3-D Digital Imaging to Revolutionize Impression Taking

According to Eric Paley, CEO of Brontes Technologies, an estimated 50% of the roughly 50 million dental impressions taken each year in the U.S. are substandard, and require a second one or lots of finish work by the dentist to get them to fit properly. “Patients and doctors hate them,” stated Paley. Is the new 3-D Imaging technology out of Brontes the solution to our impression problems?

The Wall Street Journal profiled Brontes Technologies this week and explained: “Dentists, who are usually sole practitioners, typically average several impressions each day. And dental labs, which create the dental appliances, often find that a wax or plaster-like cast may not be adequate to create a proper denture, and may request a second impression be taken. Another potential pitfall is that the impression, which is usually shipped to the lab, could get damaged or lost in shipping, Mr. Paley said.”

Paley explainted that, “The Brontes technology aims to provide a consistently accurate image for the fabricator in order to assure proper fit and comfort of dental appliances. A dentist using the Brontes system scans a wand, about the size and shape of an electric toothbrush, over each arch of a patient’s teeth while it captures their images via a camera.

The process, which is painless and conducted in the dentist’s office, creates a digital video image that is transmitted to a flat-screen panel. It presents a detailed, life-size image that can be moved and spun for viewing at different angles by simply touching the image on screen. The digital image is forwarded to a dental lab so it can produce a permanent denture or crown.

The dentist can also save the image to access when ready to apply the crown, in order to preview the work when the new item comes in. The dentist can also maintain permanent images of the patient’s mouth to track changes in patients’ dental health over time, to prevent and diagnose problems. A traditional X-ray is still necessary to determine if there is decay underneath the surface of teeth or gums.”

As regards to the technology the Journal qouted two different viewpoints:

“As for Brontes’s technology, Mr. Freedman, director of marketing of the Dental Trade Alliance, said that in the short term, dentists using it may find it difficult to find laboratories that use digital images to fabricate appliances. “I think it’s still a relatively small universe.”

But Dell Dine, vice president of research and development at National Dentex Corp., one of the largest operators of dental laboratories in the U.S., said it is just a matter of time before a support technology is developed for labs.”

What are your thoughts? Will this be a standard technology in a few years time?

Source: FRANK BYRT, Wall Street Journal

10 thoughts on “3-D Digital Imaging to Revolutionize Impression Taking

  1. JEFFREY745@AOL.COM says:

    THE USABLE LIMITS OF ANGSTROM UNITS IS ABOUT 27A~WELL ABOVE HUMAN SENSITIVITY(OCCLUSAL).

    NOT HAVING ANY EXPERIENCE WITH CAD CAM UTILIZATION(IN SITU)VS THIRTY FIVE+YEARS DEALING WITH LABORATORY WORK AND ERRORS(MINE-THEIRS-MATERIALS-PROCESS-ETC) THE MODEL WAS THE FINAL DETERMINENT OF ACCURACY AND AGAINST WHICH I CREATED DENTAL RESTORATIONS THAT HAVE WITHSTOOD THE RAVAGES OF USE AND TIME AND MY PATIENTS STUPIDITY.
    WSJ NOT WITHSTANDING, MY CONCERN IS WITH THE END RESULTS! AS ALWAYS, THEY WILL BE AS GOOD AS THE MODEL, THE TECHNICIAN AND THE DENTYIST’S ABILITY TO GET THE DAM THING TO BE COMFORTABLE AND FIT TO THE ‘PRACTICIONER’S ETHICAL LIMIT’………….INTERESTING
    BUT I WILL AWAIT YOUR BLOGS NOT THE WSJ,BEFORE BUYING A TOOTH SCANNER…………JK

  2. Anonymous says:

    I believe this is the technlogy of future. But i do not know what are the key features for its sucess. How about the format? Compatible to all kinds of CAD-CAM systems? Is there any hiding points? How about plaques (around 0.1mm, and junctions?

  3. Jeffrey Hoos DMD says:

    Every dentist is the world is trained about being accurate.
    The question really is, when is enough, enough and maybe perfect is the answer. When perfect, can you get a restoration to fit in the mouth. What tolerances are the correct tolerances. I have read in the trade journals that the impression market is going to be cut by as much as 50% over the next ten years. Will this tecnology be available to all dentists? What labs will provide these restorations and where is the end point.
    Somewhere in the dental world, in our own towns are dentists with slow speed belt drive handpieces placing amalgam with copalite. If you do not believe this, then you are kidding yourself. In that same town is someone using a cad device producing restorations himself. Which will last longer and is more accurate? I think (opinion) the early adoptors of Cad would agree that things have changed and getting better. Like any technology, improvements come really fast and make older technology look inadequate. Where is my 256k machine?
    The success will be, ease of use and decreased cost. The American way.

  4. John Sherrod says:

    I have a good college friend who works for a digital x-ray company and it has definitely spurred my interest. But they are wholesale. Where do I find dentists who actually used this equipment? Do you know of a list of dentists that have upgraded to use digital x-rays? I just changed insurance plans and I’m holding out till I find one.

  5. Tom Ryan says:

    This technology, in essence, is already being used in the labs to scan models from impressions and fabricate zirconia cores. It seems like a small step to take this into the dental office, at least to eliminate the impression step when making zirconia core porcelain restorations. My concern is the cost to the dental office may be prohibative to adopt this treatment modality.

  6. Paul Feuerstein, DMD says:

    It is not a small step at all. Although the labs are easily scanning models and impressions (Invisalign)it has turned into a difficult process to get these scanners intraorally. Note all of the delays of the Schein Evolution 4D- rumor has it that part of the delay is the laser scanner. In the machine industry, a lot of scanning is done with little “feelers” that actually touch the item and give an accurate copy to the software. This is how the Procera is scanned. Not practical in the mouth. Also there are obstacles such as tongue, cheek, limited opening and fluids that could interfere with the scans.

  7. alan banks says:

    Sign me up! I try to work cad/cam into every fixed restoration. some of the restoration is fabricated better with the computer. we’re anticipating increased and improved digital comm. to our lab via impression taking. ROE Dental Lab

  8. Ruumi Daruwalla says:

    Dentists of the future will take digital impression directly in the mouth, which is downloaded on their PC software which will help them design the optimal Crown or Bridge; will email the file to a Milling Center located in his own office (for high volume users) or at any location he chooses (for low volume users); and get the final work which is perfect fit.

    I have clinically seen many technologies in use, from Cerec to Lava to Everest to smaller companies; and this technology is the present and the future, no doubt.

    This technology is still in its infancy and to get a robust yet economical system is still a couple of years away.

  9. Derrick Veneman DDS says:

    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.

  10. Invisalign says:

    Digital impression taking is still in the early phases but it will definitely be the way all dentists will be taking impressions in the future. Ease and patient comfort is unsurpassed. It would be great for taking impressions for crowns and Invisalign. The only downside is cost which is very high. Many dentists at present cannot justify the high cost associated with this technology.

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