Clinical Applications of Digital Dental Technology E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Clinical Applications of Digital Dental Technology
Comprehensive overview of digital dentistry describing available technologies and when/how to use digital dentistry in practice
Clinical Applications of Digital Dental Technology provides comprehensive yet practical references to a wide range of potential uses for digital technology in dental practice, discussing a wide range of digital technologies including their indications, contraindications, advantages, disadvantages, limitations, and applications. Overall, the book emphasizes how to use digital dentistry in daily practice across all specialties.
With broad coverage of the subject, Clinical Applications of Digital Dental Technology discusses digital imaging, digital impressions, digital prosthodontics, digital implant planning and placement, and digital applications in endodontics, orthodontics, and oral surgery. Each chapter is written by experts in each topic and covers applications for prosthodontics, implant dentistry, oral surgery, endodontics, orthodontics, and other specialty areas.
Clinical Applications of Digital Dental Technology also includes information on:
- Software, scanning, and manufacturing capabilities which have led to an unparalleled revolution leading to a major paradigm shift in all aspects of dentistry
- Digital radiography, virtual planning, computer-aided design and manufacturing, digital impressions, digitally fabricated dentures, and the “virtual patient”
- Available technologies, plus a critical evaluation of each one to detail how they are incorporated in daily practice across all specialties
- Developing technologies in the field with special attention paid to those expected to be on the market sometime in the near future
Clinical Applications of Digital Dental Technology is an essential resource for general dentists, specialists, and students who wish to understand digital dentistry and efficiently and intelligently incorporate it into their practices. The text is also useful for laboratory technicians interested in recent digital advances in the dental field.
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Veröffentlichungsjahr: 2022
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Table of Contents
Cover
Title Page
Copyright Page
Dedication Page
Notes on Contributors
Preface
About the Companion Website
1 Digital Imaging
1.1 Introduction
1.2 Summary
References
2 Digital Impressions
2.1 Introduction
2.2 Benefits of Digital Impressions
2.3 Limitations of Digital Impressions
2.4 Clinical Considerations
2.5 Accuracy of Intraoral Scanners Compared with Conventional Impressions
2.6 Accuracy of Complete Arch vs. Quadrant Scans
2.7 Indirect Restoration Accuracy
2.8 Preparation Design
2.9 Implant Restoration Accuracy
2.10 Removable Prosthodontics
2.11 Summary
References
3 Direct Digital Manufacturing
3.1 Introduction
3.2 Scanning Devices
3.3 Digital Manufacturing
3.4 File Format in The Digital Workflow
3.5 Additive versus Subtractive Manufacturing Technologies
3.6 Materials Extrusion Technologies
3.7 Powder Bed Fusion
3.8 Binder Jetting
3.9 Sheet Lamination
3.10 Vat Photopolymerization
3.11 Applications of Digital Manufacturing in Medicine and Dentistry
3.12 Future of DDM
References
4 Additive Manufacturing Procedures and Clinical Applications in Restorative Dentistry
4.1 Introduction
4.2 Manufacturing Workflow and Manufacturing Accuracy
4.3 Polymer Additive Manufacturing
4.4 Dental Applications of Polymer Additive Manufacturing Technologies
4.5 Metal Additive Manufacturing
4.6 Dental Applications of Metal Additive Manufacturing Technologies
4.7 Ceramic Additive Manufacturing
4.8 Dental Applications of Ceramic Additive Manufacturing Technologies
References
5 Dental Materials in the Digital Age
5.1 Introduction
5.2 Materials for CAD‐CAM Prosthodontics
5.3 Manufacturing Considerations for CAD‐CAM Dental Materials
5.4 Summary
References
6 Clinical Applications of Digital Technology in Fixed Prosthodontics
6.1 History of Computer‐Aided Design/Computer‐Aided Manufacturing Technology in Fixed Prosthodontics
6.2 Current State of Computer‐Aided Restorations in Fixed Prosthodontics
6.3 Factors Impacting The Quality of CAD/CAM Fixed Dental Prostheses
6.4 Materials Used for CAD/CAM Fixed Dental Prostheses
6.5 CAD/CAM Fixed Dental Prostheses
6.6 Summary
Acknowledgments
References
7 Clinical Applications of Digital Dental Technology in Removable Prosthodontics
7.1 Introduction
7.2 Techniques Available for Fabricating CAD/CAM Complete Dentures
7.3 AvaDent® Digital Dentures
7.4 The Ivoclar Digital Denture™
7.5 Amann Girrbach® AG
7.6 VITA VIONIC®
References
8 Clinical Applications of Digital Dental Technology in Removable Partial Prosthodontics
8.1 Introduction
8.2 A Brief Historical Perspective
8.3 Introduction of CAD/CAM Technologies
8.4 Subtractive Manufacturing Technology for RPD Frameworks
8.5 Additive Manufacturing Technology for RPD Frameworks
8.6 RPD Framework Fit Assessment
Acknowledgments
References
9 Clinical Applications of Digital Dental Technology in Implant Surgery
9.1 Introduction
9.2 Prosthetically Driven 3D Implant Positioning
9.3 Computer‐Aided Implant Planning
9.4 Computer‐Aided Implant Surgery
9.5 Static Computer‐Aided Implant Surgery and Guides
9.6 CAD/CAM Fabrication of Surgical Guides
9.7 Workflows for Dynamic Computer‐Aided Implant Surgery
9.8 Robot‐Assisted Implant Placement (Haptic Guidance)
9.9 Static Versus Dynamic Computer‐Aided Implant Surgery
9.10 Clinical Applications of Computer‐Aided Implant Surgery
9.11 Future Directions
9.12 Summary
Acknowledgments
References
10 Clinical Applications of Digital Dental Technology in Implant Prosthodontics
10.1 Introduction
10.2 Implant Abutments
10.3 CAD/CAM Abutment Design
10.4 ATLANTIS Abutments
10.5 NobelProcera Abutments
10.6 BellaTek Encode System
10.7 Summary
References
11 Virtual Articulators
11.1 Traditional Mechanical Articulator
11.2 Virtual Articulator
11.3 Virtual Articulation
11.4 Conclusions
References
12 Digital Applications in Endodontics
12.1 Introduction
12.2 Digital Diagnostic Technologies
12.3 Electronic Technologies in Local Anesthesia
12.4 Digital Technologies in Root Canal Treatment
12.5 Guided Approaches for Surgical and Non‐surgical Endodontic Treatment
12.6 Artificial Intelligence in Endodontics
References
13 Clinical Applications of Digital Dental Technology in Orthodontics
13.1 Introduction
13.2 History
13.3 Imaging
13.4 Cone Beam Computed Tomography Dosage
13.5 Treatment
13.6 Removable Appliances and Aligners
13.7 Office Management
13.8 Summary
References
14 Clinical Applications of Digital Dental Technology in Maxillofacial Prosthodontics
14.1 Introduction
14.2 Digital Maxillofacial Prosthetics Workflow
14.3 Defect Digital Acquisition and Virtual Reproduction
14.4 Digital Defect Visualization and Reconstruction Design
14.5 Digital Scan Visualization
14.6 Digital Rehabilitation
14.7 Digital Skin Tone Reproduction
14.8 Digital Prosthesis Manufacture
14.9 Summary
References
15 Clinical Applications of Digital Dental Technology in Oral and Maxillofacial Surgery
15.1 Introduction
15.2 Types of Digital Data
15.3 Digital Imaging
15.4 Optical Scans
15.5 Clinical Applications
15.6 Summary
References
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 Bit depth table correlating the relationship of the exponential i...
