Automation & Non-Optical
Tomorrow's opportunities and trends
Chris Brown, BSEE
The past decade has brought about vast improvements in scanning speed, accuracy, and efficiency. What's more, we have witnessed the common closed-door box scanners transition to open-platform designs that now allow scanning of the occlusal relationship while cases are still mounted on fully or semi-adjustable articulators. Additionally, the average physical size of scanners has shrunk dramatically over recent years, reducing the overall footprint.
While these have been important steps in scanning technology evolution, have we reached the end of the road? Scan speeds are not likely to improve dramatically until higher-speed camera devices and communication protocols become more common. Most scanners currently demonstrate 7- to 12-µm accuracy when tested to relevant ISO standards. Any improvements in camera resolution will likely impact scan detail more than accuracy. But is there a true clinical relevance for the additional few microns beyond greater detail on the diamond bur, grooves on a prepared tooth, or the margin line of an abutment? Remember, cement gaps are often 50 to 90 µm and margin reinforcements are usually measured in hundreds of microns and manually finished down. So what are the next developments in scanning evolution?
When examining the landscape for future developments and improvements, the first area that comes to mind is automation or bulk scanning. Manually loading one model followed by another, removing the die, reinserting the model, removing another die, and then repeating this process for the next arch seems tedious in an otherwise digital process. Also, it is inherently inefficient given the number of scan passes required for each step. Some progress has been made in solving this problem with flexible scanning workflows where arches are scanned simultaneously or where prepared dies are scanned with opposing arches and the scan data aligned in the software, saving costly manual scanning steps.
Imagine an automated system for loading models into the scanner. At the Expodental Madrid 2018 trade show held this March in Spain, a prototype scanner was displayed with an automated loading system. Scan trays were preloaded with the appropriate model work and an automated arm would push the tray into the scanner and retrieve the tray when scanning was complete. This process is similar to the automatic disc loaders found in some milling machines. Currently this concept is best suited for orthodontic models, where removable dies or occlusal relationship scans are not required. However, if this concept is further developed for multi-part scanning, it would dramatically increase the productivity of scanners and scanner operators.
Or consider a future where scanning platforms are larger sizes and multiple sets of cameras are used to capture the data. Multiple cases could be scanned simultaneously on identifiable, case-dedicated trays or on jigs containing the model work for a specific case. Scan data could be linked by tray or jig barcodes and automatically sorted for data processing and alignment prior to moving forward to a CAD workstation.
There are other opportunities for advancement as well. Today's optical scanners continue to struggle when it comes to capturing data in areas where the cameras do not have direct views of every surface. Adjacent tooth contacts and margins are the most common areas that require additional scan passes or scan steps to gather sufficient detail and data. What if data collection weren't dependent on the capture technology needing to physically "see" the surface being scanned? Haven't we all had X-rays done in the dental chair or panographs? Some of us may have even experienced a CT imaging scan. Why couldn't CT scan technology be used for scanning impressions or model work? Actually, it already is being done in the orthodontic arena and recently that same concept has transitioned to restorative. At several tradeshows this year, manufacturers displayed impression scanning CT concepts expressly for restorative workflows. The good news: Scan speeds were considerably faster than today's optical scanners and could be mostly automated. The bad news: Scan detail at this point is considerably less than what we currently have. However, it is possible scan detail could be addressed with modifications to scan exposure time, radiation wavelength, or other parameters. And, of course, the potential for larger scan platforms could evolve to allow for bulk scanning of impressions.
Industrial CT scanning of impressions isn't truly a new technology; it has been used for a number of years. But as the demand for improved efficiency and streamlined workflows continues to increase in restorative laboratories, further development of the technology may be spurred into action much the same as it was with dental mills. A prototype micro-CT scanner was actually on display this year at the Chicago Dental Society's 2018 Midwinter Meeting. Although it scanned only one impression at a time, it wasn't much larger than a typical optical scanner in use today. The purported scanning time was very reasonable and the resolution not far off from what we would expect. This represents a significant step forward in technology advancement and quite possibly a sneak peek into the dental laboratory of the future.
We will continue to see refinement in scanning software and optimized or dedicated scanning workflows. However, in the coming years I predict the next major developments will likely come in automating the process and in developing non-optical technologies.
Tech Showcase
This product showcase spotlights the latest innovations introduced onto the marketplace in the past year. Each of these products demonstrates unique new advances, improvements, or expansion of applications within the scanning landscape. We celebrate all the new scanning innovations that have been and will be introduced this year. A complete showcase of products in this category will be published in our 2018 Product iNavigator in November.
The new Imetric L2i is the next level of Imetric's flagship Swiss Precision scanner. Paired with the company's version 9 scanning software, it offers the utmost combination of speed and data quality.
Using Nobel Biocare's new KaVo LS 3 scanner, dental technicians can access the full portfolio of NobelProcera restorations. In combination with the DTX Studio design software, users will also benefit from smooth, fast workflows and the flexibility to produce additional products locally.
The SNAP face scanner from DOF USA is a small, portable device incorporated with a high-performance tablet that allows for easy stationary and mobile face scanning, using scan targets to align the jaw scans to the face scan date.
The Planmeca Emerald by E4D is a small, lightweight, ergonomically designed digital intraoral scanner that captures accurate, vibrant color images in real time. Dental professionals can capture accurate impressions ranging from single-tooth to full-arch scans in seconds.
The new iTero Element 2 scanner from Align Technology is equipped with next-generation computing power, improved screen resolution, and an integrated lithium-ion battery for easy mobility from operatory to operatory.
The MEDIT i500 intraoral scanner represents value, efficiency, and productivity. With its impressive speed and powderless system, the i500 provides a smoother scanning experience while increasing your clinic's flexibility by allowing STL, OBJ, and PLY exports. This, combined with a revolutionary price, ensures a high return on investment for every user.
3Shape's TRIOS MOVE includes the 3Shape TRIOS 3 scanner, a PC, and a full HD touchscreen, making it easy to share digital scans, images, and treatment plans with patients. It allows the dentist to always position the screen in the right place and enjoy a superior user experience.
