Article Type : Editorials
Authors : Sikri A and Sikri J
Keywords : Dental sciences
Digitization in dental sciences is ever changing the
globe, and medicine is not any exception. The overview of a plethora of digital
devices namely the digital scanners both intraoral & extra oral with the
advent of facial scanners in conjunction to the 3D diagnostic modalities like
CBCT (Cone Beam Computed Tomography), along with designing modality namely CAD
(Computer Aided Designing) & machining/milling of the prosthesis i.e., CAM
(Computer Assisted Milling) has totally changed the whole landscape of the
dental sciences.
Classically, 2D diagnostic technologies namely the
IOPA (Intra Oral Peri Apical) radiographs, OPG (Panoramic radiographs) &
Cephalometric radiography, have been used in the past. There was a gradual
shift over to the 3D diagnostics with the inception of digitization in dental
sciences.
In today’s era of advancement, digitization is ever
changing the workflow and consequently ever-changing operational procedures.
The unique workflow generally uses the phases namely accretion of the image,
knowledge preparation/processing, the assembly, and application of the same in
clinical practices. Image acquisition generally uses tools like digital
cameras, intraoral scanners, and CBCT. Digital photography in conjunction with
the image process & virtual patient is collectively known as Digital Smile
Design (DSD) concept, a ubiquitous tool in trendy dental medicine [1-4].
Digital Scanners combine both Intraoral as well as
Extraoral scanners. Intraoral scanners or in other words the optical or digital
impression helps us to capture details of the maxillary and mandibular dental
arches. In addition to the hard tissues, the soft tissue details can also be
captured to a greater extent as a diagnostic data or a part of dental
laboratory communication. Furthermore, this becomes a tool for patient
communication & motivation. Even during the procedure, intraoral scanners
with a broader coverage can be used for impressions of the partially edentulous
or completely edentulous dental arches. However, its use pertaining to the soft
tissue scanning is still questionable and needs further studies. For tooth
preparations and dental implantology, scanners have done wonders. The
dimensional accuracy of the impressions in contrast to the conventional
impressions speaks for itself. The disadvantages of the conventional
impressions have been overcome with the advent of digital scanning
technologies. Even, the laboratory (extra oral) scanners have been used in
cases where a combination of conventional & digital impression technology
is employed [5-7].
The impressions from the digital devices are sent to
the software for further designing in CAD depending upon the choice of the
restoration. During this procedure, laboratory personnel may communicate with
the associated dental practitioner and this further improves the dental
practitioner & laboratory personnel relationships.
The designed data is sent to milling of the prosthesis
(removable or complete denture, inlays, on lays, half-crowns, full crowns,
maxillofacial prosthesis etc.) with the help of CAM which uses a pre-sintered
block to mill the prosthesis through subtractive manufacturing & RP i.e.,
Rapid Prototyping, which uses additive or layer by layer manufacturing of the
prosthesis.
The digital workflow is a boon in the field of
Prosthodontics. In addition to this, the field of Orthodontics has sufficiently
enjoyed the use of digital scanners to capture the details for fabrication of
aligners. Not only this, in field of Dental Implantology, the surgical
templates or guides have done wonders. The use of template guided implantology
has improved the accuracy and precision of the dental implant placement and
further the implant prosthetic treatment outcome.
The use of CBCT as a low dose radiation has helped to
achieve the diagnosis to par excellence in the field of dentistry. Previously,
CT (Computed Tomography) had been in picture for quite a long period of time
for medical imaging diagnosis but later its use was discouraged keeping in view
the larger amounts of radiation dosage associated with the modality. CBCT as a
3D modality has always been superior to the conventional 2D modalities
available. CBCT has really done miracle in the field of dental implantology and
ultimately been fruitful to the dental world.
The use of digital diagnosis along with digital
scanners, designs and machining has totally changed the landscape of dentistry,
giving birth to a new field of dentistry i.e., Digital Dentistry & hence
proving the statement “When Evolution
becomes Revolution”.