Table 1.2 Excess fatal cancer risk from various dental radiographic examina...
Table 1.3 Examples of the relative amounts of radiation associated with the...
Chapter 3
Table 3.1 Additive manufacturing processes and materials.
Chapter 4
Table 4.1 Factors that influence on the accuracy of additively manufactured...
Table 4.2 Main dental applications of polymer additive manufacturing techno...
Table 4.3 Main dental applications of metal additive manufacturing technolo...
Table 4.4 Additive manufacturing techniques for 3D printing ceramics and it...
Table 4.5 Potential clinical application of additively manufactured ceramic...
Chapter 6
Table 6.1 Marginal gap (μm) of computer‐aided design/computer‐aided manufac...
Table 6.2 Surface treatment recommended for dental ceramics by Vargas et al...
Table 6.3 Recommended application of computer‐aided design/computer‐aided m...
Chapter 9
Table 9.1 Comparison of static, dynamic, and robot‐assisted computer‐aided ...
Chapter 13
Table 13.1 Skeletal maturation stages of the midpalatal suture description....
Table 13.2 Dosage comparison between all types of X‐rays.
Table 13.3 Online orthodontic screening flowchart example for online consul...
Table 13.4 Orthodontic diagnosis and treatment plan flow chart example.
Chapter 14
Table 14.1 List of computer‐aided design software systems available on the ...
List of Illustrations
Chapter 1
Figure 1.1 ADA caries classification system.
Figure 1.2 ICDAS caries classification system.
Figure 1.3 ICDAS clinical examples.
Figure 1.4 ICDAS radiographic scoring system.
Figure 1.5 MPR images illustrating bilateral antrostomies in a patient with ...
Figure 1.6 MPR images highlighting an impacted maxillary right third molar o...
Figure 1.7 A panoramic image reconstructed from the CBCT volume pictured in ...
Figure 1.8 The mandibular canal passes inferior to the apices of a mesioangu...
Figure 1.9 Sectional views of an impacted and transposed maxillary right can...
Figure 1.10 A screenshot of the HTML‐based DXN AI caries detection app, deve...
Figure 1.11 A 2D BW image compared with the image stack generated by intraor...
Figure 1.12 An image of the PORTRAY 3D tomosynthesis X‐ray machine by Surrou...
Chapter 2
Figure 2.1 Use of the zoom feature to evaluate intraoral scan.
Figure 2.2 Triangular mesh created by scanner. Note areas of smaller and lar...
Figure 2.3 (a) Example of stitching error that occurred when transitioning f...
Figure 2.4 Example of anterior stitching error caused by improper scan strat...
Figure 2.5 When transitioning from occlusal to buccal or lingual surface, it...
Figure 2.6 (a) Maxillary complete‐arch scan strategy; (b) mandibular complet...
Figure 2.7 Intraoral scanners require trueness and precision for overall acc...
Figure 2.8 Intraoral picture of implant scan body
Figure 2.9 Implant scan body regions.
Figure 2.10 Digitized scan body with virtual implant analog.
Figure 2.11 (a) Intraoral scanning of a relined denture impression offers a ...
Figure 2.12 Maxillary and mandibular impression scan strategy.
Figure 2.13 (a) Maxillary edentulous scan strategy; (b) mandibular edentulou...
Chapter 3
Figure 3.1 Printed model of a cranial defect.
Figure 3.2 Diagram to describe how a cast is planned, a metal denture base i...
Figure 3.3 Medical images such as a CT scan are a stack of axial slices that...
Figure 3.4 A 5‐axis computer numerical control (CNC) milling machines.
Figure 3.5 Example of the irregular organic shapes that are best fabricated ...
Figure 3.6 An example of the mesh structure of a tooth typical of an.stl fil...
Figure 3.7 Five‐axis milling is achieved by not only moving the milling burs...
Figure 3.8 Milling requires that the design needs structures to maintain the...
Figure 3.9 The Uprint Deposition modeling machine.
Figure 3.10 Nozzle and platform arrangement of the typical fused deposition ...
Figure 3.11 Internal set‐up of the EBM, powder is held in bins on both sides...
Figure 3.12 3D cube made of titanium, a shape that cannot be fabricated usin...
Figure 3.13 The printing and cleaning chamber of a binder‐jet 3D printer.
Figure 3.14 The MCORE Iris color sheet lamination printer uses plain and col...
Figure 3.15 Parts washers are needed to clean the SLA pieces from the residu...
Figure 3.16 Post cure with light curing unit.
Figure 3.17 Model of a skull with supports.
Figure 3.18 A Connex 500 Polyjet printer.
Figure 3.19 Clear model with black supports fabricated on a Polyjet printer....
Figure 3.20 Vascular models from a CT with contrast fabricated on a binder j...
Chapter 4
Figure 4.1 Additively manufactured metal complex geometry.
Figure 4.2 Additive manufacturing categories.
Figure 4.3 Post‐processing procedures of a vat‐polymerized diagnostic cast. ...
Figure 4.4 (a) Maxillary and mandibular dentate diagnostic cast; (b) maxilla...
Figure 4.5 (a) Additively manufactured definitive cast; (b) detail of surfac...
Figure 4.6 (a) Additively manufactured implant definitive cast; (b) detail o...
Figure 4.7 Additively manufactured cast designed with different base cast de...
Figure 4.8 (a) Additively manufactured implant surgical guide before removin...
Figure 4.9 (a) Additively manufactured positioning guide before extraction p...
Figure 4.10 Additively manufactured occlusal device: (a) additively manufact...
Figure 4.11 Additively manufactured three‐piece silicone index.
Figure 4.12 (a) Additively manufactured custom tray for a complete‐arch impl...
Figure 4.13 (a) Additively manufactured interim dental crown; (b) additively...
Figure 4.14 (a) Additively manufactured maxillary denture trial; (b) additiv...
Figure 4.15 (a) Additively manufactured scan body with hollow occlusal surfa...
Figure 4.16 Tooth‐supported additively manufactured Co–Cr framework.
Figure 4.17 (a) Additively manufactured Co–Cr framework for an implant‐suppo...
Figure 4.18 Additively manufactured framework for complete‐arch implant impr...
Figure 4.19 Additively manufactured zirconia bar.
Figure 4.20 Additively manufactured zirconia dental crown with SLA technolog...
Figure 4.21 Manufacturing defects on marginal portion of additively manufact...
Figure 4.22 Additively manufactured zirconia crown using SLA technology afte...
Figure 4.23 (a) Alumina‐reinforced zirconia partial crown manufactured using...
Chapter 5
Figure 5.1 Incident light may be transmitted, absorbed, or reflected.
Figure 5.2 Even with metal reinforcement, acrylic demonstrates cracking unde...
Figure 5.3 Stress–strain curve.
Figure 5.4 (a) A 20‐year‐old gold alloy bar was removed from Branemark exter...
Figure 5.5 (a) Less than two‐year‐old locator fixture; (b) fixture demonstra...
Figure 5.6 (a) Examples of hard milling ceramic blocks: from left to right, ...
Figure 5.7 (a) Milling margin is set 100~200 μm off from the actual restorat...
Figure 5.8 (a) Chamfer margin without margin offset has a higher risk of mic...
