Digital dentistry

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Digital dentistry refers to the use of dental technologies or devices that incorporates digital or computer-controlled components to carry out dental procedures rather than using mechanical or electrical tools. The use of digital dentistry can make carrying out dental procedures more efficient than using mechanical tools, both for restorative as diagnostic purposes. Used as a way to facilitate dental treatments and propose new ways to meet rising patient demands.

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The 'father' of digital dentistry is the French professor François Duret, who invented dental CAD/CAM in 1971.[ citation needed ]

Digital dentistry technologies

Some of the technologies used in digital dentistry include:

Intra-oral cameras

X-rays have been extremely valuable for many years in assessments of oral health. However, at times the image produced can show limited information because it is only a 2D image. Intra-oral cameras (IOCs) allow an operator to see a clear image of the inside of the mouth. Similar to the size of a dental mirror IOCs have a tiny camera that is able to detect more on the 3D surface of a tooth than a 2D x-ray image is able to show. Examples include specific locations and sizes of cavities, cracked teeth, excessive erosion, abrasion and many more.

Conventional dental impressions are made by placing an impression material loaded on an impression tray over the dental arches. As it sets a negative imprint of the soft and hard tissues in the mouth. Digital intra-oral impressions made using intra-oral cameras are able to recreate the positive impression of a patient's dentition and other structures into a digital format on a computer almost instantly.

Enhancements

Colour matching

Traditionally dentists will use a physical shade guide in the dental surgery as they compare the patient's teeth to the shades in the guide, all done while the patient is in the chair. Newer computer matching techniques allow for a more superior than matching methods currently used. [2] There is always differences in perception when it comes to the human eye and observation. This was proved in a study which found that there was a high statistical correlation between a spectrophotometer and the digital camera used. [2] Now used in some dental surgeries it can improve dental-laboratory communication.

CAD/CAD in dentistry

CAD/CAM used with intra-oral scanning

Two studies investigated the accuracy of both direct an indirect digitized impressions used to make clinically acceptable zirconia crowns. It was shown that a significantly smaller marginal fit was observed when compared to traditional methods of casting, a more accurate marginal and internal fit. [3] [4] The efficiency and fit of fully ceramic restorations fabricated through CAD/CAM were evaluated through a double-blinded randomized clinical trial. Direct digitized impressions were taken straight from the patients mouths and indirect digitized impression taken from already made impressions. [4] The digitized impressions were then used to create CAD/CAM milled all-ceramic crowns. [3] Between the direct and indirect, the direct digital impression technique was statistically more accurate, they showed significantly better inter-proximal contact. [4] The entire process proved to be more time efficient for both the dentist and patient in comparison with conventional methods or taking impressions with silicone impressions and sending them to a lab.

Use of dental technology in other areas of dentistry

Within the dental profession there are already uses for digital dentistry and as technology continues to develop, proposed uses for the futures. Some examples are outlined below;

Diagnosis of caries

Caries disease process results in structural changes to the dental hard tissue. The diffusion of ions out of the tooth, known as the demineralisation process, will result in loss of mineral content. The resulting region will be filled mainly by bacteria and water. This region will have greater porosity than the surrounding tissue, which results in a distinct change in the optical properties of the affected dental tissue, providing evidence of caries-induced change. Optically based methods detect caries on changes in the specific optical properties.

Quantitative light-induced fluorescence

Changes in enamel fluorescence can be detected and measured when the tooth is illuminated by violet-blue light from a camera hand piece. The image is saved and processed. The end product is an image which gives a measure of the extent and severity of the lesion. [5]

DEXIS CariVu is a digital dentistry device that utilizes near-infrared (NIR) transillumination to detect dental caries. This device causes the tooth enamel and structure to appear transparent but porous carious lesions trap and absorb the light appearing dark in the image. This contrasting image field created makes it easy for suspicious regions that may contain early dental caries to be viewed. This image taken can be stored in electronic health records to be referenced later for monitored treatment plans by a dental professional. This non-invasive, inexpensive, and radiation-free treatment is a promising technology for the early detection of dental caries. [6]

Occlusion and TMJ analysis

Digital orthodontics

Orthodontics along with jaw surgery were the two dental specialty field that adopted CAD/CAM digital technology. [7] Clear aligner treatment specifically the Invisalign appliance was one of the early orthodontic appliances adapting digital design and 3D printing technology in orthodontics. Custom robotic bend wires entered the market around the same time yet failed to penetrate the market as much as aligners. Digital orthodontics, a practice of integrating digital imaging and 3D printing in daily practice of orthodontics is expanding in the field of orthodontics.

Virtual and augmented reality

Virtual reality (VR) is a computer-generated simulation which allows for interactive experience, it fully recreates the environment for which the simulation that is ran. Augmented reality (AR) may be considered a form of virtual reality and is a way of interacting with the real world through a simulation. The objects and individuals are augmented due to them being computer-generated, but are perceived in the real world through a camera onto a screen.

