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    Let's get digital: How digital technology has taken the dental industry by storm

    Digital technology has taken over the dental industry — and it's critical to jump on the digital train.

    The idea of being digital in pretty much all aspects of our practices has been around for a while now. Heck, I began moving toward a totally digital workflow in the late ’90s. Back then it was a lot more difficult than it is now. On top of that, there were a lot of systems that weren’t digital and wouldn’t be for several years. Consequently, even if your goal was a completely digital office, the solutions weren’t always available.

    The good news is that those systems that stood in the way have been pretty much eliminated by the tsunami-like wave of technological expansion our society has created over the last several years, and one of those systems is digital impressions.

    While the idea, and actual usage, of digital impressions has existed for more than 30 years now, the last five years or so have seen tremendous improvements in these systems followed by an expanding market penetration.

    Originally the digital impression market was a tiny niche composed of not early adopters but innovators. According to Everett M. “Ev” Rogers, “Innovators are the first individuals to adopt an innovation. Innovators are willing to take risks, youngest in age, have the highest social class, have great financial lucidity, very social, and have closest contact to scientific sources and interaction with other innovators. Risk tolerance has them adopting technologies, which may ultimately fail. Financial resources help absorb these failures.”

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    These are the people who are willing to stand right on the edge and love gadgets more than life itself. This small but strong-minded community had one choice, CEREC, and that choice dominated the market and their thoughts for over 15 years.

    Those 15 years were basically all about CAD/CAM, and so were the next few years to follow as D4D entered the market with the E4D system, which was a close competitor to CEREC. Both systems consisted of an acquisition unit with a PC and a milling unit that created restorations from blocks through subtractive processes. The systems were fairly capable of creating clinically acceptable restorations but didn’t always make the grade. Also when, on occasion, cases went off the rails, they went way off the rails. 

    Many doctors I spoke with back then said that basically when the systems worked, they worked well, but occasionally it seemed that no matter how hard one tried, there were certain cases that produced unacceptable results no matter what the doctor did. These cases resulted in doctors taking traditional impressions and a bit of disappointment in the technology by both doctor and patient.

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    Digital scannerHowever, as all good technology does, improvements in processing, software and optics pushed the technology further than ever before. Camera hardware evolved to a point of allowing true 3D rendering, powder was eliminated, and the design software made creating restorations so easy that a doctor could easily train an auxiliary to do it in a few short hours.

    As the technology became more predictable, the only hesitation point for many doctors was workflow. Many offices didn’t want to design the cases and/or spend the necessary time for milling. There was also the aspect of finishing the restorations. While some offices chose to polish the restorations, others wanted stain and glaze. This, of course, created added time to fire the porcelain in an oven, which became a requirement when lithium disilicate came on the market.

    3M Mobile True Definition scannerDigital impression and scanning systems have gotten smaller and more mobile for easier use. The 3M Mobile True Definition scanner operates off of a tablet that can be mounted or held and is easily transferable between operatories.Lots of offices saw the advantages of the imaging/acquisition part of the technology but didn’t want to be saddled with design, milling and, in many cases, firing in an oven. 

    I was a CEREC user in the early 2000s and once in a meeting with Sirona I suggested adding a network connection to the acquisition unit to allow the doctor to send the case digitally to a lab. More doctors would buy the technology, I explained, if there was an option to use a lab and maintain the “impression and send” workflow offices were used to. When the laughter died down, I was told that the advantage of CAD/CAM was the total in-office solution.

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    Fast forward to the current day and we can see that the idea of using acquisition units as impression units has taken a firm hold in the industry. Starting in about 2006, the industry began to see inroads being taken by companies that were supplying the impression part of the solution. It was in 2003 that a small startup with MIT geniuses at the helm incorporated Brontes Technologies to produce a highly accurate 3D chairside scanner. In 2006 Brontes was purchased by 3M and the product called the COS (Chairside Oral Scanner) entered the market in 2007. At the time, I found it intriguing that a company that sells more impression material than any other company had just paid $96 million to disrupt that very same impression material business. I knew things were going to change.


    Next: The changes that hit the industry

    Dr. John Flucke
    Dr. John Flucke is in private practice in Lee’s Summit, Mo. He also serves as technology editor for Dental Products Report magazine and ...


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