Monday, July 18, 2022

The Shape of Things to Come...



I am extremely enthusiastic about the next 3-5 years of dentistry!  The research and development part of the profession goes through a development cycle of what Darwin referred to as "punctuated equilibrium".  Basically meaning that changes go through peaks and valleys.  Sometimes great ideas come down like a spring rainstorm and sometimes there are droughts.

It seems that since 2020 when the pandemic changed everything, we've seen hesitations in the development of new products.  In the big picture that makes sense.  There was no need for companies to introduce a plethora of new products and/or technologies if the industry couldn't use them.

Now we are going to see some exciting changes in the industry!  One of the things that I am excited about is the ease of use in the category of in-office milling.  Milling has exploded on the lab side with many doctors receiving crowns that they don't even realize have been milled.  On the lab side of things one of the largest companies in the milling space is Roland DG’s DGShape.  The company is well known and trusted in dental labs for its precise and dependable milling solutions.

If you ask an experienced lab technician what mill they prefer, you will find that Roland is on a very short list.

The good news for doctors is that Roland is now bringing the same technology to the dental office.  Since late April, we have been working with the DGShape DWX-42W in our office with very good results.  As regular readers of this blog and my columns in DPR know, I like to keep things on the leading edge and occasionally on the bleeding edge.  Our work with DGShape is definitely leading edge kind of stuff.

I say that because DGShape has extensive experience in the milling market.  They have been providing mills to the dental labs for a very long time and have created devices that are durable, dependable, but most importantly they produce amazing results.  In fact, I'd be willing to bet that a lot of doctors out there have been placing restorations created by Roland mills and didn't even know it

The dental industry is currently riding the crest of a wave of science and technology that was created and fine tuned during the Covid layoff.  We are currently seeing, and will continue to see for the foreseeable future,  incredible changes in clinical practice.  The workflow is one of those categories that will be impacted for sure.

Our current digital workflow for many fixed restorative procedures is as follows:

  • Diagnose
  • Prepare - this is especially impacted by our Bien Air electric handpieces.  If you are in the market for electrics be sure to check out the Bien Air Nova.  You'll be impressed.
  • Digital Scan - The scan is performed with our iTero units.  We have an iTero Element and are also using the new iTero Element 5D Plus.  Scan time for a a full mouth is less than 10 minutes.  It is normally in the 5-10 minute range.
  • Download - the digital scan leaves our office and is stored in the iTero cloud.  We download the files from the cloud to our design computer.
  • Design - using Exocad design software, our 2 designated Dental Assistant Design Specialists (affectionately known as D-Rey and Boo-boo) take turns doing the digital design part of the process.
  • Mill - once the case is completed in Exocad, the file is sent to the DGShape DWX-42W and milled.
  • Polish - once the milling process is done, the restorations are polished using Ultradent's Jiffy Porcelain system.  We are currently not firing any of our restorations in an oven.
  • Deliver - the prosthesis is then tried in, adjustments done (if needed), and the case bonded into place.
The incredible ease of doing this type of dentistry is not something difficult to achieve.  The digital tools we all now have at our disposal make this much easier and much more predictable than you might imagine.  The ability to utilize open source hardware means you can basically bring any scanner you would like into the process.  I love not being locked into one manufacturer for every piece of the workflow.  I can find what I like best and what is easiest for me and my team, while delivering outstanding results.  The image at the top of this post came out of the DGShape DWX-42W this past Thursday.  THAT is the kind of result you can expect from this machine.  Done with no impression and no model.  

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