Figure 5.9 (a) Micro‐chippings on the margin: the defects are limited within...
Figure 5.10 Milling tool monitoring system.
Figure 5.11 (a) Minor damages on the milling tool: delamination of diamond p...
Figure 5.12 (a) Glass‐ceramic milling tools for Planmill 40s (Planmeca): the...
Figure 5.13 (a) Poor internal fit due to milling tool diameter compensation:...
Figure 5.14 (a) Sharp line angles and cusp tips cannot be accurately reprodu...
Figure 5.15 Typical milling tools used for zirconia or PMMA.
Figure 5.16 Pattern and size of surface adjustments are different depending ...
Figure 5.17 Margin overhang due to improper finishing: restoration margins s...
Figure 5.18 Three‐dimensional printed resin model is used to adjust proximal...
Figure 5.19 (a) Virtual design with detailed anatomy and deep grooves; (b) d...
Figure 5.20 (a) Pre‐crystallized lithium disilicate glass‐ceramic restoratio...
Figure 5.21 Lithium disilicate ceramic block: milled restoration, external s...
Figure 5.22 Enlargement factor is usually provided by the manufacturer or pr...
Figure 5.23 Pre‐sintered zirconia restoration (left): the restoration is app...
Figure 5.24 Glazed monolithic lithium disilicate ceramic veneer; optimal sur...
Figure 5.25 (a) Pre‐crystallized monolithic lithium disilicate veneer; (b) e...
Figure 5.26 (a) Patient with multiple failing composite restorations and aci...
Figure 5.27 (a) Minimal incisal cut‐back; (b) ceramic layering; (c) bilayere...
Figure 5.28 (a) Anterior veneers with incisal cut‐back; (b) bilayered lithiu...
Figure 5.29 (a) Zirconia resin bonded fixed dental prosthesis with a convent...
Figure 5.30 (a) Zirconia framework design with minimal facial cut‐back only ...
Figure 5.31 Zirconia framework design for facial veneering (top) and full ve...
Figure 5.32 (a) Milled PMMA 0.5 mm shell (left top), intraorally re‐lined wi...
Figure 5.33 CAD/CAM composite resin inlay.
Figure 5.34 (a) Three‐dimensional (3D) printed model and an implant surgical...
Figure 5.35 (a) Custom milled titanium abutment and a zirconia crown; (b) ti...
Figure 5.36 (a) Intaglio surface of a 3D‐printed metal framework: typical su...
Chapter 6
Figure 6.1 Commonly used workflows for the fabrication of restorations in fi...
Figure 6.2 Red arrows present horizontal discrepancy at the margin of a comp...
Figure 6.3 Distribution of errors found in teeth prepared for computer‐aided...
Figure 6.4 Prepared tooth with a sharp line angle and over reduced intaglio ...
Figure 6.5 Quality of virtual models produced by two intraoral scanners: TRI...
Figure 6.6 Internal parameters used for designed restoration in PlanDesign s...
Figure 6.7 Internal parameters used for designed restoration in Dental Syste...
Figure 6.8 Burs used in PlanMill 40 for milling of restorations (left); burs...
Figure 6.9 Simulation of milled restoration in PlanDesign software presentin...
Figure 6.10 Three‐dimensional printed working cast with removable dies (a); ...
Figure 6.11 Error in recording margin of prepared teeth no. 6 and no. 7 by a...
Figure 6.12 Digital model with designed crown (a); three‐dimensional printed...
Figure 6.13 Wax pattern manufactured by subtractive technique for a conventi...
Figure 6.14 Various sizes of billets for manufacturing fixed dental prosthes...
Figure 6.15 Single crowns designed on minimally prepared teeth of a patient ...
Figure 6.16 Shell designed on unprepared maxillary anterior teeth (a);
polym
...
Figure 6.17 Leucite‐based ceramic veneers fabricated for maxillary anterior ...
Figure 6.18 Partially sintered lithium disilicate billets before and after m...
Figure 6.19 Computer‐aided design/computer‐aided manufacturing monolithic li...
Figure 6.20 Bilayered computer‐aided design/computer‐aided manufacturing of ...
Figure 6.21 Partially sintered zirconia billet; unused (left) and with mille...
Figure 6.22 Computer‐aided design/computer‐aided manufacturing of monolithic...
Figure 6.23 Computer‐aided design/computer‐aided manufacturing metal alloy f...
Figure 6.24 Crown manufactured from a partially sintered zirconia (a); Co–Cr...
Figure 6.25 Full‐contour design for fabrication of a monolithic fixed dental...
Figure 6.26 Complete computer‐aided design/computer‐aided manufacturing (CAD...
Figure 6.27 Complete computer‐aided design/computer‐aided manufacturing (CAD...
Figure 6.28 Designed anterior lithium disilicate crowns. Computer‐aided desi...
Figure 6.29 Designed zirconia partial fixed dental prosthesis. Computer‐aide...
Figure 6.30 Anterior and posterior designed crowns. Computer‐aided design so...
Figure 6.31 Monolithic lithium disilicate crowns designed (a) and manufactur...
Figure 6.32 Monolithic (a) and bilayered (b) zirconia crowns designed and ma...
Figure 6.33 Patient with worn dentition (a); designed fixed dental prosthese...
Figure 6.34 Patient with misaligned maxillary anterior teeth (a); improved e...
Figure 6.35 Monolithic zirconia fixed dental prostheses designed (a) and man...
Figure 6.36 Bilayered zirconia fixed dental prostheses designed (a) and manu...
Figure 6.37 Connector dimension recommended by manufacturer measured with a ...
Chapter 7
Figure 7.1 (a) Frontal view of the patient’s existing complete dentures; (b)...
Figure 7.2 Lip ruler used to measure the length of the maxillary lip.
Figure 7.3 Fabricated maxillary and mandibular AvaDent‐Wagner EZ try‐in.
Figure 7.4 (a) Establishment of the
vertical dimension of occlusion
, midline...
Figure 7.5 Placement of AvaDent digital complete dentures.
Figure 7.6 (a) AvaDent provisional digital complete dentures; (b) trial plac...
Figure 7.7 Radiographic template with fiduciary markers.
Figure 7.8 CBCT scan of the radiographic template.
Figure 7.9 (a) Frontal view of the surgical planning with the virtual surgic...
Figure 7.10 NobelGuide surgical template.
Figure 7.11 Avadent conversion denture.
Figure 7.12 Implant placement using the NobelGuide surgical template.
Figure 7.13 Placement of Nobel Biocare multi‐unit abutments.
Figure 7.14 Placement of temporary copings for multi‐unit abutments.
Figure 7.15 (a) Buccal view of the positioning of the AvaDent conversion den...
Figure 7.16 Autopolymerizing acrylic resin injected between the channels in ...
Figure 7.17 Intaglio surface of conversion denture.
Figure 7.18 Sectioning of the struts and separation of the peripheral sectio...
Figure 7.19 Voids between the denture base and temporary copings are filled ...
Figure 7.20 Frontal view of the provisional fixed conversion denture.
Figure 7.21 Occlusal view of the provisional fixed conversion denture.
Figure 7.22 (a) Occlusal view of the finalized provisional fixed conversion ...
Figure 7.23 AvaDent implant record device.
Figure 7.24 AvaDent verification jig.
Figure 7.25 Placement of temporary copings for multi‐unit abutments.
Figure 7.26 (a) Flowable composite resin syringed between the verification j...
