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11 November 2019

Digital dentistry, dental technology and computer-controlled


Digital dentistry: scope and technologies in orthodontics

Digital dentistry may refer to any dental technology or device that incorporates digital or computer-controlled components in contrast to that of mechanical or electrical alone. The scope of digital dentistry has grown considerably during years, and is used both in diagnostic and treatment procedures. Today, digital dentistry has found its place in everyday dental practice, to facilitate dental treatments and propose new ways to meet rising patient demands. However, in order to be considered as a suitable replacement for conventional dental techniques, digital dentistry should offer: improved efficiency - both cost and time - improved accuracy in comparison to previous methods and high level of predictability of outcomes.

Technologies used in digital dentistry

Below, a brief overview of some of the technologies used in digital dentistry is given. For caries diagnosis, alternative methods, besides visual and radiographic examinations are introduced in the field of digital dentistry. The principle of fiber-optic trans-illumination (FOTI) is that transillumination of areas with disrupted enamel crystals in demineralized tooth tissues results in dark shadows due to changes in the light scattering and absorption of light photons. Another way of caries detection is digital imaging fiber optic transillumination (DIFOTI), which is based on the same principle as FOTI. Near-infrared digital imaging transillumination (NIDIT) is also used in diagnosis of caries, but instead, of using visible light, as in DIFOTI, this device uses a near infrared light to transilluminate the tooth. Lastly, laser fluorescence (LF) caries detection is based on the principle that when a red light is applied to a tooth, the caries-related changes in the tooth tissues lead to an increase in fluorescence. Computer-aided design (CAD) and computer-aided manufacturing (CAM) began its dental life in 1970s, and has now become a well accepted technology in modern dental laboratories and for some clinicians at the chairside. CAD/CAM is based around three elements: (1) data acquisition, (2) data processing and (3) manufacturing. The first two parts of the system play roles in the CAD phase, while the third is responsible for the CAM phase. In the world of digital dental radiography, much attention has been addressed to cone beam computed tomography (CBCT). CBCT machines and their accompanying software have provided a relatively fast and convenient way to acquire and output three-dimensional (3D) multiplanar images. Treatment planning of dental implants is usually performed with the aid of radiographic and clinical examinations. However, conventional techniques do not allow to associate the prosthetic requirements to the bone availability, which may result in errors during the surgical procedure. To prevent errors, guided surgery uses digital workflow on which the placement of dental implants is virtually planned based on surgical and prosthetic needs of the patient. Lasers have been used in dentistry since 1960s and have found a wide range of indications: hard tissue application, the laser is used for caries prevention, bleaching, restorative removal and curing, cavity preparation, whereas soft tissue application includes wound healing, removal of hyperplastic tissue to uncovering of impacted or partially erupted tooth, photodynamic therapy for malignancies, photostimulation of herpetic lesion. Use of the laser proved to be an effective tool to increase efficiency, specificity, ease, and cost and comfort of the dental treatment. Lastly, treatment planning software can be extremely helpful when introducing patients to the dental implant procedure. Clinicians have time to explain the treatment plan and visually demonstrate to patients the need for any additional procedures. It is also possible to discuss success rates, potential complications and treatment alternatives, walking patients through the entire clinical sequence step-by-step. To conclude, digital dentistry has the potential to change conventional techniques used in every day dentistry, and if clinicians are properly educated, it can provide increased joy in practicing dentistry, and better care for the patients.

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