Simulations produced by augmented reality can take on the reason for training activities by using technologically synthesised features which are able to mimic real life situations. [8] These can be used throughout the career timeline of a profession, from undergraduate students, specialised and training days. VR and AR systems are becoming more common in dental education. They will continue to change clinical training and encourage more receptive ways of processing individual learning needs and self-directed learning. Pedagogical tools such as these are said to lower the costs of the educational process while increasing the quality.[ citation needed ]

Limitations

Limitations on digital dentistry include cost, lack of desire to adapt to new dental technology, and misunderstanding of new technologies. [9]

The future

As digital dentistry continues to adapt and becomes more common, the approach to incorporating the topic of digital dentistry in learning outcomes during dental training must also change. As we enter 'the digital age of dental education', future practitioners need to be exposed to new digital procedures in the curriculum and teaching. [10] In an article titled "Digital Teaching and Digital Medicine: A national initiative is needed", it is suggested that faculties and ministries should be the ones to encourage integration of digital teaching into the education of future physicians and students and the learning of digital technologies which are up to date and relevant. [11]

Related Research Articles

<span class="mw-page-title-main">Dentist</span> Health care occupations caring for the mouth and teeth

A dentist, also known as a dental surgeon, is a health care professional who specializes in dentistry, the branch of medicine focused on the teeth, gums, and mouth. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.

Dental products are specially fabricated materials, designed for use in dentistry. There are many different types of dental products, and their characteristics vary according to their intended purpose.

<span class="mw-page-title-main">Bridge (dentistry)</span> Dental restoration for missing teeth

A bridge is a fixed dental restoration used to replace one or more missing teeth by joining an artificial tooth definitively to adjacent teeth or dental implants.

Dental restoration, dental fillings, or simply fillings are treatments used to restore the function, integrity, and morphology of missing tooth structure resulting from caries or external trauma as well as to the replacement of such structure supported by dental implants. They are of two broad types—direct and indirect—and are further classified by location and size. A root canal filling, for example, is a restorative technique used to fill the space where the dental pulp normally resides.

<span class="mw-page-title-main">Crown (dental restoration)</span> Dental prosthetic that recreates the visible portion of a tooth

In dentistry, a crown or a dental cap is a type of dental restoration that completely caps or encircles a tooth or dental implant. A crown may be needed when a large dental cavity threatens the health of a tooth. Some dentists will also finish root canal treatment by covering the exposed tooth with a crown. A crown is typically bonded to the tooth by dental cement. They can be made from various materials, which are usually fabricated using indirect methods. Crowns are used to improve the strength or appearance of teeth and to halt deterioration. While beneficial to dental health, the procedure and materials can be costly.

<span class="mw-page-title-main">Clear aligners</span> Transparent dental braces

Clear aligners are orthodontic devices that are a transparent, plastic form of dental braces used to adjust teeth.

<span class="mw-page-title-main">Inlays and onlays</span> Restoration procedure in dentistry

In dentistry, inlays and onlays are used to fill cavities, and then cemented in place in the tooth. This is an alternative to a direct restoration, made out of composite, amalgam or glass ionomer, that is built up within the mouth.

Teledentistry is the use of information technology and telecommunications for dental care, consultation, education, and public awareness.

<span class="mw-page-title-main">Dental impression</span>

A dental impression is a negative imprint of hard and soft tissues in the mouth from which a positive reproduction, such as a cast or model, can be formed. It is made by placing an appropriate material in a dental impression tray which is designed to roughly fit over the dental arches. The impression material is liquid or semi-solid when first mixed and placed in the mouth. It then sets to become an elastic solid, which usually takes a few minutes depending upon the material. This leaves an imprint of a person's dentition and surrounding structures of the oral cavity.

<span class="mw-page-title-main">CAD/CAM dentistry</span> Computer-aided design and manufacturing of dental prostheses

CAD/CAM dentistry is a field of dentistry and prosthodontics using CAD/CAM to improve the design and creation of dental restorations, especially dental prostheses, including crowns, crown lays, veneers, inlays and onlays, fixed dental prostheses (bridges), dental implant supported restorations, dentures, and orthodontic appliances. CAD/CAM technology allows the delivery of a well-fitting, aesthetic, and a durable prostheses for the patient. CAD/CAM complements earlier technologies used for these purposes by any combination of increasing the speed of design and creation; increasing the convenience or simplicity of the design, creation, and insertion processes; and making possible restorations and appliances that otherwise would have been infeasible. Other goals include reducing unit cost and making affordable restorations and appliances that otherwise would have been prohibitively expensive. However, to date, chairside CAD/CAM often involves extra time on the part of the dentist, and the fee is often at least two times higher than for conventional restorative treatments using lab services.

<span class="mw-page-title-main">Dental radiography</span> X-ray imaging in dentistry

Dental radiographs, commonly known as X-rays, are radiographs used to diagnose hidden dental structures, malignant or benign masses, bone loss, and cavities.

Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery, digital surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.

<span class="mw-page-title-main">Pediatric dentistry</span> Branch of dentistry

Pediatric dentistry is the branch of dentistry dealing with children from birth through adolescence. The specialty of pediatric dentistry is recognized by the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.

