Digital Impression Systems: How Fast Will This Be Adopted?

IteroIntra oral digital impression systems are coming to the forefront of dentistry. But how fast is the adoption going to happen?

These digital impressions systems replace the tray and putty method of impressing patients with a highly detailed digital scan of the tooth prep area. This technology-driven process eliminates the imprecision synonymous with conventional impressions. It also improves communication between the dental laboratory and the dentist, increases productivity, and lowers rejection rates.

Big manufacturers are excited about the potential of this technology. In 2006, 3M purchased Brontes Technologies, a developer of proprietary 3-D intraoral imaging technology IOS, for $95 million. Another interesting system is the Cadent iTero™ .

Here’s how the Cadent iTero™ works: Once the digital impression is captured, it is reviewed on screen for accuracy and the margin is identified. Then it is emailed to Cadent’s manufacturing facility for milling into the physical model. That model is then sent to the laboratory for restoration fabrication.

As the company states:

“With significant benefits such as increased patient satisfaction, improved clinical outcomes, and enhanced office efficiencies, iTero will change your impression of digital impressions.”More information can be found at: http://www.cadentitero.com/

Clearly this area of digital technology is quite exciting. Initially, it seems like there will be a hybrid of both traditional and digital impressions.

But, how fast is it the adoption of digital impression systems going to happen? Is there interest from patients, clinicians and labs? Will it have the major positive effect on the Crown, Bridge and Implant process in the dental office and laboratory that manufacturers are claiming? Would you consider using digital impression your dental practice or lab?

Leave your thoughts and comments below.

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Filed Under Fixed Prosthodontics, Removable Prosthodontics, Restorative, What's Hot, Digital Impression Systems, Impression Materials, What's New 

Comments

19 Responses to “Digital Impression Systems: How Fast Will This Be Adopted?”

  1. dr ramesh bulbule on July 5th, 2007 1:11 am

    it certainly sounds exciting to read atleast. how it will turnout when one gets an opportunity to see and use is all speculation. I hope it will not be one of those technology items that are spoken about a lot and then disappoint at the end. Cant wait to get my hands on this one.

  2. Jeffrey Hoos DMD on July 6th, 2007 7:33 pm

    I have had a chance to play with a little….Some places it will not reach and of course…..no moisture anywhere.
    It is just the beginning. Impression companies know that there will be decrease in the impression business. BUT…..people just starting out…no way

  3. Mark Jackson on July 12th, 2007 5:15 pm

    I participated in the double blind studies for CADENT for several years. We would make two crowns. One conventional, and one via the Cadent scanner. By the end of the trial period, the Cadent crown was very nice, and seated 70% of the time or better.

    I wish I could post pictures of the models for you to see, but there are extremely accurate. I am also a Lava milling center and have seen some of the Brontes materials and they look very interesting as well. But as others have said, this is an emerging technology and will take some time to catch on.

    BTW, a bad digital impression is just as useless as a bad silicone one. If you don’t have godd fluid and tissue control, it’s worthless.

  4. Gary Henkel on July 12th, 2007 5:15 pm

    i have been involved with the iTero system from the outset, and have found it to be quick, easy, and deadly accurate. we did 3 cases today. digital impressioning is going to be the way of the future.

    gary

  5. dr ramesh bulbule on July 22nd, 2007 2:36 am

    Dr Gary Henkel, I have been loking for literature on digital impressions. have not found any. Could you please send me some.
    Thanks,
    Dr Ramesh Bulbule
    drramesh3153@gmail.com

  6. gary henkel on August 10th, 2007 12:14 pm

    my article on the iTero is being published in the august edition of the Compendium. When it becomes available i’ll be happy to make sure you receive a copy. i did extensive literature searches in preparing the piece, and you won’t find a lot of references, and a good number you find will be 20 years old, because frankly they don’t exist. We will be establishing a whole new body of data over the next several years in this area.

    gary

  7. dr ramesh bulbule on September 1st, 2007 12:49 am

    Dear Gary
    i am glad to know you will be publishing an article on digital impressions. I am looking forward to receiving a copy. Thanks,

  8. iain macarthur on September 13th, 2007 2:58 pm

    do you not still need to take a regular imp to construct good direct provisional crowns especially in multi unit cases?

  9. Gary Henkel on September 13th, 2007 6:49 pm

    nothing changes from your usual crown and bridge techniques other than your impression is digital instead of physical. your choices for temporization, preparation, finish lines, etc., remain as they always have been. no alteration from your usual and customary procedures at all.

    gary

  10. iain macarthur on September 14th, 2007 10:29 am

    thanks Gary
    I only asked as to market the digital imp system as ‘no uncomfortable impressions required’ to prospective patients and then to take a pre op imp then use it post op to seat the provisionals may come as a surprise to the patient and their expectations of the system. I realise there are other benefits ie accuracy etc

    iain

  11. DR.Tarek on September 20th, 2007 6:06 pm

    I have experience with cerec 3D. The benefit of it that can make a crown. inlay, or veneer at the same session. Do you have this facility in this system.Thanks

  12. xqg1981 on October 1st, 2007 10:57 am

    Hi,Dr Gary Henkel,Could you please send me a copy of your article?
    xq1981@gmail.com

  13. Ankur Arora on January 7th, 2008 9:42 am

    the digital impressions seeems to be very exciting, but how do we mount the cast obtained on a semi adjustable articulators? I think there will be a lot of occlusal corrections to be done after fabrication as it dosent uses semi adjustable articulators.