Figure 7.27 (a) Implant record device seated on top of the verification jig ...
Figure 7.28 Implant record device covered with modeling base plate wax and c...
Figure 7.29 (a) Heavy‐body impression material placed in the record device; ...
Figure 7.30 Use of the opposing provisional denture to orient the implant re...
Figure 7.31 A Q‐tip is used to expose the occlusal aspect of the temporary c...
Figure 7.32 (a) Intaglio surface of the impression; (b) cameo surface of the...
Figure 7.33 Interocclusal record between the implant record device and the o...
Figure 7.34 (a) Definitive maxillary conversion denture and mandibular fixed...
Figure 7.35 (a) Frontal view of the placement of the definitive denture and ...
Figure 7.36 (a) Maxillary and (b) mandibular definitive impression.
Figure 7.37 Wax‐rim bite registration performed in the traditional manner.
Figure 7.38 (a) Digital preview of scanned mandibular, maxillary casts and w...
Figure 7.39 (a) Maxillary duplicate denture; (b) mandibular duplicate dentur...
Figure 7.40 (a) Scanned definitive impressions and bite registration of the ...
Figure 7.41 Centric tray.
Figure 7.42 Heavy‐body impression material of putty consistency.
Figure 7.43 Loaded centric tray inserted in the patient’s mouth at the estim...
Figure 7.44 Putty material is washed with a light‐body
polyvinyl siloxane
fo...
Figure 7.45 (a) UTS CAD record adjusted in the frontal plane to the patient’...
Figure 7.46 (a) Lip ruler used to measure the length of the maxillary lip; (...
Figure 7.47 (a) Frontal view of virtual rims designed with the receptor site...
Figure 7.48 Fabricated specialized rims with resin occlusal shims attached t...
Figure 7.49 (a) Trial placement of the maxillary and mandibular milled rims;...
Figure 7.50 Gothic arch tracing traced on the gnathometer CAD.
Figure 7.51 (a) Resin tab secured in place on the gnathometer CAD: the hole ...
Figure 7.52 (a) Milled monoblock trial dentures; (b) trial placement of mill...
Figure 7.53 (a) Printed trial dentures; (b) trial placement of printed trial...
Figure 7.54 (a)
Polymethyl methacrylate
disks for milling denture base and t...
Figure 7.55 Oversize milled teeth bonded to oversize milled base for final m...
Figure 7.56 (a) Bicolored monolithic Ivotion disc; (b) virtual design of Ivo...
Figure 7.57 Single milling process of Ivotion disc.
Figure 7.58 Placement of definitive dentures.
Figure 7.59 Maxillary and mandibular Dentca stock trays and lip ruler.
Figure 7.60 (a) Maxillary Dentca detachable tray; (b) mandibular Dentca deta...
Figure 7.61 Surgical blade used to slice through the definitive impression m...
Figure 7.62 Stylus slotted into the mandibular Dentca tray.
Figure 7.63 Aerosol indicator marking spray covering the maxillary occlusal ...
Figure 7.64 Establishment of the appropriate
occlusal vertical dimension
....
Figure 7.65 Gothic arch recording on the maxillary occlusal tracing plate....
Figure 7.66 Dentca jaw relation record.
Figure 7.67 Dentca lip ruler used to measure the length of the maxillary lip...
Figure 7.68 Definitive Dentca dentures.
Figure 7.69 Virtual design of complete dentures.
Figure 7.70 Different available denture teeth.
Figure 7.71 (a) Intaglio surface of the chosen denture teeth mold is milled ...
Figure 7.72 Baltic denture system kit.
Figure 7.73 Available trays with different size and shape of teeth.
Figure 7.74 Maxillary and mandibular dentures after being milled in a five‐a...
Figure 7.75
Polymethyl methacrylate
milling blanks available in three differ...
Figure 7.76 Definitive milled dentures.
Figure 7.77 (a) Resin for three‐dimensional (3D) printing; (b) specially des...
Figure 7.78 (a) Teeth in a chemical bath that contains a conditioning agent;...
Figure 7.79 Definitive printed Dentsply dentures.
Chapter 8
Figure 8.1 According to the dentist's prescription. The digital mandibular c...
Figure 8.2 Framework components are sequentially added to complete the digit...
Figure 8.3 Maxillary master cast is surveyed, blocked‐out, and relieved acco...
Figure 8.4 Completed maxillary CAD framework is ready for Co–Cr milling.
Figure 8.5 Highly automated computer numeric controlled Röders TEC RXD5 high...
Figure 8.6 One‐sided clamping of Co–Cr stock within the fixture permits effi...
Figure 8.7 Milling production of a mandibular RPD framework. The machine's i...
Figure 8.8 With milling production completed, the RPD framework is separated...
Figure 8.9 Note the exceptional quality of the as‐milled cameo surfaces of t...
Figure 8.10 Note the exceptional quality of the as‐milled intaglio surface o...
Figure 8.11 Note the exceptional quality of the as‐milled cameo surface of t...
Figure 8.12 Note the exceptional quality of the as‐milled intaglio surface o...
Figure 8.13 Final Cr–Co framework on the master cast demonstrating the appea...
Figure 8.14 Close‐up occlusal view of right‐side clasp assemblies. Note inti...
Figure 8.15 Close‐up facial view of right‐side direct retainers. Clasp arms ...
Figure 8.16 Close‐up image from a distal perspective of a molar clasp assemb...
Figure 8.17 Maxillary framework design is developed by the dentist, recorded...
Figure 8.18 Scanned cast is digitally surveyed according to the prescribed d...
Figure 8.19 Framework components are sequentially added to the blocked‐out a...
Figure 8.20 Completed maxillary CAD framework.
Figure 8.21 Mandibular framework design is developed by the dentist, recorde...
Figure 8.22 Scanned cast is digitally surveyed according to the prescribed f...
Figure 8.23 Framework components are sequentially added to the prepared digi...
Figure 8.24 Completed mandibular CAD framework.
Figure 8.25 Acetal framework manufacturing will be accomplished in the ZENOT...
Figure 8.26 Parent acetal material is clamped into the fixture within the ma...
Figure 8.27 Still tethered within the parent material, milling of these acet...
Figure 8.28 Completed acetal maxillary framework fitted to the master cast (...
Figure 8.29 Completed acetal mandibular framework fitted to the master cast ...
Figure 8.30 Note less than optimal marginal fit along lingual platting and r...
Figure 8.31 Again, note less than optimal marginal fit along lingual plattin...
Figure 8.32 As required by both manufacturing method and material selection,...
Figure 8.33 Facial view of the excessively bulky circumferential clasp.
Figure 8.34 Manufacturing method and material selected for this framework ne...
Figure 8.35 When the bulky rest illustrated in Figure 8.34 is adjusted to ac...
Figure 8.36 Maxillary master cast is scanned and digital data is imported in...
Figure 8.37 Transfer of the dentist's framework design includes clasp assemb...
Figure 8.38 Cast is digitally surveyed as prescribed keeping the cast tilt t...
Figure 8.39 Parallel and shaped blockout is evident in this image. Framework...
Figure 8.40 Completed maxillary CAD pattern for a PEEK resin RPD framework. ...
Figure 8.41 Mandibular master cast is scanned and digital data is imported i...
Figure 8.42 Cast is digitally surveyed as prescribed and keeping the cast ti...
Figure 8.43 Framework components are sequentially added to the blocked‐out a...
