“A CD. How quaint. We have these in museums.”
Eoin Colfer, The Eternity Code
The digital revolution has made its way to the dental field and and digital dentistry is here to stay. The integration of biologic , engineering, computer and material sciences has afforded the field of dentistry many of the advances that used to be a mere imaginary dream in the past.
Electronic Medical Records (EMR)
An electronic medical record (EMR) is a digital version of a paper chart that contains all of a patient’s medical history from one practice. An EMR is mostly used by providers for diagnosis and treatment. Better information means improved and safer health care. The adoption of EMR allows for gathering of more complete and accurate information about a patient’s health. In an emergency, EMR can provide instant access to information about the patient’s medical history, medications, and allergies. No need to look for charts and decipher handwritten notes. It also allows for better coordination of care with other team members and referral sources. Click here< to see how electronic records are improving patient care.
Digital Intra-oral Imaging
A picture is worth a thousand words. Intra oral photography is an indispensable toot in today’s modern dental care. Rather than describing our findings and dental conditions, in a matter of seconds, our patients can see their dental conditions on a computer screen or tablet device. By sharing the images with our patient, we can engage in co-diagnosis and collaborative treatment planning to help restore their mouth to optimal health. Pre-treatment photographs can be stored and added to the Electronic Medical Record. Additionally, in some instances, we can simulate proposed treatments to help visualize how the end result can look like..
The benefits of digital radiography (x-rays) cannot be overstated. First and foremost, they greatly reduce exposure to radiation. Here are some examples of radiation exposure expected from digital radiography.
A digital sensor (small x-rays inside the mouth): 0.004-0.006 mSv (75% less than equivalent film image)
A digital panoramic image (Machine goes around the head for imaging the both jaws): 0.020 mSv
Comparing this to exposure from naturally occurring radiation from the sun and cosmic rays. A flight from London to Los Angeles is 0.080 mSv , the equivalent of FOUR digital panoramic x rays.
There is no need for the use of chemicals and film that are harmful to the environment. Not the mention the inconvenience associated with developing and disposing of the film lead shields and used development solutions. Digital x rays greatly facilitate communication between dentist and patient and among different providers. The digital images are immediately available to view. Using current technology, it is very easy to enhance, enlarge, or refine the X-ray images. Brightness, color and/or contrast of digital X-rays can be adjusted without re-exposing the patient for another film. Patients are now able to view their X-rays instantaneously on the computer monitor screens located in each treatment room. A digital x ray can be sent or received via e mail from any dentist world in a matter of seconds and are stored in the patient’s electronic record without the fear fading or degradation over time.
3-D imaging and Reconstruction
Two-dimensional imaging techniques have been used in dentistry since the first intra-oral radiograph was taken in 1896. Recent advancements in computer technology has enabled the introduction of Cone Beam CT (CBCT) scanners to the dental field. CBCT provides 3-dimensional imaging of the area of interest with great detail similar to the CAT SCAN your medical doctor may order for certain conditions.
A conventional 2-D x-ray is a great diagnostic tool for most dental conditions. However, it only represents a flat image of a three-dimensional object. This, in some instances, can present certain limitations. Three-dimensional imaging opens up another dimension in diagnosis and treatment planning and allows us to visualize certain anatomic structures with greater accuracy and detail. Cross sectional images of the jaws allow the dentist to measure the “thickness” of the bone in the area of interest which is not possible using a conventional 2-D image. The imaging program through certain algorithm, can render a 3-D reconstruction of the area which can be manipulated and in the computer for viewing
Computer Aided treatment Planning
Precision and minimally invasive surgery are the hallmark of 21st century medicine. Recent advances in imaging and 3-D image formatting has enabled us to perform “virtual” implant surgery and treatment planning with extreme precision in a computer environment. The result is a more precise surgery and predictable outcome for our patients. No more guess work or diagnostic mishaps due to lack of information. By performing the implant procedure with the restorative end in mind, we can now offer our patients the best possible results with extreme accuracy, predictability with the least amount of trauma.
3-D printing and modelling
Implant dentistry, from virtual to reality. With 3-D printing technology, we can “print” a physical model of the patient’s anatomy. Imagine the the value of the information that can be gathered form actually “holding” a physical model of the area of interest as opposed to “looking” at a 2-D representation of such a structure. The process starts with acquiring the patient’s anatomic data through a CT scan. This information can then be converted into a three dimensional data file that can be sent to a printing machine that will fabricate the model layer by layer with high accuracy and precision. This technology is about 30 years old but it has just become more available with the introduction of more powerful computers and software program. When needed, a surgical guide can be manufactured from this data that facilitates the surgical procedure and enables us to position the implants based on the virtual surgical plan. Thus connecting the virtual world to the real world.
Computer Aided Design and Manufacturing
Computer aided design and manufacturing (CAD-CAM) has many application in the dental field. Similar to scanning a document on a scanner of fax machine, the dental model can be digitized through scanning with an optical or laser scanner. Once digitized, the digital file can be manipulated and transferred to another program where dental restorations can be designed. The process of designing the dental prosthesis with the aid of computer software and hardware is referred to as computer aided design. This represents the CAD portion of CAD CAM. Once the design has been finalized and approved, the design file can be transferred and converted into a manufacturing file that a milling machine can understand. The milling machine then fabricated the restoration with the exact specifications and material of our choices. This represents the CAM portion of CAD CAM. This process is routinely used for the fabrication of cosmetic and implant restorations and provides us with precise fitting and beautiful looking restorations.