Digital Impressions “The Next Digital…”

By Bill Busch, DMD MAGD

It seems like it was just yesterday that I was twenty-seven years old and thinking about digital X-ray. Now, twenty years later, I am writing about digital impression taking—something the great Dr. Gordon Christensen says will be commonplace by 2020.

I got into digital dentistry immediately upon graduating from dental school; thanks to the launch of the personal computer by IBM back in the 80s. I graduated from dental school in 1989 and added my first computer to my office in 1991 to do basic accounting and patient ledgers.

One thing that I learned with any technology that you use is that the more you use it the more impatient you become. I still remember 40-second curing of composite. Now it is down to 3–5 seconds and now I want it down to 1 second!

Knowing that it would be the basis for many future technology-related decisions I would make for my practice, I decided to first purchase a robust practice-management system. That purchase was Dentrix dental systems. I believed back then that the future would include an electronic dental record (EDR) and, in order for that to happen, dentistry would need new science and technology. The first piece to that puzzle would have to be digitizing the radiography process. Once this was done, everything else concerning the patient record could be accomplished.

I added digital impression taking to my practice in 2001 and, next to going paperless, it was probably the biggest milestone. Believe it or not, digital impression taking has been around for twenty-five years but, in my experience, it has only been truly reliable in the last ten. Today, digital impression taking is awesome and gives you many options. It lets you decide if you will make crowns, veneers, inlays, and onlays in your own office (DIY) or send the digital impression directly to the lab via the Internet. The systems for in-office creation of restorations are called CAD/CAM in-office systems, and include D4D (exclusive to Henry Schein Dental) and CEREC. D4D and CEREC users have the ability to take digital impressions from their in-office systems and send them directly to the lab.

Digital impression-taking also allows you to acquire the digital impression—via a specialized intraoral camera—and then forward it to the lab. This can be done with the Lava C.O.S. (“Chairside Optical Scanner” from 3M) and ITero (from Cadent) and, there are several others on the horizon. I personally like the in-office systems such as the D4D because it gives me the option of doing it in-office or having it be lab-made, depending on the case.

There are many options with digital impressions—and plenty of advantages as well, including:

  1. Perfect impressions every time.
  2. No messy impressions that take 2–4 minutes to set.
  3. No impression material cost, no impression tray, no impression adhesive, no temp cement, no temporary, etc. (in-office system only).
  4. No need for a second visit from the patient (in-office system only).
  5. Easy, multiple-unit impressions.
  6. 100% reliable restorations. (3M’s Lava C.O.S. system takes it a step further by guaranteeing the fit of the restoration.)
  7. Smaller carbon footprints. (The lab is not using fuel to physically pick up your case since you are sending it over the Internet and, if you are using one of the in-office systems, you leave an even smaller carbon footprint because the patient does not have to return for a second visit.)
  8. Faster completion of the case and ability to produce more in a given year.

You can start with anything when it comes to making digital dentistry a part of your practice—a practice-management system, digital X-rays, electronic dental records, digital impressions, etc. Just be sure to add one at a time. And, do not delay in making the investment because you are waiting for the next improvement. Get moving!

Dr. Bill Busch is a general dentist in Kansas City, Missouri. He has been practicing for over twenty years and focuses on cosmetic, implant, and reconstructive dentistry. He is also the creator and co-founder of TeamSmile, a dental outreach program that helps underserved children around the country.

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