Figure 8.44 Parallel and shaped blockout is evident in this view. Clasp patt...
Figure 8.45 Occlusal view of completed mandibular CAD pattern for a PEEK res...
Figure 8.46 Lingual view of completed mandibular CAD pattern for a PEEK resi...
Figure 8.47 Post‐milling occlusal view of completed maxillary PEEK framework...
Figure 8.48 Post‐milling occlusal view of completed mandibular PEEK framewor...
Figure 8.49 Occlusal view of the finished and polished maxillary PEEK framew...
Figure 8.50 Occlusal view of the finished and polished mandibular PEEK frame...
Figure 8.51 Intaglio surface view of the finished and polished maxillary RPD...
Figure 8.52 Intaglio surface view of the finished and polished mandibular RP...
Figure 8.53 Close‐up facial view of the maxillary right‐side direct retainer...
Figure 8.54 Close‐up lingual view of the mandibular left‐side major connecto...
Figure 8.55 Close‐up occlusal view of the maxillary right‐side clasp assembl...
Figure 8.56 Close‐up lingual view of mandibular anterior sextant. Note the i...
Figure 8.57 Framework design is developed by the dentist, recorded in a pres...
Figure 8.58 Master cast is scanned (7Series desktop scanner, Dental Wings In...
Figure 8.59 Digital cast is manipulated through all virtual spatial planes t...
Figure 8.60 Parallel (or tapered) blockout apical to heights of contour is v...
Figure 8.61 Framework components are sequentially added to the blocked‐out a...
Figure 8.62 Completed maxillary CAD pattern for a Co–Cr alloy framework.
Figure 8.63 Bracing elements are added across the arch and across clasp asse...
Figure 8.64 Vertically oriented supporting elements are automatically added ...
Figure 8.65 Automated addition of vertical supporting elements must be caref...
Figure 8.66 A build file illustrating designed, braced, and supported digita...
Figure 8.67 Additive Manufacturing Systems M 270 for direct metal laser sint...
Figure 8.68 Within the sintering chamber, a thin layer of metal alloy powder...
Figure 8.69 Re‐coater blade sweeps across the submerged build platform distr...
Figure 8.70 Re‐coater blade has now moved across the build platform distribu...
Figure 8.71 Computer‐controlled sintering of metal alloy particles continues...
Figure 8.72 With the sintering process completed and the chamber door opened...
Figure 8.73 Build platform is raised and powder dispersed to reveal the addi...
Figure 8.74 Co–Cr alloy frameworks with as‐manufactured surface finish still...
Figure 8.75 Frameworks are subjected to two heat treatments. The first (temp...
Figure 8.76 Frameworks still attached to the build platform in the process o...
Figure 8.77 Supporting elements are fractured by hand from their connection ...
Figure 8.78 Bracing elements remain attached to the frameworks in preparatio...
Figure 8.79 Second heat treatment (annealing) is accomplished to produce the...
Figure 8.80 Finished and polished framework seated on the master cast (above...
Figure 8.81 A completed maxillary SLM framework seated on the master cast. C...
Figure 8.82 Completed mandibular SLM framework seated on the master cast. Ma...
Figure 8.83 Visual inspection of rest, clasp, and major connector margin ada...
Figure 8.84 A completed mandibular SLM framework seated on the master cast. ...
Figure 8.85 Visual assessment of this maxillary SLM framework reveals visual...
Figure 8.86 Visual assessment of this maxillary SLM framework reveals visual...
Figure 8.87 Direct manufacturing Objet Eden 260VS Dental Advantage 3D printe...
Figure 8.88 Water‐soluble support material and light‐activated pattern resin...
Figure 8.89 Build platform is vertically lowered (
≥
16 μm build layers)...
Figure 8.90 Completed resin framework pattern with support material removed....
Figure 8.91 Moving out of the digital workflow, multiple printed framework p...
Chapter 9
Figure 9.1 Classification of computer‐aided implant surgery.
Figure 9.2 Static computer‐aided implant placement in completely edentulous ...
Figure 9.3 Clinical case demonstrating an unbounded edentulous space using a...
Figure 9.4 Patient with edentulous left central incisor extracted six weeks ...
Figure 9.5 Superimposition/registration as part of the process for static co...
Figure 9.6 Digital implant planning for fully guided implant placement of a ...
Figure 9.7 (a) Surgical guide in position after full‐thickness flap elevatio...
Figure 9.8 (a) Guided bone regeneration using autogenous bone with deprotein...
Figure 9.9 (a) Facial view; (b) occlusal view of the surgical site three mon...
Figure 9.10 Workflow for static computer‐aided implant placement in partial ...
Figure 9.11 Digital implant planning of fully edentulous patient using doubl...
Figure 9.12 Surgical sequence of fully guided implant placement in fully ede...
Figure 9.13 Illustration of a (a) panoramic view of initial implant planning...
Figure 9.14 (a) Panoramic view; (b) frontal clinical view of final metal‐cer...
Figure 9.15 Digital implant planning of fully edentulous patient using seque...
Figure 9.16 Surgical sequence of fully guided implant placement using sequen...
Figure 9.17 Provisional restoration was a milled PMMA with anchor pins in th...
Figure 9.18 Workflow for static computer‐aided implant placement in complete...
Figure 9.19 Workflow for dynamic computer‐aided implant placement.
Figure 9.20 Workflow for robot‐assisted (haptic guidance) implant placement....
Chapter 10
Figure 10.1 Use of titanium abutments to restore implants with severe angula...
Figure 10.2 (a) A titanium prefabricated abutment designed for an implant wi...
Figure 10.3 A GoldAdapt (NobelBiocare) custom abutment and retaining screw, ...
Figure 10.4 (a) Healing abutments placed on implants in the area of mandibul...
Figure 10.5 Overall implant restoration workflow based on design types, scre...
Figure 10.6 Overall implant restoration design and manufacturing workflow.
Figure 10.7 (a) Example of a NobelBiocare scan body; (b) alignment of scan b...
Figure 10.8 (a) A split‐file design shown in 3Shape's dental design software...
Figure 10.9 (a) Occlusal view of scanned master cast and the design of CAD/C...
Figure 10.10 (a) Scanned mandibular cast and design of custom abutment on th...
Figure 10.11 (a) Occlusal view of milled ATLANTIS abutments fabricated by DE...
Figure 10.12 (a) Occlusal view of metal ceramic‐restorations fabricated on t...
Figure 10.13 (a) Custom abutments designed using the NobelProcera system; (b...
Figure 10.14 (a) Occlusal view of free‐form milled bar fabricated using the ...
Figure 10.15 (a) Frontal view of master cast that is scanned into NobelProce...
Figure 10.16 The Encode healing abutment (Biomet 3I).
Figure 10.17 NobelBiocare's multiunit abutments (MUAs): 17°, 4‐mm high MUA, ...
Figure 10.18 (a) Clinical presentation at the time of implant‐level impressi...
Chapter 11
Figure 11.1 (a) Fully adjustable articulator can be adjusted to duplicate a ...
Figure 11.2 Semi‐adjustable articulator (Model 2240 Articulator; Whipmix Cor...
Figure 11.3 (a) A protrusive record can be made intraorally with record base...
Figure 11.4 (a) A mathematically simulated virtual articulator is similar to...
Figure 11.5 The application of facial scan, intraoral scan, and virtual arti...
