Dentistry Question

[AmericaLC]

Hello, I'm a dental student and I'd like to know if there has been any technological improvement in dentistry that improves or facilitates the procedures? If so, what are those improvements?

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[charlestweed]

I don’t know about general dentistry. But for ortho, the answer is NONE. I still use the same original equipment and chairs. I haven’t upgraded anything since I built my first office in 2005. I’ve practiced ortho the same way that I was taught 20+ years ago. My staff and I work just as efficiently (and treat similar number of patients per day) as the offices that have modern equipment, which cost 5-6 times more. Newer equipment often the give doctors more headache due to the additional time required for staff training…..and due to the frequent repairs and maintenances. It’s going backward....and more expensive.

A few years ago, the corp office that I currently work part time for, bought a bunch of intraoral scanners for us to do invisalign treatments for our patients. And now most of these scanners are sitting in the corner collecting dust. It’s because of the high staff turnover and no one knows how to operate the scanners. Whenever we have a clear aligner case, we just take the PVS impressions.

 

[littleler]

Hello, I'm a dental student and I'd like to know if there has been any technological improvement in dentistry that improves or facilitates the procedures? If so, what are those improvements?

Soo I’m a dental assistant. Not sure what you’re looking for in terms of answers but the biggest improvement has been digital scanners. We currently use a scanner for crown preps and ortho cases(Invisalign). I do think traditional impressions are best though. I think that might be about it.

Impression materials have gotten better, we sometimes use Alginot which takes longer to distort than traditional alginate for impressions. It can be helpful if pour ups cannot be immediately done.

 

[dentistrydmd]

Digital technologies and workflows. Less impressions, less casts, more accurate records, analysis of minute changes over time.

 

[AmericaLC]

Soo I’m a dental assistant. Not sure what you’re looking for in terms of answers but the biggest improvement has been digital scanners. We currently use a scanner for crown preps and ortho cases(Invisalign). I do think traditional impressions are best though. I think that might be about it.

Impression materials have gotten better, we sometimes use Alginot which takes longer to distort than traditional alginate for impressions. It can be helpful if pour ups cannot be immediately done.

Thank you for your answer!

 

[AmericaLC]

Th

I don’t know about general dentistry. But for ortho, the answer is NONE. I still use the same original equipment and chairs. I haven’t upgraded anything since I built my first office in 2005. I’ve practiced ortho the same way that I was taught 20+ years ago. My staff and I work just as efficiently (and treat similar number of patients per day) as the offices that have modern equipment, which cost 5-6 times more. Newer equipment often the give doctors more headache due to the additional time required for staff training…..and due to the frequent repairs and maintenances. It’s going backward....and more expensive.

A few years ago, the corp office that I currently work part time for, bought a bunch of intraoral scanners for us to do invisalign treatments for our patients. And now most of these scanners are sitting in the corner collecting dust. It’s because of the high staff turnover and no one knows how to operate the scanners. Whenever we have a clear aligner case, we just take the PVS impressions.

Thank you sm!

 

[2TH MVR]

I don’t know about general dentistry. But for ortho, the answer is NONE. I still use the same original equipment and chairs. I haven’t upgraded anything since I built my first office in 2005. I’ve practiced ortho the same way that I was taught 20+ years ago. My staff and I work just as efficiently (and treat similar number of patients per day) as the offices that have modern equipment, which cost 5-6 times more. Newer equipment often the give doctors more headache due to the additional time required for staff training…..and due to the frequent repairs and maintenances. It’s going backward....and more expensive.

A few years ago, the corp office that I currently work part time for, bought a bunch of intraoral scanners for us to do invisalign treatments for our patients. And now most of these scanners are sitting in the corner collecting dust. It’s because of the high staff turnover and no one knows how to operate the scanners. Whenever we have a clear aligner case, we just take the PVS impressions.

I love the scanners. We use them all the time. Retainers are definitely better with literally no adjustments at delivery. Can't imagine going back to alginate impressions.

 

[charlestweed]

I love the scanners. We use them all the time. Retainers are definitely better with literally no adjustments at delivery. Can't imagine going back to alginate impressions.

I love alginate.

The problem with the intraoral scanner is you can’t take multiple impressions (scans) on multiple patients at the same time. Another problem is you have to rely on one person who knows how to use the scanner effectively and this will affect the work flow. For alginate, any of my 5 chairside assistants can take impressions. And with one stone mix, we can pour multiple impressions at the same time. The third problem with the scanner is you can’t make the same day essix retainers for the patients because it takes an hour to setup/print/trim the 3-D model. My patients only have to wait 45 minutes (after final debond) to get their retainers. For patients who lost their retainers and need new ones, they can get them in 45 minutes. I use quickset Snap stone (from Whipmix) which enables me to obtain the dental cast in less than 15 minutes. Like what one of the above posters said, the new alginate material is pretty good. You can even re-pour the impressions the 2nd time and you can still get good fits.

