Introducing Dentists to Their New Intraoral Scanner

At this point, most CAD technicians review many scans a day. In that review, they are deciding if the laboratory can confidently produce the requested restoration from the information given. It is essential for the dentist and laboratory to have an open line of communication to discuss the clinician’s preferences, receive feedback, and work together through and beyond their learning curve. This can be done by the dentist after sending a scan to discuss with a technician what they are looking for, review emailed screenshots, use remote desktop software, and/or, with some scanners, use near-real-time evaluation before the patient has left the chair. The author’s laboratory makes the commitment to first-time digital customers to waive remake fees on up to five single-unit posterior digital cases in the first month. This type of benefit helps a practice settle in without feeling the need for immediate perfection. That said, it is important to begin a partnership with single-unit cases to get acclimatized to the new process and see some positive results before moving on to more complex restorative cases.

Adapting to using an IOS in their chairside process can seem cumbersome to dentists at first. Some will begin using their scanner slowly to develop a consistent workflow. Easing in can help identify holes in efficiency and iron out a process that best fits their day-to-day needs. This is an important part of self-training and discovery. A solid commitment to this ramp-up period will help to ensure the restoration team reaps the benefits of the equipment and prevent the dentist from experiencing any buyer’s remorse.

Ideally, the scan wand is only a replacement for the impression tray, so the clinician should take the same steps to ensure quality impressions. In the author’s laboratory, they often see scans that do not have cord packed, do not have the proper moisture control, and have distortion or debris in critical areas. An IOS is not a magic wand. The following information will ensure that proper scans are sent, allowing for the best outcome for your laboratory, your dentist clients, and most importantly, your patients.

Proper tissue retraction allows for clear and correct scanning of perhaps the most critical area of any restoration: the margin. Intraoral scanners can see only what is visible to the eye. Therefore it is best for clinicians to use two-cord retraction to capture the most complete scans. It is also critical for them to remember that they have the ability to review their scans and zoom in on any suspect or hard-to-reach areas while the patient is in the chair. That way any weak spots in the images can be rescanned before the dentist sends the files to the laboratory. The immediacy of this technology ensures the dentist can capture all the data with scans in one visit, and will not need the patient back to recapture a scan, which can be the biggest waste of patient and clinician time. Help educate your dentist clients to quality check their scans in detail before releasing the patient and clicking send to safeguard your—and their—desired efficiency.

If two-cord retraction for margin visibility is the most important tip for dentists to follow, moisture control is a very close second. This is especially important because moisture gathers in some of the most critical areas. Intraoral scan users should dry the site and surrounding area using compressed air or suction just ahead of scanning. Whatever the method, the person scanning should always verify that the scan area is clear of debris and moisture. Pay special attention to the interproximal areas and deep preparations. Also, confirm that the scanner wand is clean and dry. Once the scan is performed, they should review it before sending to the laboratory, as a review may reveal some spots where moisture interfered with the scan clarity.

Often, the author’s laboratory will receive scans that have only one adjacent tooth on each end and just as much information captured on the antagonist. This gives the laboratory very little to work with in terms of matching anatomy, and this lack of information also opens up the possibility of functional issues. It is important to have as much information as possible to adapt to existing dentition and establish function. This is especially critical when scanning in the anterior. The dentist should be encouraged to include a pre-operative scan on anterior cases when possible, especially for multi-unit restorations. At minimum, the person scanning should capture a full quadrant when collecting data for a single restoration. No matter what the case, a laboratory technician’s favorite scan or impression is always a full arch.

Along the same lines as providing the most relevant information possible, clinicians should not submit a scan with voids or missing data. Rather, they should diligently follow the scan order as instructed for their IOS. Most scanners follow the occlusal-buccal-lingual (OBL) scan strategy: scan the occlusal surface, followed by the buccal, and then the lingual. Scanning out of order makes it possible to capture and submit too much information, not enough, or a combination of both. Doing so defeats the purpose of cost savings and efficiency, which can come from unnecessary back and forth communication between dentist and laboratory, interrupting valuable production time. Many laboratories also charge labor fees for time spent cleaning up digital files that may have voids or excess information that would need to be cropped from the scan to prevent using unnecessary amounts of print resin.

All this points back to those two critical aspects of adopting new technologies: training and communication. It is imperative to all involved that the dentist make the most of that time and master the use of their new investment. The ease of use and ability to collaborate with the laboratory makes an IOS a useful and profitable tool for dentists to use in their practice. With solid training and diligent practice, your dentist clients will be on their way to properly reaping the benefits of their scanners in no time.

That includes improving their relationships with their patients, as an IOS becomes a very effective tool for communicating and interacting with the people receiving treatment. The dentist can better educate them with 3D imaging, color scans, and photos, giving them a deeper level of engagement when it comes to their treatment planning—and increased investment in the process and the treatment as a whole.

Considering all these advantages, it is no wonder that the adoption curve for intraoral scanners continues to rise. More restoration teams—both dentists and laboratories—are discovering how much value this technology adds to their workflow.

Chris Valdez is a CAD/CAM Manager at Peebles Prosthetics, Inc., in Lakewood, Colorado.