Figure 11.6 In a brief summarized digital workflow, three clinical steps are...
Figure 11.7 Older models of intraoral scanners may require surface powdering...
Figure 11.8 (a) New generation of intraoral scanners does not require the us...
Figure 11.9 (a) Standard tessellation language (STL) file is widely used in ...
Figure 11.10 (a) Structured light technology (GO!SCAN 50; Creaform 3D scanni...
Figure 11.11 Stationary stereophotogrammetry‐based facial scanner (3DMD) sho...
Figure 11.12 (a) Low‐cost stereophotogrammetry‐based facial scanner (Bellus ...
Figure 11.13 It is critical to record facial anatomic surface landmarks accu...
Figure 11.14 (a) Cone‐beam computed tomography (CBCT) is now an essential 3D...
Figure 11.15 (a) Virtual interocclusal records can be made with intraoral sc...
Figure 11.16 New generation of intraoral scanners usually offer occlusal ana...
Figure 11.17 (a) Dual scan protocol for computer‐guided surgery planning is ...
Figure 11.18 (a) Intraoral scans in the polygon file format (PLY) file forma...
Figure 11.19 (a) Different reference planes can be selected to align 3D virt...
Figure 11.20 (a) CAD/CAM prostheses are designed on the intraoral scans. In ...
Chapter 12
Figure 12.1 (a) Traditional radiograph; (b)
cone beam computed tomography
(C...
Figure 12.2 (a) Typical magnetic resonance image of posterior teeth and surr...
Figure 12.3 The Mora Vision video imaging system is an example of digital il...
Figure 12.4 (a) Ultrasonic instruments of varying types and sizes for differ...
Figure 12.5 (a) GentleWave unit; (b) mandibular molar isolated and accessed;...
Figure 12.6 (a) Calcified #6 with periapical pain and radiolucency; (b)
cone
...
Chapter 13
Figure 13.1 Chronological history of orthodontics and digital orthodontics....
Figure 13.2 (a) Digital maxillary periapical X‐ray. (b) Digital mandibular p...
Figure 13.3 Digital maxillary and mandibular bitewing X‐ray.
Figure 13.4 Digital panoramic X‐ray.
Figure 13.5 Midpalatal skeletal maturation system stages.
Figure 13.6 (a) Digital lateral cephalometric X‐ray. (b) Digital lateral cep...
Figure 13.7 (a) Digital cone beam computed tomography (CBCT) occlusal view w...
Figure 13.8 Magnetic Resonance Imaging (MRI) of a temporomandibular joint (T...
Figure 13.9 (a) Canon photographic camera. (b) Nikon photographic camera. (c...
Figure 13.10 (a) iTero intraoral dental scanner (Align Technology). (b) 3Sha...
Figure 13.11 Invisalign ClinCheck example.
Figure 13.12 Maxillary and mandibular Invisalign clear aligners.
Figure 13.13 Example of bondable attachments to better guide dental movement...
Chapter 14
Figure 14.1 Illustrative steps showing construction sequence of an implant‐r...
Figure 14.2 An example of a light scanner employed in scanning a cast model ...
Figure 14.3 Shows a patient with right orbital defect where his photogrammet...
Figure 14.4 A three‐dimensional image of a patient's face (in silver) amalga...
Figure 14.5 Screen view of segmentation software (CMF Pro Plan) showing pati...
Figure 14.6 Three‐dimensional reconstructions of a patient's hard tissue (bo...
Figure 14.7 Novel treatment of left‐side mandibular hyperplasia via mirror i...
Figure 14.8 Computer‐aided design of large orbital prosthesis restoring righ...
Figure 14.9 Managing bilaterally missing ears via three‐dimensional planning...
Figure 14.10 Three‐dimensional planning of implant placement and inclination...
Figure 14.11 Three‐dimensional planning of bimaxillary jaw movement and corr...
Figure 14.12 Digital skin reproduction of four different areas of an ear to ...
Figure 14.13 Image of a three‐dimensional (3D)‐printed nose of different ski...
Figure 14.14 Packing a silicone elastomer inside a three‐dimensional designe...
Figure 14.15 One of the first cases to report a three‐dimensional printed no...
Chapter 15
Figure 15.1 (a) Panoramic radiograph depicting maxillary supernumerary teeth...
Figure 15.2 Intraoral digital occlusal scans (TRIOs).
Figure 15.3 (a) Three‐dimensional virtual planning of implants to ensure avo...
Figure 15.4 (a) Three‐dimensional view of a cone‐beam computed tomographic (...
Figure 15.5 (a) In cases with multiple supernumerary impactions, a cone‐beam...
Figure 15.6 (a) Ossifying fibroma of the mandible showing the relationship o...
Figure 15.7 (a) Cortical expansion, thinning, and perforation can be seen fr...
Figure 15.8 (a) Computed tomography (bone window) showing loss of the superi...
Figure 15.9 (a) Cone‐beam computed tomography localization of salivary stone...
Figure 15.10 (a) Endoscopic view of salivary stone within Wharton’s duct of ...
Figure 15.11 (a) Virtual surgical plan of double‐barrel fibula flap with sim...
Figure 15.12 (a) Three‐dimensional printed cutting guide and implant placeme...
Figure 15.13 (a) Composite skull representing digital analog of patient skul...
Figure 15.14 Virtual surgical plan showing maxillomandibular advancement for...
Figure 15.15 Digital planning for custom porous (1) and (2) polyethylene che...
Figure 15.16 Virtual surgical plan for bilateral custom alloplastic total te...
Figure 15.17 Three‐dimensional reconstruction of a pan‐facial fracture.
Figure 15.18 (a) Stereolithic (SLA) model of orbital floor fracture; (b) cus...
Figure 15.19 (a) A case of poor treatment of bilateral mandible fractures us...
Figure 15.20 (a) Virtual surgical plan for a three‐dimensional (3D) printed ...
Figure 15.21 Navigation used to map out the margins of a maxillary ossifying...
Figure 15.22 (a) Robotic‐assisted surgery (DaVinci system) being used to per...
Figure 15.23 Robotic surgery (MedRobotics system) uses a robotic camera whil...
Guide
Cover Page
Title Page
Copyright Page
Dedication Page
Notes on Contributors
Preface
About the Companion Website
Table of Contents
Begin Reading
Index
Wiley End User License Agreement
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Clinical Applications of Digital Dental Technology
Second Edition
Edited by
Radi Masri, BDS, MS, PhD
University of Maryland
Baltimore
MD, USA
Carl F. Driscoll, DMD
University of Maryland
Baltimore
MD, USA
This second edition first published 2023© 2023 John Wiley & Sons, Inc.
Edition HistoryJohn Wiley & Sons (1e, 2015)
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of Radi Masri and Carl F. Driscoll to be identified as the authors of the editorial material in this work has been asserted in accordance with law.
