How the flexible scanning of digital impressions leads to optimal clinical results

July 12, 2013

More than 20 years after in-office CAD/CAM systems first started appearing in dental practices, the industry has finally evolved to a point that allows dentists flexibility in their scanners, mills and materials. This is a welcomed change from the early days of digital scanning, and this flexibility, combined with more realistic price points for the average dentist, is making digital dentistry more practical than ever before.  Digital impressions and open architecture

More than 20 years after in-office CAD/CAM systems first started appearing in dental practices, the industry has finally evolved to a point that allows dentists flexibility in their scanners, mills and materials. This is a welcomed change from the early days of digital scanning, and this flexibility, combined with more realistic price points for the average dentist, is making digital dentistry more practical than ever before. 

Digital impressions and open architecture

This evolution is exemplified by the recently introduced 3M™ True Definition Scanner. There are several qualities that make this scanner unique in the market. First, instead of being compatible with only one milling system, the 3M True Definition Scanner offers dentists choices from among a variety of workflows. A trusted connection with the E4D system from D4D Technologies  lets dentists with chairside mills use the scanner as an efficient part of same-day treatments. The scanner’s additional connections with BIOMET 3i and Authorized Lava™ Milling Centers also give dentists the option to send scans out for custom implant abutments or milling of restorations. Furthermore, the scanner offers open connections, meaning dentists can use the system’s STL files to access an even wider range of workflows. 

It’s affordable

In addition to its flexibility, another key highlight of the 3M True Definition Scanner is its low cost. The system has a suggested retail price of $11,995, making it significantly more affordable than other scanners on the market. At this price, digital scanning becomes an attractive prospect for almost any dental practice.  

In my practice, having integrated the 3M True Definition Scanner with the E4D system, I have seen firsthand the efficiency and affordability it enables. With these tools, we can offer same-day restorations cost effectively, thanks to a smooth process in which the scanner, design system and mill all work together. I also appreciate that I still have the flexibility to scan cases and send them to a lab if the case calls for it. I prefer lab-fabricated restorations for second molars, so with this system I have the option to scan the impression and use whichever workflow and restorative material I feel are most appropriate for the case. 

Realizing efficiency through a family of products

In addition to realizing efficiency by using the 3M True Definition Scanner and the E4D system, I also find that using products that are designed to work together helps me achieve greater efficacy and the best results. In this case, I take advantage of 3M ESPE’s Trifecta Method, which uses 3M™ ESPE™ Scotchbond™ Universal Adhesive and 3M™ ESPE™ RelyX™ Ultimate Adhesive Resin Cement to bond a 3M™ ESPE™ Lava™ Ultimate Restoration milled using my E4D unit. Compatibility of materials is always an important concern, and I trust this family of products because they provide a streamlined restorative solution that results in a beautiful final restoration that will maintain its strength and esthetic qualities.

Lava Ultimate restorative is a resin nano ceramic material that can be milled in-office or ordered through laboratories. It requires no firing, and mills and polishes easily. I see improved edge quality over many other materials because of its less brittle nature, and I appreciate the added convenience of being able to make easy adjustments in the mouth with composite.

Restorations made using Lava Ultimate restorative must be adhesively bonded, and Scotchbond Universal adhesive helps simplify the adhesive step by providing high bond strength to indirect and direct surfaces without a separate primer. It also works with total-etch and self-etch applications, offering flexibility and just one simple technique for direct and indirect restorations.

RelyX Ultimate cement is a fast and easy product to use in conjunction with Scotchbond Universal adhesive because the dark cure activator for the adhesive is built in, requiring fewer components.

The following case highlights the simple use of the 3M True Definition Scanner with the E4D system and 3M ESPE’s Trifecta Method. 

 

Next Page: Case Presentation

Case presentation

The patient presented with a failed composite resin restoration and recurrent decay on No. 14, which had undermined the distobuccal cusp (Fig. 1). The patient consented to a full crown treatment that would use 3M™ ESPE™ Lava™ Ultimate Restorative and the E4D system to create the crown in the dental office in a single appointment.  

Fig. 1

The tooth was prepared according to the usual protocols and a laser was used to clean the margins in a few areas. 

A size 0 cord was packed into the sulcus, followed by retraction paste from the 3M™ ESPE™ Retraction Capsule to help with coagulation (Fig. 2). 

Fig. 2

  

Fig.  3

A thin, even layer of powder was applied to the arch (Fig. 3), followed by a brief spray of air to thin the powder. 

The quadrant and opposing arch were scanned with the 3M True Definition Scanner, which took about two minutes per arch (Fig. 4).   

Following the scan, prescription information was input and the case was sent to the E4D Studio for design (Fig. 5). 

Fig. 4

 

 Fig. 5

The design was completed in five to seven minutes, and the block of Lava Ultimate restorative was then milled with the E4D Milling Center.

Milling was completed in about 12 minutes, after which the crown was tried in the mouth to confirm its fit. No adjustments were necessary, and the crown was then polished. 

3M™ ESPE™ CoJet™ Sand was used to sandblast the inside of the crown for approximately 20 seconds, followed by a 5-second air dry prior to application of 3M™ ESPE™ Scotchbond™ Universal Adhesive as a primer. 

The preparation was cleaned with alcohol and sterile water, and Scotchbond Universal adhesive was applied and scrubbed into the tooth structure for 20 seconds, followed by air drying for approximately five seconds to remove alcohol solvent. 

The crown was cemented with 3M™ ESPE™ RelyX™ Ultimate Cement. 

 

The crown was tack-cured to harden the excess cement to a gel stage before the excess was cleaned away and polishing was performed. The final result was an esthetic restoration with a great fit that the patient was very pleased with (Figs. 6 and 7). 

Fig. 6

Fig. 7

Digital scanning as a gateway

The Trusted Connection between the 3M True Definition Scanner and E4D system means that in the time it takes me to walk the 10 yards from my operatory to the design studio, my scanning file has already transferred and is ready for design. This smooth interface adds to the efficiency of in-office CAD/CAM and makes the system a pleasure to work with. 

In the digital workflow, it’s also important that material choices help simplify the procedure and add value. By choosing products that are designed to work together for ease of use and a high-quality final product, even further efficiency and patient satisfaction can be realized.

Dentists have many choices among in-office CAD/CAM tools, but the trend toward increased flexibility and workflows is important to keep in mind when making a selection. By making digital scanning a simple and non-exclusive gateway to a variety of workflows and restorative materials, the 3M True Definition Scanner allows dentists to keep their options open and access their preferred tools and workflows for any given case.