Are you interested in intraoral scanning? In this article, I will cover tips to make it easier if you are just getting started or looking to refine and expand the use of intraoral scanning in your practice.
It may sound like I am discouraging you from getting into scanning. I am not. I love it and routinely use it in my practice. My goal is to give you a realistic look and help you avoid some pitfalls I have experienced.
One big key point when it comes to scanning is to define your goals for its use in your practice. Do you want to use it on every case or — perhaps more realistically, at least at this point of the intraoral scanning evolution — which case types do you want to use it for?
Do you want to use intraoral scanning for everything and eliminate physical impression completely? This would, at least with the current evolutional status of the technology, limit cases in certain ways. Or do you want to use it for the applications and cases that are slam dunks? If you are like me, it is easy to get caught up in the hype and want to totally eliminate traditional impressions and scan everything.
The problem is, while scanning technology has come a very long way, there are some gaps that can negatively impact certain cases if you choose to try for total elimination of traditional impressions. Some of these gaps include things like the lack of cost-effective, refined and easy ways to capture a digital facebow and that not all labs can accept digital records or are comfortable working with digital, so you may have to change labs and if you want physical models printed from your scans it is a whole new workflow to learn. Not to mention that there is literature to show that stone models are still superior in term of accuracy when it some cases.
By now, you’re probably getting the message that while I love intraoral scanning, I would not suggest planning to completely eliminate physical impressions in your practice. At least not yet, but I think that will become a realistic goal in the not-too-distant future and at some point, I can see physical impressions being a thing of the past, much like belt-driven handpieces.
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What would I suggest you use intraoral scanning for now? If you need or want records — physical or digital — for a patient in traditional orthodontics with brackets or wires, intraoral scanning excels, since you can leave the hardware on instead of either having to remove it or settle for torn, distorted impressions. It’s also useful for cases you do not need or want a facebow for, and for things like bleaching trays. One important thing to realize is with things like bleaching trays, if you make them in your office, you will need to print or have models printed and that is likely, at least at this point, to take longer than pouring an old-school impression.
I have shared some of the negatives when it comes to intraoral scanning, so why should you still be interested? For starters, patients love it! Not only do they find it cool, high-tech and something that likely sets you apart from their previous dentist, I cannot recall the last patient that said, “You know, I liked that goo you guys used to use.”
Beyond this, we can now have digital records that do not require physical storage space, which is great. Who likes needing a bigger office or renting storage space to store physical records, not to mention the hassle in locating the physical records when you need them?
Let’s say you are ready to get started with intraoral scanning, or you are at least considering it for your practice. Here are three things to consider when evaluating scanners:
1. Define how you will use intraoral scanning
Will you be sending scans to your labs? If so, make sure you know which scanners they like to work with.
I say this because some are closed systems that use proprietary file formats and others are open systems that use file formats that can be used with numerous programs. Beyond this, some open systems are harder and more expensive for labs to use, especially when receiving the scans.
Do you want to mill things in your office? If so, which milling units work with the scanners you are considering?
Do you want to print things in your office? If so, how easy is it to get the files ready to print and into your printer’s software?
Are you going to scan full arches or just quadrants?
2. How easy to use are the scanners you are considering?
Some scanners make it super easy to acquire scans, and with little to no training you will be capturing full arches with relative ease while others will be a challenge even with extensive experience. These are better suited for quadrants.
If you are thinking of scanning full arches or having your assistants do at least some of your scanning, and I would recommend you plan on both, then it is critical to ensure the scanner is easy to use.
3. Get help holding the lips, cheeks and tongue out of the way
Just like with traditional impressions, you need the lips, cheeks and tongue out of the way to get a good result. With experience you can do this on your own, though it is often easier, especially when starting out in your scanning journey, to have a team member help. If that’s not possible or practical, use something like an OptraGate.
John R. Carson, D.D.S., is a member of Spear Visiting Faculty and a contributor to Spear Digest.