I have heard it estimated that in the next five years 31% of all dental impressions will be captured digitally. So why are so many dentists making the investment? I have had the opportunity to take digital impressions with the Cerec System by Sirona for the last few years. Both as a practitioner and as an educator I love the technology and I have experienced many advantages. The foundation of the advantages is that you get to see your own preparations and the final impression and model in real-time while the patient is still present. One of the most frustrating things in private practice is getting a call from the lab that an impression I took has flaws. Often there is no question, and we will have to call the patient and have them come back in, get them numb, take off the provisional and take a new impression. This is an in inconvenience for the patient, diminishes the productivity of the procedure and can potentially impact how the patient feels about our office. Other times the lab is calling so that
I make the decision to ask them to “make it work” versus bringing the patient back in. This is never a good or comfortable choice. Even with evaluating all of my impressions with 4.8 power loupes, I am still not able to pick up the same issues that the lab can. First the lab is looking at an actual die, not the negative on the inside of an impression, and often they are using twenty power magnification.
Digital impressions allow me to have the same view of my preparations that the lab has. I can take a quadrant digital impression in under two minutes and have a virtual model that on a computer screen is large enough to properly evaluate. If the impression didn’t get the entire margin, or was missing a portion of the prep, I now have the ability to simply retake the impression, or improve my retraction and retake the impression without an additional appointment. This ability to quickly get an impression and see my preps on the computer screen is the source of another advantage. This technology will without question have a positive impact on your preparations. As an educator I use the technology to teach prep design, because seeing it twenty times magnification allows us to do more precise preps. The precision of the margins, the taper, and the polish of the prep walls and rounded angles all contribute to a better fitting restoration and longer clinical survival.
We can discuss the difference in the patient experience between digital and actual impressions, or the cost of the materials versus having the technology. When it is all said and done to me the advantage of improved clinical outcomes, increased predictability of procedures and streamlined systems make the other conversations irrelevant. Given this it is no surprise to me that an ever increasing number of offices have already made the transition to digital impressions and the adoption rates are steadily growing.
Jerry Zanni says
Very informative blog.
Can you say more about the advantage of smoothened preps vs just using diamonds and no further refinement.
Lee Ann Brady says
I smooth all of my preps. There are a lot of ways to accomplish this step, fine diamonds, carbide burs, white stone, and probably more. For a period of time we heard that rougher preps enhanced bond strengths. This has limited clinical significance, and smooth preps have great clinical value. Whether using traditional impression material or digital smoother preps impress more accurately. They also create more accurate dies, and for all porcelain the smoothness of the prep and precision of the margins is a great advantage to the glass.
Hans Guter says
So true. My CEREC has made my preps better because of the reasons you listed. I have used the unit to also evaluate preps that I am going to be making impressions on to avoid the “headaches and decisions” you mentioned.
Lee Ann Brady says
Exactly, Hans, I use my unit the same way and do screening images, it has been a great help. Are you using Cerec Connect? This can be another way to reduce the number of impressions you make the traditional way.
Mike Skramstad says
Great Blog Lee!