Disruptive innovation: The advantages of Digital Denture technology for your practice and laboratory
Disruptive is a word you tend to hear quite a lot these days, especially in the digital economy. Disruption is a process in which existing ways of doing business (products, technologies, services) are replaced and sometimes driven out of use by new technologies. Two examples of disruptive innovations are Uber, which changed the conventional taxi industry, and Netflix, which has rendered traditional video stores virtually obsolete.
Disruptive technologies in the dental industry
In the dental industry, people tend to talk about digital dentures as a disruptive innovation. An example of this is the Ivoclar Vivadent Digital Denture Professional process: The prosthetic team is provided with a virtual model based on a three-dimensional data file (digitalized conventional impression). Once the data has been fed into the program, the software can design the denture virtually by itself. Should any individual adjustments be necessary, they can be easily applied. The physical dentures are milled based on the final design files. To a certain ear, this all sounds quite “space age”, but it is nonetheless reality.
Digital dental prosthetics requires the skills of dentists and technicians
Through my lecturing and consulting work, I have come to understand that some of the veteran denturists and dental technicians feel "threatened” by our field’s emergent digital future. While this is understandable, I believe their trepidation is misplaced. Rather, we should take a positive stance on digital technologies. My experience compels me to argue that, collectively, we ought to embrace the emergence of disruptive technology, such as digital denture prosthetics. The most important “stuff” from which digital dentures are made is not a nebulous string of 0s and 1s (binary code). Rather, it is the specialist using the software that creates the denture. Digital denture design software requires - and indeed relies on - an input of patient data for the design process. And that is where we come in – for we first must assess and feed the data into the software.
Digital denturism works for many patients
The advantages of digital denturism are myriad. Those who have been reading the specialist publications with interest are likely to be familiar with several of them. Most significantly for many practices and laboratories, digitally designed dental prostheses are predictable and repeatable. Once a digital denture has been made, it can be reproduced at a moment’s notice without any further invasive involvement of the patient. Furthermore, the digital manufacturing process results in a uniform thickness of the denture base. The digital workflow can generate various articulation and occlusal schemes, which can then be adjusted to meet the specific needs of the patient. In my practice, having the ability to individualize tooth moulds to my specifications at the push of a button has been invaluable.
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Conversely, conventional dentures, which we might now call “analog dentures”, present a host of challenges. Fabricating a conventional prosthesis is a lengthy procedure, requiring repeat office visits and comparatively long turnaround times. The entire procedure is expensive, time-consuming and often bothersome for patients. While these issues have long been understood as unavoidable inconveniences germane to complete denture prosthetics, technological progress means this need not remain the case. The fabrication of a well-integrated digital denture requires less intervention by dentists and dental technicians. The digital workflow is significantly more efficient. This means that digital denture prosthetics can save laboratories and practices - and their patients - time and money.
Denture base milled in the PrograMill PM7 (OversizeMilling Process CAM 5)
Dental arch milled from polychromatic PMMA material (SR Vivodent CAD Multi)
Know-how, experience and skill will remain key to denture prosthetics
In spite of it all, it must be stressed that the technical and clinical skills and practical experience that dental professionals have accrued around analog processing procedures will not become obsolete. Even the most innovative tools and technologies, such as three-dimensional scanners and printers and sophisticated milling machines, require accurate patient data. The software can only produce effective digital dentures with the know-how of the expert.
An initial impression still constitutes the foundation of any prosthesis, conventional or digital. While a digital denture system will reliably produce good, accurate and repeatable dentures, optimal results require proper data input. Dentists must capture accurate manual impressions and bite registrations using conventional methods. Clinical devices such as the Centric Tray, UTS CAD and Gnathometer CAD facilitate the digital process considerably and make it predictable.
In my practice at The Denture Center, the basic foundational principles of denture manufacturing still inform everything that happens on a day-to-day basis. First, every patient receives a carefully per-formed, high-quality preliminary impression, followed by a functional impression with gothic arch trac-ing. In addition, a detailed esthetic evaluation based on a physical try-in process is performed. Only then do we manufacture a final prosthesis, using high-quality PMMA material and CAD/CAM technol-ogy.
I invite you to examine our workflow on the following pages. We hope we can provide compelling evi-dence of exactly what we mean when we argue that digital denture technology is not a menace. Sometimes, disruption works out best for everybody.
Completed denture immediately after the final milling process. Denture base and arch are bonded together.