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.

41 thoughts on “Digital Impression Systems: How Fast Will This Be Adopted?

  1. 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. 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. 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. 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. 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

  6. 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,

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

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. Its been just over a year since I first read about the digital Impressions on this site. I have not come across any more literature. I am sure if the technology is freely available in the north america and europe. It certainly is unheard of in Asia and the middle east. I know 3M Espe recently launched their technology for digital impressions in US but only a select group was invited. I have not seen anything in the journals either. Does anyone has any articles on this? I look forward to hearing from guys who have any leads.
    Dr Ramesh

  19. Can anyone of the Itero users comment on this issue: how do you handle cases where implants are involved? Can this or any other digital impression system deal with implant prosthetics?

  20. From a lab perspective, I love the Cadent system. Feedback on my work is that it fits better and delivery is more than cut in half. Cadent is continually updating this system (updates are free, I believe) and I firmly believe this technology is ready to explode. Of the 2 or 3 doc’s I know that have it, they have no regrets in purchasing it.

  21. For Dr. E Harish,

    Yes, it can. You seat the implant ubutments in place intraorally and then scan them. (Though I’ve not had a complicated implant case come to me yet.) The biggest implant case I’ve done involved 3 lower right abutments.

  22. At our lab, we are currently supportint Cadent iTero. The system is wonderful and patients love it. Our dentists have received a lot of referrals due to the wow factor of the equipment.. No more messy, goopy material and it is so much quicker and comfortable for the patient. Get on it! It is wonderful!

  23. Dr. Ramesh,

    Have you visited Cadent’s website? There are links to all the publications regarding iTero. I wrote an article in Dentistry Today in Sept. 07. Check it out and let me know if you have any questions. I have been using iTero for over 3 years. I was one of the beta testers in July of 05. It is amazing technology and it eliminates re-makes by almost 100%. Patients love it and I can think of maybe 5 patients in 3 years where I wasn’t able to use it. Amazing technology.

    Bret

  24. Does anyone know how these systems are being priced? I understand the cost to the dentist might be around $10K – does that seem to be consistent with what some of the recent purchasers have found? I would think this technology is one of the rare ones that both patients and dentists will undoubtedly love – the big ? for me is the cost and can the ecnomics work?

  25. I am currently a student in Nova Scotia taking Dental Assisting at NSCC. I would be very interested on finding out if anyone could give me any information on this New Technology.
    We had decided to do our Table Clinic on Digital impressions VS Alginate and the pros and cons. I need as much input and information as I can get. Greatly appreciated.

  26. iData Research Inc., a global medical research company, has just completed their comprehensive analysis of the 2009 US Dental Prosthetic and CAD/CAM Device Market. This report analyzes, in detail, the latest in Digital Impression Taking Systems.

    Includes
    -units sold
    -average selling prices
    -market shares
    -forecasts (to 2015)
    -market drivers and limiters
    -complete competitor analysis
    -market trends

    Tanya

  27. I am currently a part time student working at a dental lab and soon will graduate to become a dental technician. One of my final projects is ellective studies where we have to do a written report and presentation on any topic to do with dentistry. After searching the web i was intrigued on the topic of digital impression taking. My presentation will be done in front of technicians dentists and feel they would find this topic interesting. I would be very grateful if any one could send me some information on this topic, i.e Pros and cons, costs .

  28. hello sir
    im a dental student doing my 3 rd year in CSI college of dental science and research insitute madurI TAMILNADU INDIA .
    i like to know more abou digital impressions.please help me

  29. hello, I’m a dental student in belgium and I’m making a thesis about digital impressions. Someone who knows good articles, research, differcence with conventional impressions,..?
    Kind regards.

    stijn

  30. hei!:) I am as well as dental students who is making her thesis on impression materials for fixed prostodontics and digital impression articles will be of great help. Has any of the above students got some?! I would really like to work together on this theme, so write me on dra_alina@yahoo.com if you are interested on this. Thanks:)

  31. I am looking for a dentist in the Chicagoland area or more specifically the Aurora, Illinois area who makes digital impressions. I have a gag reflex to the traditional method and would like to try the digital. Thank you,

  32. dear dr.
    it is an intresting and great work done in dental impressions
    i would like to know where is this technology available in south india and to be precise in the state of andhra pradesh in southern part on india
    i am jus waiting to see it live and my hands are eager to work on it
    please do help me in this regard

  33. Digital impressions are in dreams for third world.Hope Our people may find it cost effective when it is available in remote corners of india and tamilnadu

  34. I have been working on Dr. Derrick Veneman’s Cadent iTero models since May 2007. Literally, we’ve just cracked the 1,000 unit barrier with less than a 1% remake. Out of those thousand, I can only remember less than two hand-fulls that gave us any issues. They were simple mis-reads of margin in which the doctor may have created a bevel, to sub-g deep margins. Most of those remakes were difficult margins to find probably even with polyvinyl impressions.

    You can’t knock the advances of digital impression taking. They’re nice models, clean, and accurate. They doctors love the ease and simplicity. And it gives the doctors time to B.S. with the patient longer now, since their insertions are half the time. Even full arches are not a challange with this system. =)

  35. i am a patient seeking the name and address of a dentist in manhattan new york , n.y. using digital impressions

  36. Dear Friends, there are more systems on sale and undergoing development. My only problem with Itero is that they are partners with Straumann wich means this equipment will be expensive. I am CDT (NT) with 14 years experience and am anxious for this technology. I am willing to work with manufacturers to help with R&D and with marketing but to no answers as of yet.

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