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2023: Innovative treatments in dentistry
The first step in the mass introduction of digital diagnostic and treatment tools into dental practice was the use of devices for three-dimensional scanning of the oral cavity, i.e. cone-beam computed tomography (CBCT).
Today, almost every patient received a referral from a dentist for CT, and more and more medium and large clinics are purchasing such equipment for their own use so as not to send patients to CT centers.
Why did this diagnostic method so quickly take such an important place in the field of dentistry? The case is in a combination of three key factors:
- this is very fast - the study itself takes about a minute, the file formation takes 20-25 minutes, after which the patient and the dentist receive a disk with the image;
- complete painlessness and comfort for the patient, which cannot be said about the traditional X-ray image, including the targeted one, when the patient presses a film to the gum with his finger, which causes a vomiting reflex and is especially unpleasant with pulpites;
- highest image accuracy - high detail, three-dimensional format, the ability to study the picture in the oral cavity in layers, from different angles, etc. All this ensures the accuracy of diagnostics, and therefore the accuracy of all manipulations, a decrease in the frequency of complications.
But the introduction of KLKT was just the beginning of the digitalization of dentistry.
Orthodontics and Digital Tools
For many decades, the only method of correcting the bite was the bracket system. It was extremely difficult to predict the result of the treatment, and therefore the result of the treatment was often disappointing for the patient - not to mention that it could last for years. Throughout that time, the patient had to endure food restrictions and carry out complex and long-term hygiene procedures, and after removing the braces under them, broken caries teeth and inflamed gums were often found.
In the 90s of the 20th century, another system was proposed - correction of the bite with removable eliners. The success of this system is largely related to the digital environment. To plan treatment, the orthodontist loads all diagnostic data into a special software and then performs virtual movements of each tooth.
Digital planners help to predict all movements of all teeth with high accuracy, take into account the location of the roots, the state of the bone, soft tissues, etc. As a result, the patient sees the result even before the start of treatment, and the treatment itself is much faster and more comfortable.
Capps-eliners themselves are also made on digitally controlled machines, and therefore are extremely accurate and completely individual: there is not a single similar or identical eliner.
Implantation planning
Special software is also used by implant surgeons: a program based on diagnostic data obtained using digital means helps to plan the installation of implants - to select the length and diameter, select the optimal places for installation, calculate the depth and angle of inclination, etc.
To implement a digital implantation plan, a surgical navigation template is used, which is made by an orthopedist. The template helps the surgeon carry out a fully controlled operation, which significantly reduces the risks of complications and rejection of implants. It is especially important to use digital implants in the smile area and with complete adentation.
Digital prosthetics
Of course, we are not talking about virtual prostheses, but about means that facilitate the patient's position and the doctor's work. This is, firstly, an intraoral scan of the oral cavity instead of taking casts. The scan takes a minute or two, forms a complete and most detailed image of the oral cavity in 3D format. In this, its advantages over taking casts, which last a long time, cause severe discomfort and does not provide the same accuracy.
According to accurate 3D models, it is planned to manufacture a prosthesis. All data is transferred to the dental laboratory, where a dental technician on a milling machine under digital control creates an exact copy of a model made of ceramic or zirconia. Such prostheses provide a tight and tight fit, which protects the tooth and jaw tissues from infection, guarantees high aesthetic qualities of the prosthesis and functionality, since it fully corresponds to the anatomy of the tooth.
For the manufacture of temporary structures, many clinics already use 3D printing, which significantly speeds up the prosthetics process. The patient does not need to wait until a temporary crown is delivered from the laboratory.
In addition, many clinics use the CEREC (English Chirside Economic Restoration of Esthetic Ceramics) technique to create permanent structures right in the dentist's office, without the participation of a dental laboratory. Having received a 3D model after scanning, the doctor sends it to a milling machine, which draws a veneer, tab or crown from a solid block of ceramic. In total, instead of one, or even two weeks, the patient needs to wait only one or two hours.
Author: Yulia Klouda, head of the expert journal on dentistry
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