Registered OfficeJohn Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA
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Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials, or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Library of Congress Cataloging‐in‐Publication DataNames: Masri, Radi, 1975‐ editor. | Driscoll, Carl F., editor.Title: Clinical applications of digital dental technology / edited by Radi Masri, Carl F. Driscoll.Description: Second edition. | Hoboken, NJ : Wiley‐Blackwell, 2023. | Includes bibliographical references and index.Identifiers: LCCN 2022019896 (print) | LCCN 2022019897 (ebook) | ISBN 9781119800583 (cloth) | ISBN 9781119800590 (Adobe PDF) | ISBN 9781119800606 (epub)Subjects: MESH: Technology, Dental | Prosthodontics–methods | Endodontics–methods | Surgery, Computer‐Assisted | Radiography, Dental, Digital | Computer‐Aided DesignClassification: LCC RK656 (print) | LCC RK656 (ebook) | NLM WU 150 | DDC 617.6/90284–dc23/eng/20220810LC record available at https://lccn.loc.gov/2022019896LC ebook record available at https://lccn.loc.gov/2022019897
Cover Image: Courtesy of Radi MasriCover Design by Wiley
By Radi MasriTo my family, who allowed me the latitude to grow and excel. To JJ and Adam who continue to remind me what life is truly about, and to my previous, current, and past residents who I continuously learn from.
By Carl F. DriscollWith heartfelt thanks, this book is dedicated to all my mentors, residents, colleagues, family, and friends that encouraged me to follow my dream of being a dentist, prosthodontist, educator, author, and researcher. A special dedication to my co‐author, Radi Masri, who started out as my resident but has developed over the years to be my colleague, mentor, and supervisor, but most of all, my friend.
Notes on Contributors
Hongseok An, DDS, MSDAssistant Professor of Prosthodontics and Director of the digital dentistry curriculum at Marquette University School of Dentistry
Nadim Z. Baba, DMD, MSD, FACPProfessor, Advanced Specialty Education Program in Prosthodontics Loma Linda University School of Dentistry Loma Linda, CAUSA
Jose A. Bosio, BDS, MSAlumni & Friends of Orthodontics Endowed Clinical Associate ProfessorDivision Chief of and Postgraduate Orthodontic Program DirectorDepartment of Orthodontics and Pediatric DentistryUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
David R. Cagna, DMD, MSProfessor and ChairDepartment of Prosthodontics and Associate Dean Postgraduate Affairs DirectorAdvanced Prosthodontics ProgramUniversity of Tennessee Health Science: Center College of DentistryMemphis, TNUSA
Seung Kee Choi, DMD, MSClinical Assistant ProfessorDivision of ProsthodonticsUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
Nicholas Callahan, MD, MPH, DMDAssociate ProfessorDepartment of Oral and Maxillofacial SurgeryUniversity of Illinois, College of DentistryChicago, ILUSA
Andre Barbisan De Souza, DDS, MScAssistant ProfessorDepartment of ProsthodonticsTufts University School of Dental Medicine Boston, MAUSA
Carl F. Driscoll, DMDProfessorDivision of ProsthodonticsUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
Private practice
Ashraf F. Fouad, DDS, MSProfessor and Chair, Department of EndodonticsDirector, Advanced Educational Program in EndodonticsSchool of Dentistry, UABThe University of Alabama at Birmingham
Brian J. Goodacre, DDS, MSDDirectorClinical TechnologiesNobel Biocare North AmericaBrea, CAUSA
Adjunct Associate ProfessorLoma Linda University School of DentistryLoma Linda, CAUSA
Charles J. Goodacre, DDS, MSDDistinguished ProfessorLoma Linda University School of DentistryLoma Linda, CAUSA
Sarah E. Goodacre, DDSDental General Practice Residency DirectorVeterans Administration Healthcare SystemLoma Linda, CAUSA
Gerald T. Grant, DMD, MS, FACPProfessorDepartment of Rehabilitation and Restorative DentistryUniversity of Louisville School of DentistryLouisville, KYUSA
Gary D. Hack, DDSAssociate ProfessorUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
Michael Han, DDS, FACSAssistant Professor and Program DirectorDepartment of Oral and Maxillofacial SurgeryUniversity of IllinoisCollege of DentistryChicago, ILUSA
Muhanad Moh’d Hatamleh, BSc, MPhil, MSc, Dip, PhDConsultant Clinical ScientistLondonUK
Assistant ProfessorLuminus Technical University CollegeAmman, Jordan
Scott Hollis, DDS, MDSAssociate ProfessorDepartment of Prosthodontics and Assistant DirectorAdvanced Prosthodontics ProgramUniversity of Tennessee Health Science Center: College of DentistryMemphis, TNUSA
Joanna Kempler, DDS, MSPrivate PracticeWaldorf, MDUSA
Frank LaucielloDirector of Removable Prosthodontics ResearchDevelopment and Education for Ivoclar VivadentAmherst, NYUSA
Clinical Associate Professor in the Restorative Department at SUNYBuffalo, NYUSA
Wei‐Shao Lin, DDS, FACP, PhD, MBAAssociate ProfessorProgram Director, and Interim ChairAdvanced Education Program in ProsthodonticsDepartment of ProsthodonticsIndiana University School of DentistryIndianapolis, INUSA
Mariam Margvelashvili‐Malament, DMD, MSc, PhDAssistant ProfessorDepartment of ProsthodonticsTufts University School of Dental MedicineBoston, MAUSA
Radi Masri, DDS, MS, PhDProgram Director and ProfessorDivision of ProsthodonticsUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
Michael Miloro, DMD, MD, FACSProfessor and HeadDepartment of Oral and Maxillofacial SurgeryUniversity of Illinois College of DentistryChicago, ILUSA
Dean Morton, BDS, MSProfessor, DirectorCenter for ImplantEsthetic and Innovative DentistryDepartment of ProsthodonticsIndiana University School of DentistryIndianapolis, INUSA
Jeffery B. Price, DDS, MS, MAGDDepartment of Oncology & Diagnostic SciencesUniversity of Maryland School of DentistryUniversity of MarylandBaltimore, MDUSA
Marta Revilla‐León, DDS, MSD, PhDAffiliate Assistant ProfessorGraduate ProsthodonticsDepartment of Restorative DentistrySchool of DentistryUniversity of WashingtonSeattle, WAUSA
Director of Research and Digital DentistryKois CenterSeattle, WAUSA
Adjunct ProfessorDepartment of ProsthodonticsTufts UniversityBoston, MAUSA
Ramtin Sadid‐Zadeh, DDS, MSAssistant Professor and Assistant Dean of Digital TechnologyDepartment of Restorative DentistryUniversity at Buffalo School of Dental MedicineBuffalo, NYUSA
Geoffrey A. Thompson, DDS, MS
Professor of Prosthodontics
Dental College of Georgia at Augusta University
Hans‐Peter Weber, DMD, Dr. Med. DentProsthodontics EmeritusTufts University School of Dental MedicineMedford CampusMedford, MAUSA
ProsthodontistClearChoice Dental Implant CenterQuincy, MAUSA
Chao‐Chieh Yang, DDS, MSDClinical Assistant ProfessorAssistant Program Director, Advanced Education Program in ProsthodonticsDepartment of ProsthodonticsIndiana University School of DentistryIndianapolis, INUSA
Amirali Zandinejad, DDS, MScAssociate Professor with Tenure and Program Director AEGD Residency ProgramDepartment of Comprehensive DentistryCollege of DentistryTexas A&M UniversityDallas, TXUSA
Preface
The evolution of the art and science of dentistry has always been gradual and steady, driven primarily by innovations and new treatment protocols that challenged conventional wisdom such as the invention of the turbine hand piece and the introduction of dental endosseous implants.
While these innovations were few and far between, the recent explosion in digital technology, software, scanning, and manufacturing capabilities caused an unparalleled revolution leading to a major paradigm shift in all aspects of dentistry. Not only is digital radiography routine practice in dental clinics these days, but virtual planning and computer‐aided design and manufacturing are also becoming mainstream. Digital impressions, digitally fabricated dentures, and the virtual patient are no longer science fiction, but are indeed, a reality.
