New age of 3D

Simon Garthwaite looks at the many ways state-of-the-art digital technology is revolutionising the clinical experience, for the patients, for the dentist and for the dental team...

Evolving technology and integration of digital solutions have transformed many areas of dentistry from a traditional two-dimensional (2D) approach into an advanced three–dimensional (3D) technique. The new age of modern technology is benefiting both dental practices and laboratories alike, with the enhancement of speed and accuracy in data collection, storage, retrieval and communication.

Orthodontics is one area that is rapidly embracing new materials and advanced technologies, including the intraoral and facial scanners, digital radiology, cone–beam computer tomography (CBCT) and additive manufacturing. Working as a team, practitioners and technicians are utilising the latest advancements to improve efficiency, accuracy, consistency and predictability of treatment outcomes.

Imaging in particular has progressed significantly in recent years. The first intraoral radiograph was taken in 1896 by Rontgen W.C., and then in the mid–1980s CAD/CAM systems were used for the first time in the dental field. Now digital intraoral impression devices allow high–resolution 3D virtual models to be captured. This improved technology has transformed the way clinical work is performed, allowing practitioners to reach beyond the limitations of their senses to see what is really happening in the mouth. Intraoral mapping based on different non–contact optical principles and technologies is possible without the negative aspects of dental impressions, such as imprecision or discomfort to the patient. The digital models also provide flexibility for design and manufacture of a large range of dental restorations, implants, study models and orthodontic appliances, such as customised indirect brackets, expanders, aligners, retainers and arch wires.

With the expanding array of imaging modalities, digital study models offer a reliable alternative to traditional plaster casts. Many of the latest scanners available on the market today make it possible to create a 3D model of the oral cavity, without the need to take a traditional impression. This reduces time, increases patient comfort and improves diagnosis, treatment planning and prognosis value. Although plaster models have long been the gold standard for dentition analysis, they have several disadvantages, including labour–intensive work, demand on physical storage space, fragility, degradation and problems with potential loss during transfer.

Digital models on the other hand provide fast and easy electronic transfer of data, immediate access and reduced storage requirements. They can be accompanied with the patient’s digital records, photographs, radiographs and clinical notes, making the technicians job that bit easier. Digital models can be virtually manipulated to specific sections and used to analyse individual teeth, arch forms, amount of crowding or spacing and type of malocclusion. Moreover, if a physical model of the dentition is required for the manufacturing of an orthodontic appliance, digital models can be 3D printed with a rapid prototyping technology.

Another advantage of many digital systems is that they work in conjunction with web–based technology, which allows raw images to be securely transmitted to the cloud storage facility where they can be further processed or refined for diagnostic purposes. The highly–accurate open file formats can be incorporated into the patient electronic health record which can be remotely stored, accessed and managed through a secure, online–based digital hub from anywhere in the world. These systems not only provide a massive amount of storage space, but also improve convenience and speed for communication between the lab and dental practice. This streamlines the entire process, as dentists are able to take an image of the patient’s mouth and send the digital file directly to the laboratory so that the technician can immediately begin work — designing from the detailed model for enhanced accuracy and enhanced clinical outcomes for the patient.

Of course, the main disadvantage of modern technology is the high initial investment. However, as new systems and models continue to be developed, prices remain competitive. From imaging to product design and manufacture, technologies will continue to offer more affordable and feasible diagnostic and treatment applications beyond the current methods. Dental labs can also benefit from the speed, accuracy and reliability of modern digital systems to work alongside practices and ultimately provide patients with first–class treatment.

At the cutting–edge of technological advancement, Carestream Dental offers a selection of innovative systems designed to make life easy for the modern dental practice. The CS 8100 3D, for example, harnesses the power of 3D and brings it within reach of every general dental practice. The speed, accuracy and quality of the system are phenomenal, providing practitioner and technician with everything they require to collaborate and develop solutions for patients.

The rapid development of technology is commanding fantastic opportunities within the dental industry, making it possible to scan digital impressions, create virtual designs and 3D print different types of appliances. Whether practices utilise one or several of the leading–edge solutions now available, daily workflows are improved for delivery of truly outstanding patient care.

We’d like to give special thanks to Dr Mark Chrimes at Market Weighton Dental Practice for his time and assistance in support of the photography for this article.