Fewer Models, Better Outcomes

Modern intraoral scanners can produce incredibly accurate topographic measurements while reducing the risk of human error considerably when compared to model-based design. We define accuracy as a combination of trueness and precision tested on different substrates, under different lighting conditions, for crown preparation and full-arch scanning; based on the results of 11 peer-reviewed papers published between 2018 and 2020, we are convinced that intraoral scanners can increase accuracy by that definition. A hygienist trained to perform an intraoral scan can quickly create a high-resolution image, minimize scan retakes, and enable consistent restorative outcomes.

Modern intraoral scanning systems are evolving in real-time. Intraoral scans are fast to acquire and can be sent electronically for receipt in the laboratory within minutes, as opposed to days of transit time for physical impressions. Once the dentist electronically sends scans directly from their intraoral scanner, we can access scans via cloud-based portals. Moving to digital scans allows us to speed up time to production, increasing our project throughput and benefiting our bottom line. With the system we use, dentists can leverage tools such as trimming scans and margin marking, which helps save time and allows our laboratory to receive more meaningful scan information. Digital transformation may eventually lead to such features as real-time video consultations and chairside collaboration between dentists and laboratories.

With our digital workflow, we can skip the use of physical models entirely for simple cases and improve our cost-of-goods expenditure and our margins overall. Working solely off a digital scan that has incredibly accurate and consistent measurements, we import the scan into CAD and begin restoration work immediately. Getting to this point was not an "out of the box" experience. The powerful technology driving this capability is only one part of the equation. The other is experience. As we took on more digital cases, we were able to cross-reference and validate specific parameters to achieve consistent quality outcomes. We were then able to have a highly reliable workflow that started with digital scanning and carried through to CAD/CAM production. Over time, we realized enough consistency and efficiency to forego traditional model making entirely, and most model work altogether. Today, we carry out most restorative and appliance work via digital production.

As effective, efficient, and (on a lighter note) fun as digital systems are, it is impressive how implementing a digital workflow has positively impacted our margins. Processing cases faster, and with a higher degree of accuracy and confidence, has empowered us to reach business goals, reduce day-to-day staff burdens, and stay organized and agile. The value of innovation is predictable and constant, and we look forward to integrating new tools and technologies to continue delivering quick, consultative, high-quality products and services in the years ahead.

Jeff Plumlee is General Manager at NDX Keller (formerly Keller Laboratories) in Fenton, Missouri.