Digital Impression Systems
One area of enormous change in dentistry is in the digital impression realm. Digital impressions are no longer in their infancy. In many clinical scenarios, it is at the very least equal to conventional impression methods.
Digital impression systems offer advantages to patients and clinicians alike. The patient experience improves because there is no longer a tray with messy, foul-tasting goop in the patient’s mouth, forcing the patient to remain still for extended periods of time. The need to breathe in noxious smells is also no longer necessary, and complications like gagging are reduced or eliminated.
The dental provider benefits from obtaining more detailed clinical information. Advantages include an increased ability to capture the image of the preparation in a couple of minutes, the immediate visualization of the preparation in a magnified format, and an ability to digitally design treatment solutions. In practices equipped with milling devices (and eventually 3D printing), the final restoration can be fabricated and delivered in one visit, which speeds up treatment time.
In the digital impression world, the way images are captured is evolving, with newer systems utilizing video and eliminating the need for sprays. Older methods of still photo capture and stitching together the images to make a completed virtual impression are quickly becoming obsolete. The continuous streaming allows for expedited image capture, accuracy that was once unprecedented and has now become standard operating procedure, reduced patient treatment time, and the option to design, mill, and place an immediate restoration in one dental visit. Some manufacturers offer open architecture file formats that allow images to be sent or milled on a variety of platforms while others remain closed. Closed architecture systems require the operator to stay within the system and that manufacturer’s product line.As digital impression systems’ cameras get smaller in size, it is now possible to virtually impress even second molars. Traditional impression systems are limited to one mold or one final product, whereas digital impression systems are limitless, reusable, and agile pictures that can be magnified to 10,000 times (or more) and viewed from multiple angles.
Digital impression techniques can be used for multiple units and even full-arch restorations. With the ability to perform virtual articulation of all of these, full-mouth restorations are becoming a reality. The only hurdle now is mastering the accuracy of the articulated transfer to optimize occlusal relationships.
In the world of implant dentistry, digital impressions are now becoming the standard. The placement of a scan body into the implant gives the exact orientation of the implant. Orthodontic digital impressions are state-of-the-art for capture of pre-treatment records and planning of sequencing with aligners that are fabricated from the images. For the completely edentulous patient, digital impressions assist with virtual articulation, wherein teeth can be placed from a digital library. A trial denture can be fabricated in 24 hours and tried in the mouth.
Digital impression technology requires an investment in hardware/software and, as with any technology, there is a learning curve. The numerous developers/manufacturers of these technologies offer variations on product design, features, maintenance, and training. One should explore all of these options so that the correct choice is made for a particular dental practice’s needs.
There is no question that digital impressions are here to stay, and that in the very near future, the advantages they provide will become the standard of care.
About the Author
Frank J. Tuminelli, DMD, FACP
Immediate Past President
American College of Prosthodontics
Private Practice
Great Neck, New York