Computers and software have been used in dental medicine since the 1960s. Since then, computers and information technology have spread progressively in dental practice. According to one study, in 2000, 85.1% of all dentists in the United States were using computers.

<span class="mw-page-title-main">Panoramic radiograph</span> Type of X-ray

A panoramic radiograph is a panoramic scanning dental X-ray of the upper and lower jaw. It shows a two-dimensional view of a half-circle from ear to ear. Panoramic radiography is a form of focal plane tomography; thus, images of multiple planes are taken to make up the composite panoramic image, where the maxilla and mandible are in the focal trough and the structures that are superficial and deep to the trough are blurred.

<span class="mw-page-title-main">Cone beam computed tomography</span> Medical imaging technique

Cone beam computed tomography is a medical imaging technique consisting of X-ray computed tomography where the X-rays are divergent, forming a cone.

<span class="mw-page-title-main">Align Technology</span> American company that produces orthodontics devices

Align Technology is an American manufacturer of 3D digital scanners and Invisalign clear aligners used in orthodontics. It was founded in 1997 and is headquartered in Tempe, Arizona. The company manufactures the aligners in Juarez, Mexico, and its scanners in Israel and China. The company is best known for its Invisalign system, which is a clear aligner treatment used to straighten teeth.

The history of dental treatments dates back to thousands of years. The scope of this article is limited to the pre-1981 history.

Anterior teeth are some of the most scrutinized teeth, as the size, shape and color of the anterior upper teeth plays an important role in dental aesthetics and smile aesthetics. A few aesthetic anterior problems, such as dental caries, tooth fracture, enamel defects and diastemas, can be solved with composite restorations. Composite restorations can also improve dental aesthetics by changing the shape, color, length and alignment of teeth.

A root-analogue dental implant (RAI) – also known as a truly anatomic dental implant, or an anatomical/custom implant – is a medical device to replace one or more roots of a single tooth immediately after extraction. In contrast to common titanium screw type implants, these implants are custom-made to exactly match the extraction socket of the specific patient. Thus there is usually no need for surgery.

References

  1. ↑ Oberoi G, Nitsch S, Edelmayer M, Janjić K, Müller AS, Agis H (22 November 2018). "3D Printing-Encompassing the Facets of Dentistry". Frontiers in Bioengineering and Biotechnology. 6: 172. doi: 10.3389/fbioe.2018.00172 . PMC   6262086 . PMID   30525032.
  2. 1 2 Jarad FD, Russell MD, Moss BW (July 2005). "The use of digital imaging for colour matching and communication in restorative dentistry". British Dental Journal. 199 (1): 43–9, discussion 33. doi: 10.1038/sj.bdj.4812559 . PMID   16003426.
  3. 1 2 Ahrberg D, Lauer HC, Ahrberg M, Weigl P (March 2016). "Evaluation of fit and efficiency of CAD/CAM fabricated all-ceramic restorations based on direct and indirect digitalization: a double-blinded, randomized clinical trial". Clinical Oral Investigations. 20 (2): 291–300. doi:10.1007/s00784-015-1504-6. PMID   26070435. S2CID   12513904.
  4. 1 2 3 Syrek A, Reich G, Ranftl D, Klein C, Cerny B, Brodesser J (July 2010). "Clinical evaluation of all-ceramic crowns fabricated from intraoral digital impressions based on the principle of active wavefront sampling". Journal of Dentistry. 38 (7): 553–9. doi:10.1016/j.jdent.2010.03.015. PMID   20381576.
  5. ↑ Karlsson L (2010). "Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue". International Journal of Dentistry. 2010: 270729. doi: 10.1155/2010/270729 . PMC   2864452 . PMID   20454579.
  6. ↑ "StackPath".
  7. ↑ D'Urso, Paul S.; Barker, Timothy M.; Earwaker, W. John; Bruce, Lain J.; Atkinson, R. Leigh; Lanigan, Michael W.; Arvier, John F.; Effeney, David J. (February 1999). "Stereolithographic biomodelling in cranio-maxillofacial surgery: a prospective trial". Journal of Cranio-Maxillofacial Surgery. 27 (1): 30–37. doi:10.1016/s1010-5182(99)80007-9. ISSN   1010-5182. PMID   10188125.
  8. ↑ Wierinck E, Puttemans V, van Steenberghe D (February 2006). "Effect of tutorial input in addition to augmented feedback on manual dexterity training and its retention". European Journal of Dental Education. 10 (1): 24–31. doi:10.1111/j.1600-0579.2006.00392.x. PMID   16436081.
  9. ↑ Digital dentistry: Is this the future of dentistry?- Dental Economics
  10. ↑ Duke, Alice (Autumn 2016). "Entering the Digital Age of Dental Education". BDJ Student: 35, 36.
  11. ↑ Haag M, Igel C, Fischer MR (2018). "Digital Teaching and Digital Medicine: A national initiative is needed". GMS Journal for Medical Education. 35 (3): Doc43. doi:10.3205/zma001189. PMC   6120157 . PMID   30186953.
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