For patients that get the Hawley retainers, we usually take the alginate impressions with the wires and brackets on their teeth to reduce the chance of making errors when the asssistant puts the wires back on. And the lab guy just shaves off the brackets/wires on the stone casts to make the Hawley retainers.

Alginate has been proven to work for years. And it's dirt cheap.....only $4 per 1lb bag on Net32.com. There's no reason to waste the money on the much slower more expensive scanners and then have to rely on the outside 3-D printing services. The sale reps try to get your money. I use alginate on myself and on my own kids. We don’t have any problem with the fit and finish. Without the alginate, we wouldn't be able to do 4-5 debonds every day and replace lost retainers for our patients the same day. Being efficient is key.

 

[DrJeff]

I love the scanners. We use them all the time. Retainers are definitely better with literally no adjustments at delivery. Can't imagine going back to alginate impressions.

My wife in her ortho practice started using the iTero scanner than Invisalign pushes. She liked it, but I heard her regularly complaing about how "slow" it was to get a full mouth scan (probably 3 to 5 minutes depending on how cooperative the patient was/wasn't).

Then about a year ago, I had to prep a crown for her, and when my assistant had her post prep scan with my Trios scanner done in about 30 seconds (granted it wasn't a full mouth at that point) my wife was amazed at the speed of my Trios, and asked my assistant how quickly she could do a scan of her (my wife's) full mouth. When my assistant had that done in about a minute, my wife started the process to get rid of her iTero and get a Trios in her office. She's been very happy with that decision!

From a scanner standpoint, the iTero's that the invisalign folks are corporately tied too, will get a quality scan, no doubt about it, however there are other, much quicker, arguably "better" scanners out there.

Getting a digital scanner about 5 years ago now, in my mind has been right up there with switching to digital radiography, a little over 10 years ago now in my practice, as 2 things that without a doubt in my mind have been in the top 2 or 3 things where technology has helped me and how I practice dentistry. I would say that switching from air driven to electric handpieces is probably the 3rd of the 3 biggest advancements to me in the 25+ years I have been in private practice now

 

[charlestweed]

That right there was a huge waste of money + the training time + the headaches for having to switch from Itero to Trios scanner. I am pretty sure that the greedy dental companies will introduce newer scanners and printers in the future and claim that they will work better and faster. And the doctors will have to spend more money to upgrade. The thing is the patients don’t know the difference between the traditional impression technique and digital technique. As long as the teeth are straight at the end of the tx, they are happy. As long as a crown fits and functions well, they are happy. The use of all of these expensive toys doesn’t help increase the case acceptance nor help boost the efficiency/production. It’s the doctor’s clinical and communication skills that help.

Alginate impression only takes a minute to capture one arch if you use the quickset kind + warm water. The problem with digital technique is you can’t obtain a working dental cast quickly like you can with the traditional method. With either method, traditional vs digital, the doctor’s time is not affected because the staff do all the work for him/her.

These expensive toys work great when they work. But they become a big headache when they stop working. At the corp office that I currently work for, we have had to cancel new start cases several times because the stupid digital x ray unit keeps giving us problems….either the x ray unit itself or the Dexis software. The patients, who really wanted to start, had to drive to a nearby brand office to get the x rays taken.....and digital image then had to be printed on a piece of plain paper (more time wasted)......and it looked horrible on plain paper. I really miss the old film unit that they got rid of 6 months ago…..slow but reliable.

 

[littleler]

My wife in her ortho practice started using the iTero scanner than Invisalign pushes. She liked it, but I heard her regularly complaing about how "slow" it was to get a full mouth scan (probably 3 to 5 minutes depending on how cooperative the patient was/wasn't).

Then about a year ago, I had to prep a crown for her, and when my assistant had her post prep scan with my Trios scanner done in about 30 seconds (granted it wasn't a full mouth at that point) my wife was amazed at the speed of my Trios, and asked my assistant how quickly she could do a scan of her (my wife's) full mouth. When my assistant had that done in about a minute, my wife started the process to get rid of her iTero and get a Trios in her office. She's been very happy with that decision!

From a scanner standpoint, the iTero's that the invisalign folks are corporately tied too, will get a quality scan, no doubt about it, however there are other, much quicker, arguably "better" scanners out there.

Getting a digital scanner about 5 years ago now, in my mind has been right up there with switching to digital radiography, a little over 10 years ago now in my practice, as 2 things that without a doubt in my mind have been in the top 2 or 3 things where technology has helped me and how I practice dentistry. I would say that switching from air driven to electric handpieces is probably the 3rd of the 3 biggest advancements to me in the 25+ years I have been in private practice now

The Trios is AMAZING it’s the best scanner I’ve used from an assistant perspective. The iTero isn’t bad but it lags and more up to date scanners will still pick up information intraorally if there’s saliva/blood in the mouth. With the iTero the mouth has to be as dry as possible.