Digital impression scanning — improving workflow and the orthodontic experience

James Bonham discusses how the modern laboratory can benefit the patient and the practice

Today’s technology-centric world associates high-tech with high quality. This holds true in orthodontics, and we have experienced meaningful advancements in recent years. These innovations save time, advance diagnostics, and greatly improve the patient experience in an orthodontic practice. The ability to take digital impressions is a game changing technology that delivers meaningful benefits to doctors, staff, and patients and also to the modern orthodontic laboratory.

Forward-thinking laboratories are searching for ways to improve orthodontic practice efficiency and overall appliance quality. Their experience can be an asset to new digital-scanning offices, offering process implementation assistance and tips for improving scanning techniques. Orthodontists will appreciate the benefits that digital impression systems can provide — optimized workflow, improved case acceptance, reduced impression redundancy, eliminated appointments, and best of all, the ability to produce precision-fit custom lab appliances.

One of the most important aspects of any orthodontic practice is case acceptance. What better selling point to a new patient than discovering that this technology eliminates those goopy, gag-inducing impressions. Patients and orthodontists alike appreciate the fact that after the scan is achieved, treatment options can be reviewed and discussed immediately, and post-orthodontic treatment scenarios can be simulated. This instant consultation tool provides a high-tech educational experience for the patient in addition to providing important information for the doctor.

Digital scanning also improves efficiency by avoiding impression redundancy. The traditional process requires multiple impressions, one for records and a second for any lab appliance. A single digital impression produces 3D models for diagnostic records, and can also be sent to the lab for appliance production or indirect bonding trays.

While patients want the best treatment possible, they also want to achieve their results in the shortest time possible. The timesaving begins by eliminating the conventional separator appointment. The laboratory can digitally separate and fit the bands from the original records scan. Simply place the separators after taking the scan, and then deliver the appliance at the next appointment. Also, a technology-centered lab can make multiple appliances, like an expander and transpalatal arch (TPA), from this single scan. Sophisticated software allows the lab to expand the virtual model to the doctor’s specifications before printing both construction models. The result is the ability for the orthodontist to deliver TPA appliances on the same day of expander removal. This example of digital workflow eliminates two appointments and several weeks of treatment time. Fixed and removable retainers can also be delivered on bracket-removal day.

Many patients will inevitably misplace their removable retainers, causing their teeth to shift. Replacement retainers require a new appointment for impressions. The ideal solution to minimize relapse is to provide back-up retainers for the patient. Digital technology in the lab makes this a simple and affordable solution. Multiple removable retainers with integrated digital enhancements can be produced from one printed model. Orthodontists can increase efficiency and ensure long-term stability with new digital products like the Guardian smile retention system from Specialty Appliances. Retainers can even be delivered at the debonding appointment, as explained in the Guardian process below:

1. One appointment before debonding, remove the archwires and acquire a digital impression, including brackets.
2. Digital technicians use 3D software to carefully remove all appliances from the digital model.
3. Upon request, technicians can also manipulate the model before printing it to include minor anterior refinements and band space closure.
4. The model is printed, and undercuts are blocked out.
5. Multiple retainers can be affordably fashioned from one durable printed model, eliminating the need for future retainer impressions and improving long-term retention potential.
6. Retainers are delivered the same day the braces come off. The patient receives back-up retainers and the printed models for future needs.

Digital impressions equal or exceed the accuracy of conventional impressions, according to full arch impression studies. Deleting multiple traditional impression-taking steps will improve accuracy and greatly reduce distortions. Orthodontic laboratories have corroborated this by reporting a substantial drop in remakes after practices switch to digital impressions. Specialty Appliances’ laboratory also reports dropping from around 7% impression rejections compared to less than 1% with digital impressions. High-resolution accuracy and the scanning software’s ability to immediately identify missing data give clinical assistants an opportunity to capture a new image of the area.

Advancements in technology flourish for the orthodontic practice. Digital enhancements like intraoral scanning are revolutionizing the way orthodontists operate in the modern practice. Taking advantage of these efficiency gains can optimize their scanner investment in a very short time. Partnering with an experienced digital lab will also save orthodontists time and money, and improve their patients’ experience as well as their reputation.