  14. Anonymous on April 12th, 2008 9:59 pm

    What happens when you have a subgingival finish line? With iTero I guess you have to do a gingivectomy to expose the finish line. If the camera cannot see the finish line, it will not be reproduced in the master model.

  15. Derrick Veneman DDS on April 27th, 2008 3:15 pm

    Derrick Veneman DDS on April 27th, 2008 11:43 am I have been using digital impression technology since May of 2007.The system I have adopted in my practice is the Cadent i-tero system. This system is very easy to use and has a small learning curve. I have used this laser technology to scan well over 325 units with only 2 units that had short clinical margins due to my mistake of inadequate tissue retraction. the operator may prep and retract tissue as normal( cord, electrosurge, diode laser, expasyl etc..) and then takes a series of quick scans of the prep, adjacent teeth, opposing dentition and a digital bite registration. Next a 3D virtual model appears on the screen. You may check to see if you like prep design, may check your margins and there is a mode to check interocclusal clearance between prep and opposing dentition. The data is then emailed to cadent and they will find your margins and check out the data. Cadent then emails the data to their milling center in New Jersey where the model work is milled out with a 5-axis milling machine. The model is then delivered to my dental lab within 2-3 days of our data acquisition. Dental labs also have the option of buying the software if you want them to find margins or design substructures for zirconia or waxup for metalwork.
    I have done single unit crowns, 3,4,and 5 unit bridges, porcelain veneers,a 17 unit veneer case. I get impeccable fits with no wobble on the dies, margins are closed, and the bites are right on. My lab trusts the digital bite over the blue mousse bites, we cross checked the cases for a while and the digital bites won every time. Cadent has there own proprietary sectional articulators for posterior an anterior cases. We have even mounted the cases with face bows and our SAM III articulators.
    This system is great. I have noticed great patient satisfaction, outstanding fits ,no impression material, no pulls, bubbles etc.., we get the impression the first time. My dental lab loves it, they have no modelwork. The scans cost me around $20 -$25 and the modelwork $25 which I plit with my lab. I save on cost of impression material, impression trays, adhesive, impression syringes etc.. literally no remakes. My largest savings is chair time inserting.
    Cadent just launched their full arch software, before we were limited to 10 units per arch. They are also making their architecture open so their data will be able to be integrated into different milling centers so you can have copings milled concurrently with your modelwork and have both delivered to you labs to stack or press porcelain. I believe they will be after the fixture level implant impression market next. It will be very interesting to see how this technology will be integratedwith CT scans of the TM joints and articulator technology.
    Other things I like- no powder( what the laser sees is what you get if you have unobsructed view of the margins you got it). The camera can touch the prep, you do not have to be a certain workingdistance from the prep for accuracy, the modelwork is hard to abrade, one model can be used for tissue model, working model and solid model( the prepped tooth slides right out of the sulcus) and additional duplicate dies can be ordered. Soft tissue spans(edentulous areas) are picked up flawlessly, the integration of the data is unbelievable.
    For moisture control I use the Isolite system. The models can be mounted on any facebow. Since the digital bite registrations are right on you can take a new bite registration directly from these models and transfer the mounting to you articulators.

  16. Russ Fitton on May 1st, 2008 11:01 pm

    We have been using our iTero since May of 2007 also. We have placed several hundred units and have had a couple of problems that were minor. Our lab loves the models and the marginal fit of the crowns have been excellent. The future is here now. Our patients love the idea that there isn’t any foul tasting impression material. They also perceive our office as being on the cutting edge of technology. The staff loves it also since they get to take the scans of the opposing arch. It improves efficiency since the digital impression goes directly to the lab and they are not spending time with lab slips and packaging up cases. This is especially handy for Fridays and Saturdays when impressions tend to sit around until Monday to be sent.
    If you work multiple operatories the iTero is easily moved between them. If i can answer any other questions for you about it let me know.

  17. Dr. PR on May 6th, 2008 6:08 am

    Is this system only for the high-end boutique practices? In real world dentistry, I have to deal with crown and bridge preparations that often have subgingival finish lines where I have to pack cord and retract the tissue for impressions. I do not see how this system will work for anything other than ideal preparations with supragingival finish lines.

  18. Dan McEowen on May 7th, 2008 10:05 pm

    To Dr PR. I work in the same real world of subgingival margins as you and use the iTero on every case with absolutely fantastic results. I use a small 940 wavelength diode laser to eliminate excess tissue and control bleeding. As these lasers remove tissue they also decontaminate the sulcular area. With a well made temporary, tissues are healthy and blood free at the time of the impression as well as at cementation. Once you take the plunge, you will loathe the day you have to get out impression material for that “special” case. Itero margins are dead on and the lab loves it. I have very few “ideal cases” — so give it a try.

  19. dr ramesh bulbule on May 9th, 2008 1:48 am

    Dear Dr Gary,
    I am still waiting for the copy of your article that was tobe published in July 2007.
    Shall appreciate if you could send me one.
    Thanks
    Dr Ramesh
    drramesh3153@gmail.com

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