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The Final Four

The modern dental practice continues to evolve at a very rapid pace. Many systems that were based on paper and film for close to a century are being replaced with digital counterparts. There are now computers in almost every office and a large percentage of offices are using digital radiography, intraoral cameras, digital cameras, and practice and image management software. Many have embraced the Internet to handle mundane chores such as confirming patient appointments and even scheduling online. In short, the concept of a “paperless” practice is very realistic and obtainable in 2008.

A review of these newer technologies shows that all of them were introduced to the dental market with very slow and sustained growth for 5–10 years before they became more popular. As with many businesses, dental practices are slow to adapt to change, and dentists want to be assured that investments they make in new technology will show a positive return on that investment. Although some new technologies have dubious value, there are currently four that were introduced over the past few years that I feel will be of great benefit to dental offices in the near future.

Magnification
Dentists are working in a very small and confined area inside the mouth; the systems that have been popular for many years are loupes—magnifying glasses that attach to regular glasses to enhance what we are able to see. The problems that some dentists have found with loupes include a limited field of vision and poor posture related to that. The modern alternative is a high-tech system that includes a microscope and an LCD monitor, allowing images from the scope to be displayed on the screen in real time. It allows the dentist to sit comfortably by the chair with proper posture. Many of them have a slim design so that they can fit into most dental operatories. The mounting options for these systems are also varied, allowing the monitor to be attached to a light pole, wall or ceiling. Of course, they can integrate with current imaging software already in use in the practice. A few companies that produce these systems, such as Camsight and MagnaVu, sell them for anywhere from $30,000 to $50,000.

Taking the magnification concept one step further, one of the most interesting systems is the DentiMag3D. While utilizing the same design as the previously mentioned systems, they use a special 3-D monitor and comfortable 3-D glasses that can easily fit over your existing eyewear. This is ideal for sharing the image with multiple users, students or the patient, so everyone has depth perception! The DentiMag3D does not attach to your current optical microscope, but rather provides a complete and comprehensive replacement for it, upgrading your surgical suite to a fully digital environment.

Shade Matching
We try to pick a proper shade for a new crown for a patient, perhaps even take a good quality digital camera image that we then forward on to the lab. Yet, when we get the crown back, the shade doesn’t even come close to what we need it to be. It’s not the lab’s fault; the problem is in trying to relay accurate information to them. The best known of the shade-matching software programs is one called ClearMatch. ClearMatch is a shade analysis and communication tool for dentists and dental laboratories. It is a software-only system that allows the user to select the digital camera and use an existing PC to perform highly accurate analysis of shade, value and anatomical features of teeth. It is a software system that is able to normalize digital images. This system costs around $1,700, although there are other payment options such as a per-case basis.

Cone Beam
Cone Beam or 3-D imaging is the new frontier for digital radiography. These systems go by many different names, so the best way to describe them is as a cross between a digital pan/ceph and a CAT scan machine. The most popular model right now in the United States is the i-Cat by Imaging Sciences. I could describe the system in detail, but this excerpt from an i-Cat user does the best job of explaining why they are becoming so popular:

“Compared to medical scanners, Cone Beam Scanning is ten times more accurate while reducing a patient’s exposure to radiation by more than 95%. Pre-surgical implant treatment planning, preparing to remove impacted third molars, determining how sinus grafts and ridge augmentations have healed and determining the ideal position for a single-tooth replacements are just some of the benefits of Cone Beam scanning technology. Since Cone Beam scanning permits multiple slices through the axial, sagittal and coronal views,the guesswork is removed when it is critical to determine the width of edentulous ridges, whether or not cancellous bone exists between cortical plates, the position of supernumerary and developing tooth buds, if sockets have filled with bones, if irregularities exist to the condyles, and where the mandibular nerve is relative to an impacted tooth and implant sites; or to visualize the borders of a cyst or tumor. Cone Beam scanning has an added benefit in that it can take the maxilla and mandible in a single scan.”

Probably the biggest drawback to these systems is the initial cost: they average around $170,000–$200,000 each, although newer units from Gendex and Kodak are coming in under $120,000.

Impressions
Who would have thought in 2007 that the age-old system of taking impressions would become passé? New systems—one from Cadent called the iTero, and the Lava by 3M—aim to do just that. According to Cadent, the iTero is designed to replace the uncomfortable and imprecise method of conventional impression taking. Powered by proprietary imaging technology, it enables the dentist to take a digital scan of the patient’s teeth and bite, make any necessary adjustments in real time and then transmit the file via a wireless Internet connection to a Cadent-partnering laboratory for further processing. From there the digital file is transmitted to Cadent where a model is milled. The physical model is then sent to the laboratory where a highly precise physical restoration is created.

It’s impossible to predict which technologies will take off in dentistry for the future. However, the four I’ve listed here are already generating some great press and have the right concepts and design to become an integral part of dental practices in the next few years.

Lorne Lavine, DMD is the Founder and President of Dental Technology Consultants. Dr. Lavine holds two prestigious certifications, the A+ Certified Technician designation and the Network+ Certified Professional. These designations demonstrate proficiency in computer repair, operating systems, network design and installation. Dental Technology Consultants provide dentists a full range of services relating to the implementation of technology.

Dr. Lavine can be reached directly at 1.866.204.339 or drlavine@thedentistsnetwork.net