Dentaltown December 2022 - 12

professional courtesy
column
Plug Into the Future
W
hat's the next big thing in dentistry? Is there
something on your wish list that would
make you more effi cient, provide better outcomes
or reduce your overhead?
We have entered an era where skilled team members
are more diffi cult to fi nd, yet we have access to technology
with the potential to do some heavy lifting. This
month, I'm going to introduce some concepts for your
consideration, and I would love to read your feedback
about them.
Designs for the future
The adoption of intraoral scanners for digital impressions
has happened much more rapidly than the
suite of same-day dentistry devices that paved the way
in this category. That's not much of a surprise, when
you consider that to begin doing everything in-offi ce
and getting rid of your lab bill costs a ton of money and
requires a fundamental change in patient fl ow. Only a
small number of dentists have transformed their practices
completely so far.
The reality of having skilled team members who
can manage the design, milling, staining, fi ring and
fi nishing of these restorations is intimidating-and
diffi cult to sustain. Take a single scan and send it to
fi ve different digital labs, and I promise you won't get
fi ve identical crowns back. Why? Machines can make
great proposals, but humans will improve the design
with more detailed anatomy and contours.
Design is such a critical element that I would argue
more offi ces would consider milling or printing
restorations if they could send their scans and receive a
ready-to-manufacture design shortly thereafter. I mentioned
this idea in a recent column
discussing 3D-printed nightguards:
Several remote services will design
one to your specs and send you a
design ready for printing. Yes, some
dentists have installed the software
in their practices to design their own
nightguard and do it all, but I'd say
most of us don't want to take on that
aspect of the treatment.
by Thomas Giacobbi, DDS, FAGD, editorial director
12 DECEMBER 2022 // dentaltown.com
Getting-and sharing-the right information
Meanwhile, surgical guides for implant placement
can provide a similar but more complicated opportunity
for remote manufacture.
I restore implants but don't place them. Like many
general dentists in my situation, I've had to restore
too many implants that would've had a better result
if a surgical guide had been used. (In my book, two of
these cases is " too many. " )
One of the technical challenges is correctly compiling
the information: The surgeon has the CBCT image
for planning but needs to get an intraoral scan from me
that can be merged with the CBCT. Once the surgical
guide has been designed, it then needs to be printed.
Should this happen at the general dentist's offi ce or the
surgeon's offi ce? Bottom line: You need a surgeon who
is willing to make a change and use surgical guides on
a routine basis so every implant, regardless of location,
is designed with consideration for the best restorative
outcome.
In the short term, many capable labs can bring
these elements together to produce a surgical guide.
Sometimes the lag time can be a factor. That's why the
ability to manufacture this in-house may be an attractive
model in the future.
I often wonder if some of the larger labs would
consider satellite milling and fi nishing, operating in
a manner similar to Amazon distribution centers: As
orders come into the central facility from all over the
country, the designs could be sent to strategic locations
in large cities around the country to be milled and fi nished.
This model could reduce delivery times signifi -
cantly. I imagine there would be cases where a group of
dentists could share a space where together they would
have enough volume of lab work to make a model like
this fl y.
The fact that we routinely share large volumes of
patient-specifi c data every day is a modern miracle. We
are starting to discover all the possibilities.
How would you like to practice in the future?
Please share your comments on the digital version of
this article at dentaltown.com/magazine. You can also
reach me via email at tom@dentaltown.com. ■
http://www.dentaltown.com/magazine http://www.dentaltown.com
Dentaltown December 2022

Table of Contents for the Digital Edition of Dentaltown December 2022