A new discipline, digital dentistry, has emerged and the dental field is scrambling to fully integrate it into clinical practice and educational curricula and as such, a comprehensive textbook that details the digital technology available, describes its indications, contraindications, advantages, disadvantages, limitations, and applications in the various dental fields is sorely needed.
There are a limited number of books and book chapters that address digital radiography, digital surgical treatment planning, and digital photography, but none address digital dentistry comprehensively. Although these topics will be addressed in this book, the scope is entirely different. The main focus is the practical application of digital technology in all aspects of dentistry. Available technologies will be discussed and critically evaluated to detail how they are incorporated in daily practice across all specialties. Realizing that technology changes rapidly, developing technologies and those expected to be on the market in the future will also be discussed.
Thus, this book is intended for a broad audience that includes dental students, general practitioners, specialists of all the dental disciplines, including prosthodontists, endodontists, orthodontists, oral and maxillofacial surgeons, periodontists, and oral and maxillofacial radiologists. It is also useful for laboratory technicians, dental assistants, and dental hygienists and anyone interested in recent digital advances in the dental field. We hope the reader will gain a comprehensive understanding of digital applications in dentistry.
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/masri/clinical
The website includes:
Videos
1Digital Imaging
Jeffery B. Price
1.1 Introduction
Imaging, in one form or another, has been used in the dental profession since the first intraoral radiographic images were exposed by the German dentist, Otto Walkhoff (Langland et al. 1984) in early 1896, just 14 days after W.C. Röntgen publicly announced his discovery of X‐rays (McCoy 1919, Bushong 2008). Many landmark improvements have been made over the more than 120‐year history of oral radiography (American Association of Oral and Maxillofacial Radiologists (AAOMR)2021, Molteni 2021).
The first receptors were glass, but film set the standard for the greater part of the twentieth century until the 1990s, when the development of digital radiography for dental use was commercialized by the Trophy company who released the RVGui system (Mouyen et al. 1989). Other companies such as Kodak, Gendex, Schick, Planmeca, Sirona, and Dexis were also early pioneers of digital radiography.
The adoption of digital radiography by the dental profession has been slow but steady and seems to have been governed, at least partly, by the “diffusion of innovation” theory espoused by Dr. Everett Rogers (2003). His work describes how various technological improvements have been adopted by end‐users of technology throughout the second‐half of the twentieth and early twenty‐first centuries. Two of the most important tenets of adoption of technology are the concepts of threshold and critical mass.
Threshold is a trait of a group and refers to the number of individuals in a group who must be using a technology or engaging in an activity before an individual adopts technology or engages in an activity. Critical mass is another characteristic of a group and occurs at the point in time when enough individuals in the group have adopted an innovation to allow for the self‐sustaining future growth of adoption of the innovation. As more innovators adopt a technology, such as digital radiography, the perceived benefit of the technology becomes greater and greater to ever increasing numbers of other future adopters until eventually the technology becomes commonplace.
Digital radiography is the most common advanced dental technology that patients experience during diagnostic visits. According to the most recent dental office survey completed by the Conference of Radiation Control Program Directors in 2014–2015 and published in 2019, 86% of offices used digital imaging (Conference of Radiation Control Program Directors 2019). The numbers of dentists using digital imaging continue to increase. If you are still using film, the question should not be “Should I switch to a digital radiography system?” but instead “Which digital system will most easily integrate into my office?”
This leads to another question – What advantages do digital radiography offer the dental profession as compared with simply continuing with the use of conventional film? Let us look at them.
1.1.1 Digital Versus Conventional Film Radiography
The most common speed class, or sensitivity, of intraoral film has been D‐speed film; the prime example of this film in the United States is Kodak’s Ultra‐Speed National Council on Radiation Protection and Measurements (NCRP2012). The amount of radiation dose required to generate a diagnostic image using this film is approximately twice the amount required for Kodak’s Insight, an F‐speed film; in other words, F‐speed film is twice as fast as D‐speed film. According to Moyal, who used the 1999 NEXT data, the skin entrance dose of a typical D‐speed posterior bitewing is ~1.7 mGy (Moyal 2007). According to NCRP Report #172, the median skin entrance dose for a D‐speed film exposure is ~2.2 mGy, whereas the typical E–F‐speed film dose is ~1.3 mGy, and the median skin entrance dose from digital systems is ~0.8 mGy (NCRP 2012). According to NCRP #145 and others, it appears that dentists who use F‐speed film tend to over‐expose the film and then under‐develop it; this explains why the radiation dose savings with F‐speed film is not as great as it could be since F‐speed film is twice as fast as D‐speed film (NCRP 2004, NCRP 2012). If F‐speed film were used per the manufacturers’ instructions, the exposure time and/or milliamperage would be half that of D‐speed film and the radiation dose would then be half.
Why has there been so much resistance against the dental profession moving away from D‐speed film and embracing digital radiography? First of all, operating a dental office is much like running a fine‐tuned production or manufacturing facility; dentists spend years perfecting all the systems needed in a dental office, including the radiography system. Changing the type of imaging system risks upsetting the dentist’s capability to generate comprehensive diagnoses. To persuade individual dentists to change, there has to be compelling reasons. Until recently, most of the dentists in the United States have not been persuaded to make the change to digital radiography. It has taken many years to reach the threshold and the critical mass for the dental profession to make the switch to digital radiography. And, in all likelihood, there are dentists who will retire from active practice before they switch from film to digital radiography.
There are many reasons to adopt digital radiography: decreased environmental burdens by eliminating developer and fixer chemicals along with the associated silver and iodide bromide chemical waste; improved accuracy in image processing of digital images; decreased time required to capture and view images with increased efficiency of patient treatment; reduced radiation dose to the patient; improved ability to involve the patient in the diagnosis and treatment planning process with co‐diagnosis and patient education while viewing images on a computer monitor; and viewing software to dynamically enhance the image (Wenzel 2006, Wenzel and Møystad 2010, Farman et al. 2008). However, if dentists are to enjoy these benefits, the radiographic diagnoses for digital systems must be at least as reliably accurate as those obtained with film (Wenzel 2006).
Two primary co‐factors seem to be more important than others in driving more dentists away from film and toward digital radiography – the increased use of computers in the dental office and the reduced radiation doses with digital radiography. These factors will be explored further in the next section.
1.1.1.1 Increased Use of Computers in The Dental Office
This book’s focus is digital dentistry and later sections will deal with how computers interface with every facet of dentistry. The earliest uses of the computer in dentistry were in the business office and accounting. Over the ensuing years, computer use spread to full‐service practice management systems with digital electronic patient charts, including digital image management systems. The use of computers in the business operations side of the dental practice allowed dentists to gain experience and confidence in how computers could increase financial efficiency and reliability in practice operations. The next step was to integrate computer applications developed for clinical uses. As a component of creating the virtual dental patient, initially, the two most prominent roles were electronic patient records and digital radiography. In the following sections, we will explore the attributes of digital radiography, including decreased radiation doses as compared with film, improved operator workflow and efficiency, fewer errors with fewer retakes, wider dynamic range, increased opportunity for co‐diagnosis and patient education with the patient, improved image storage and retrievability, and communication with other providers (Farman et al. 2008
