The process of fabricating dental prosthetics has changed rapidly over the last decade with the most impactful change being our decision to switch to digital workflows. That is helping us ensure a better product that continues to improve as new technology emerges.

Traditionally, a dental team took analog impressions that were hand waxed and hand cast before a hand-applied porcelain or acrylic technique was utilized to fabricate the final restoration. The process was time consuming and dependent upon the skill of the lab technician and accuracy of the analog models.

Larger laboratories evolved into digital workflows like other manufacturing industries, allowing for more accuracy and precision along with the ability to perform quality control and consistency.

With the ability to control a variety of parameters through a digital workflow, we can now design, control and standardize occlusion, interproximal contacts, marginal fit and emergence profile. Additionally, if a remake of a fractured prosthesis is required, the digital workflow allows for the prosthetic to be remade by simply remilling from the stored scan data.

The ideal way to initiate a digital workflow is to perform an intraoral scan. While most large dental laboratories have adopted digital capabilities, intraoral scanners are still underutilized in dental offices. Currently, in many dental offices, an analog impression is taken and sent to the dental laboratory, where it has to be scanned before a digital workflow is carried out.

The analog impression is the least accurate and least reproducible part of the process and introduces a source of error perpetuated in the fabrication of the prosthesis. To avoid that risk, we have been utilizing an intraoral scanner to fabricate study models and allow for digital planning of implant placement. The improvement is distinct.

While the quality of alginate study models that we receive and that we produce ourselves is variable, the digital workflow ensures greater consistency and accuracy. Now that we have had the intraoral scanner for almost a year, we are slowly moving away from requesting analog study models because of accuracy issues.

If you would like to take advantage of a digital workflow for your implant restorations, please let me know and we can put that process into effect. The only situation where an intraoral scan for final restoration might be problematic is if there is need to perform “guide planes” for interproximal contact or if occlusal equilibration is required prior to restoration.

While we have aligned our office with Jamestown Dental Lab, a subsidiary of ROE Dental Laboratory, it is your choice where you send your restorations. ROE allows the full spectrum of digital workflows to be utilized.

Another way to best utilize a digital workflow is to incorporate digital photography for shade, esthetics, lip line and smile design. This “extra step” has a very low additional cost and can be performed by staff. There are a number of digital platforms available that allow you to design restorations you can show your patient and perform a “digital wax up”.

We would welcome the opportunity to discuss digital workflows or answer any questions you may have.
 

Dr. David W. Todd, DMD, MD, Oral SurgeonDr. David W. Todd, DMD, MD, has been active in his profession. He has authored 18 articles in various publications and made numerous presentations at state, regional, and national meetings. For Dr. Todd’s full bio click here.