One of our biggest objectives here at Spear is to continuously foster a positive, supportive community of dental professionals from around the world. Spear TALK is one major way we’ve been able to encourage engagement and conversation among our members over the years. It’s a safe space for clinicians to connect with like-minded colleagues, openly ask for advice, share clinical tips, and find support and guidance on any dental topic.

Digital dentistry has consistently been a hot topic across the board. Investing in new technology can feel daunting, but the Spear community is full of insights and suggestions for making the best decision on how to get started. Check out this recent Spear TALK post from a doctor asking for guidance before investing in an intraoral scanner.

intraoral scanner

I have been thinking of buying an intraoral scanner to replace PVS impressions in my GP office; however, I see many renowned prosthodontists still using PVS as their preferred impression material. I wonder why they don’t use this technology if it can be more accurate than regular impressions, faster communication with the lab and supposedly more comfortable for patients?

Thank You!

A number of clinicians shared their experiences with intraoral scanners in the comments, but there were a few in particular that we felt should be highlighted.

One member expressed concerns about margin visibility in such technology and cautioned that scanning may not be the best choice for all cases.

For single tooth dentistry (crown and bridge), digital scanning is the way to go. We have a CEREC (we also mill most in-office posterior crowns). We just ordered an iTero to help with Invisalign and have an extra scanner for crown and bridge and implants For larger cases, I have tried scanning and having the case made with printed models and the cases never fit super well. The restorations just don't fit tight on the models...lots of wiggle room in my opinion. When you look close at printed models, you'll see why...margins just aren't super clear. You have to realize that it's difficult when going from digital (scanner, model-less) back to analog world (model work) particularly with large restorative cases. Bob Winter reviewed this very issue in the Restorative Design workshop. He advised for right now, against going with printed models for big cases.

Another clinician offered a suggestion to remedy these marginal issues:

We love our intraoral scanner; however, sometimes taking a PVS or PE impression is easier if the scanner cannot see the margin.

I think you are wise to wade into digital dentistry first with a scanner then later add in-office milling if it suits you.

So how does a first-time buyer make the right decision when it comes to the best scanning technology for their practice?

One clinician (who said at the time of posting that he already owned a CEREC© Omnicam scanner and was in the market for a new one) offered an extensive breakdown of his decision-making process in an effort to help first-time buyers select the best scanner for their needs.

These are my (somewhat biased) reviews of some of the IO scanners that are on the market that I tested in-person and on a live subject over the last week. I have been a CEREC owner since 1999 starting with the CEREC 3 and now Omnicam.

3 Shape Trios: good scanner, one of the best for accuracy according to Dr. Michael Scherer, expensive though, my quote was $50,000.

Medit: impressive scanner, fast, light, full color, open file format, no additional monthly costs, one of the newest and least expensive scanners on the market at $18,000, however the handle/camera seemed to be cheap to me

iTero: very large tip and was told that it helps in retraction but had difficulty getting to the 2nd molars in a small mouth, approximately costs $500/month to download files, time lapse technology shows patient’s wear/changes over time (couldn’t this be done with other cameras?)

Carestream 3600: another nice camera, fast, smaller head than some of the others, open file format, no additional monthly fees, $30,000 for color $18,000 for black/white.

3M TruDef: another good scanner and one of the most accurate as told by Dr. Michael Scherer. A little slower than some the others. Black and white images though, no color, you must use powder but it is minimal, just a light spray, not a big deal, especially when compared to CEREC 3D. Sometimes I find I must use powder with my Omnicam for gold and other shiny objects.

Straumann Dental Wings: good images, small wand, but this was actually my least favorite of all of the cameras tested. Slower than some of the others. You must be 8 mm away from the teeth for it to record images, if not the camera stops and shows a red color on the capture window. There is a small window to focus on the teeth and a large window which shows the images but there is a slight delay when capturing. I’m sure with time I could get used to the 8 mm focal length but I used to capture at different distances to get interproximally and other difficult areas.

What advice would you give this doctor? If you’re a Spear Online member, you can view the full Spear TALK thread and join the conversation here. If you’re not a member, you can learn more and get a demo now at speareducation.com/sign-up.

(Editor’s note: The Spear Talk post and comments were mostly left as-is from the original format.)


Comments

Commenter's Profile Image Ramin M.
February 26th, 2019
I have had an I tero in the office for the last 4 years. It is the older model, so the scanning time is slow, but we also do Invisalign for which it is quite useful. The single crowns and 3 to 4 unit bridges have been fine, close to no occlusal adjustments, and very few cases of open margins. in some of the bridges the compression of the pontics on gingiva were excessive. Comprehensive cases still need wax and work up. With itero the cons are the monthly fees, and the fact that it is a closed system.
Commenter's Profile Image David K.
March 6th, 2019
Thanks for the great review of scanners- huge help from a CEREC doc! I have been using CEREC since 2002 but am still with the Bluecam which since I have been powdering forever works well. I use for everything and can do cutbacks, staining etc.. Certainly a trick to doing large cases but thanks to CEREC Doctors group I can do them with a good workflow. However, my software upgrade path is at the end of the line so am having to reinvest and look anew. .I would never go back to all PVC but if I look at all the upgrades I have done I wonder if there was truly a positive ROI. Sure helps my quality control as I don't do enough to have an inhouse lab so I can fix things to my hearts content and I mill inhouse. I am not sure I see the point of digital scanning and sending for milling as than you have to do temporaries and cement inserts. One thing I am starting to focus in is using a scanner such as Shining 3D to scan impressions or models for larger cases or splints etc. vs the cost of a whole new intraoral scanner and milling unit. Although, digital impressions are so nice as you know instantly whether you nail it or not. Of course seeing your treatment magnified 100 times is truly humbling. The one thing I would think about if you are looking is how open the system is... CEREC has been a very closed system. I am merging conebeams with STLS etc and CEREC was slow to allow export to STL. Hope this helps someone.