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    How technology is changing the implant workflow

    Examining how technology is helping more general dentists delve into implant dentistry.

    It’s not news that dentistry is undergoing a huge change thanks to technology. CAD/CAM restorations are becoming the norm, making patient care simpler and faster than ever before and facilitating a more streamlined flow between dentists and labs. More labs and practices are investing in 3D printers, and as soon as a suitable material for printing long-term restorations is available, one can only imagine the effects. But as one dental laboratory manager said, no dental workflow has changed as much as implant-based restorations.

    Today, technology is enabling more general dentists to get into implant dentistry. With the right tools, dentists can do the case virtually before ever touching the patient. That helps them see the final outcome as well as any obstacles they may face along the way. Rather than calling an audible, they can plan accordingly. Any dentist who’s interested can design and print surgical guides in the office, though it’s just as easy to have the lab do it if that’s preferred.

    Once the patient is healed and ready for the restoration, dentists already know that the final restoration will be in the right position. In fact, before they start, they’ve already ensured that it’s safe, esthetic and in perfect occlusion, thanks to digital treatment planning software and surgical guides.

    Related reading: 5 things you need to know about dental implants

    And that’s a good thing because dental implantology has plenty of room to grow in this country.  

    “The penetration of implants is still pretty low,” says Paresh Patel, DDS. “I would say that implants in the United States are still at around five or six percent penetration, so there’s a whole set of the population out there who don’t have implants but could benefit from implants.”

    The cost of implants is likely a major barrier for many people, but Dr. Patel says another reason implant penetration isn’t as high as it could be is not as many dentists offer the procedure.

    “We need to get more dentists educated about implants, so they can provide that kind of service for their patients,” he says. “If we can teach dentists to not just extract teeth, but to preserve the site, we can incorporate all these other fancy things like CBCT and surgical guides to ensure that we have the confidence to place the implant where we think it needs to go.”

    The good news is that implants could soon take up a larger piece of the dental pie. Thanks to a fully digital workflow, it’s easier than ever for dentists to offer implants in their practices.

    “User interfaces for digital technology are increasingly intuitive and we are aiming for more automation at various steps in the treatment flow,” says Dr. Pascal Kunz, vice president of product management for digital dentistry at Nobel Biocare.

    The old way

    To compare the new to the old, let’s first review the old. Traditionally, implant cases started by taking an analog impression before sending it to the lab, where laboratory technicians would insert an impression post and fabricate an abutment and crown. The lab technicians would often be concerned with correcting the results of dentists who forgot to take prosthetic requirements into consideration during implant planning. As a result, the tools available to lab techs were designed for redressing mistakes rather than preventing them. Back in the operatory on surgery day, the dentist would carefully drill a pilot hole by hand, being careful not to drill too deep on accident.

    Times have changed. “Most of the work that used to be done manually can now be done through advanced technological planning and ordering software, or outsourced if desired,” says Priya Menon, director of marketing, North America, at Dentsply Sirona Implants. “In place of the analog process of taking an impression, intraoral scanning provides accurate information about the patients’ dentition and soft tissue.”

    More from the author: The evolution of dental materials

    Part of that advanced technological planning consists of digital impressions, design software and surgical guides. And that takes the stress off both sides: Lab techs are no longer correcting mistakes after they happen, and dentists know that the surgical guide will keep their drill exactly where it needs to be from X, Y and Z. From start to finish, the digital workflow takes the stress away from implant planning and placement.

    Implant workflow“When we first started doing CAD/CAM dentistry, it was really just to scan a tooth or scan a model for Invisalign or something like that,” Dr. Patel says. “But now I think just about every implant system has a scanning flag or a scan body that we can put into the implant. It’s going to be a more accurate way to transmit that information to the laboratory, like the timing of the implant and the location of the implant in relation to the adjacent teeth as well as the soft-tissue profile.”  

    Erinne Kennedy, DMD, MPH, didn’t place implants until her residency, where she learned how to place implants traditionally using periapical radiographs and a custom stent.

    “After doing it the traditional way, I learned the value of digital dentistry and digital implant placement, especially digitally guided surgery,” she says. “I’ve learned about how innovation can make it not only seamless but predictable. It was a good experience to have done it that way and then to see what technology could offer.”

    Up next: Creating a digital workflow...

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