Whether you’re preparing to use clear aligners, or performing restorative work, such as crowns and bridges, the right intraoral scanner can be a game changer when it comes to capturing a full arch impression. But scanning for clear aligners and dental restorations can be a challenge, and requires the right equipment and skill to capture interproximal data, applicable hard and soft tissue, as well as the distal of the most posterior tooth.
To help identify the right scanner to use, Matt Kunzler, a technology advisor with Henry Schein, has taken the time to compare and contrast four of the market’s leading products that have been optimized for full arch scanning.
A 15-year dental industry veteran, digital workflow specialist and certified trainer for a wide range of intraoral and extraoral imaging technology, Mr. Kunzler has helped more than 100 dental practices transition to using intraoral scanners.
There are a variety of scanners to choose from, each with its own pros and cons. All four of these discussed here will perform well for everything from orthodontics to crown and bridge work.
The Planmeca Emerald™ S scanner integrates directly with Henry Schein’s ortho aligner, Reveal®, and works with most all aligner companies. One aspect that makes this system unique is that the design software, scanner and the mill are all produced by the same manufacturer. Its Romexis® Cloud software is used for scanning and tracking each case. This all-in-one software captures 2D and 3D images, as well as smile design images.
Another unique feature of the scanner is that it comes with two scanning tips in different sizes, which is helpful if you have a younger patient or a patient who can’t open their mouth wide enough. The scanning tips are “smart,” and can actually count how long they’ve been in use. Another nice feature is that it comes with a replaceable cord, so if the cord breaks, it can be replaced in the field in seconds.
The KaVo X 700™ scanner has one scanning tip, which can be positioned either down for the bottom arch or up for the upper arch. This way, you can keep the button in the same grip; you don’t have to turn the tip over to scan the maxillary arch.
Ortho simulation software is already included, so you can manipulate the teeth, put them in the most esthetic location and show the patient what their teeth might look like before and after orthodontics. It can also be combined with DTX Studio™ for those who have a KaVo product for their cone beam computed tomography (CBCT) unit.
The scanner can plug directly into your computer, without any hub or docking station, as long as you have a USB connection. It also comes with a removable cord.
The 3Shape TRIOS® 4 wireless scanner comes with replaceable scanning tips that are smart heated. Like the KaVo scanner, the tips can be turned upside down for upper scans. It comes with a communication portal, which is a powerful tool for communicating with the laboratory in compliance with HIPAA. The scanner can work wirelessly or in wired mode, in case the battery runs dead and you forgot to charge it, or if the power went out the night before.
One powerful feature is its optional treatment simulation software, which makes it easy to articulate the patient’s bite and movements and show this video on screen to patients.
The scanner integrates directly with Reveal, but it’s not a complete CAD/CAM system in the sense that it has its own design software. It’s meant for chairside scans, but you can pair it with a third-party mill.
The Dentsply Sirona Primescan scanner has a large focal distance, which is a real advantage because it enables you to capture an incredible amount of information at one time. Ortho simulation is already included with the scanner. This product comes with a steel scanning tip, which can be removed for disinfection. There is also the option to have a disposable tip, which can be an easier and faster option. The scanner is battery-powered and you can scan without having it plugged into the wall.
Each of these four scanners has audible feedback, so you don’t need to look behind yourself when trying to take the scan. This is one way to set up the operatory for proper scanning, helping to avoid twisting and turning that can cause neck and back strain.
All four scanners also have a feature called active delete, which makes it possible to remove images of the cheek and tongue as you scan. Given the right protocols, this is easy to do with a little help during retraction.
Setting yourself up for success
Once you’ve decided on an intraoral scanner, it’s essential to take the time to properly set yourself up for success — each time you scan a patient. Make sure the scanning tips, mirrors and camera lenses are clean. Be sure all of the tools you use are dry, clean, disinfected and ready to go. Another key to success is related to the scan path itself, whether it’s occlusal, buccal or lingual. It’s critical to ensure the scan is as accurate as possible, and this requires following the manufacturer’s specific scan path.
When scanning for crowns and bridges or orthodontics, the main goal is to have a complete scan with as little vacant territory as possible. Spending time on training is the best way to optimize your scanning technique. There are a number of YouTube videos that will demonstrate how to capture a full arch using the proper scan path.
You can also take advantage of the training provided by each scanner’s manufacturer. This will not only demonstrate how to use the scanner but also how to evaluate if you’ve taken a good quality scan. This involves articulating the models and moving them from left to right to make sure the distal substance of the molars, as well as all of the inner proximal, have been captured in the scans.
Each of these intraoral scanners offers powerful capabilities to enhance your practice, helping increase patient comfort by eliminating physical impressioning, as well as speed up the time it takes to complete treatment. These scanners also provide opportunities for better patient education when preparing for restorative treatment like crowns and bridges or orthodontic appliances like clear aligners. Instead of merely showing a patient an X-ray, you can visualize the entire upper and lower teeth, as well as the bite, so they can see exactly what’s going on and the treatment path. That is very impactful — not only for the overall patient experience, but for case acceptance as well.
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