materials and techniques make it all the more critical that labs and doctors communicate clearly.

One thing that’s helping with communication is digital impression-taking technology, and both Cadent’s iTero (cadentitero.com) and 3M ESPE’s Lava Chairside Oral Scanner C.O.S. (3MESPE.com/LavaCOS) created a buzz in the industry in 2008. This technology can eliminate the messy, sometimes uncomfortable process of taking traditional impressions. It can also deliver quality diagnostics and accuracy. According to DPR’s April 2008 CAD/CAM Survey, 38% of the respondents are interested in investigating digital impression taking to send virtual impressions to the lab, and 17% said they plan to purchase a system in the future.

Zahn Dental (henryschein.com/us-en/zahn) Marketing Manager Stan Maragos believes this digital communication between dentists and labs will help CAD/CAM growth explode in the near future, even if the majority of GPs were to choose to pass on the actual milling side of CAD/CAM fabrications. “The integration of technology takes communication between the dentist and the lab to the interactive level; this is big,” he said in April.

Thirty-eight percent of the respondents to that April survey said they think CAD/CAM use will become mainstream while they are still actively practicing dentistry, and 44% are very interested in the chairside technology but consider cost a roadblock. Almost seven in 10 of our readers uses a lab with a CAD/CAM milling system for fabricating indirect restorations, which shows just how much further along the technology is with labs­—10% of the respondents own/use a chairside CAD/CAM restoration fabrication system.

Sirona Dental Systems (sirona.com) President Michael Augins believes patient benefits, including single-visit restorations, along with improved results, will help make CAD/CAM dentistry the standard of care.

“We believe that in the near future, nearly every dentist will be placing CAD/CAM restorations either fabricated chairside in the office, or done via a CAD/CAM system in a lab,” said Augins, whose company first brought CAD/CAM into dental offices in 1985 with the original CEREC unit.

Look for plenty of advances in CAD/CAM technology and dentist-lab communication as the industry continues to evolve in 2009. Dr. Sameer Puri, Director of CAD/CAM at the Scottsdale Center for Dentistry and Co-Founder of CEREC Doctors (cerecdoctors.com), has this to say when taking a look ahead: “As far as CAD/CAM’s growth goes, I think we are in a great time. The acceptance of CAD/CAM is growing at a great rate and more and more clinicians are realizing that this is no longer a fringe technology for the computer geeks.

This is a mainstream piece of equipment that can integrate into many different practices. Its ability to treat inlays, onlays, crowns and veneers allows clinicians not only to provide an uncompromised service to their patients, but also to make it a profitable investment in their practice.”