digital international No. 1, 2024
Editorial by Editor-in-Chief Dr Scott D. Ganz: Artificial intelligence—do we need to be smarter?
/ Table of contents
/ Dentistry digests a volatile 2023: The fourth quarter of 2023 yielded mixed results for dental companies as the industry struggled with the ongoing effects of the SARS-CoV-2 pandemic.
/ News: Intra-oral scanners helpful in paediatric dental communication—study
/ Market report by Donna Santos and Dr Kamran Zamanian, iData Research: Digital fuel—what is propelling the markets for 3D printers and other CAD/CAM devices?
/ Clinical report by Ronen Horovitz & Dr George Freedman: 3D face scanning: Affordable and user-friendly
/ Potential of AI as an assistant in oral surgery considering accuracy and legal aspects: An interview with Prof. Víctor Díaz-Flores García
/ “Our vision is to accelerate access to oral care globally”: An interview with Dr Amir Mansouri, CEO of SprintRay
/ The balance between innovation and tradition: An interview with Dr Christoph Reinschmidt and Albin Gygli, Straumann Group
/ User report by Dr Miloš Ljubičič: 3D-printing inlays, onlays and overlays with SprintRay: A revolutionary approach to dental restorations
/ Case report by Dr Marco Degidi & Gianluca Sighinolfi: Immediate loading of the posterior maxilla with two abutment-level bridges produced in a digital workflow
/ Case report by Dr Adam Nulty: Guided implant placement and restoration: A comprehensive approach
/ Case report by Drs Isaac D. Tawil & Scott D. Ganz: Fully digital full arch? Continued advancements in full- arch implant restoration
/ “Photography is absolutely critical for the modern dental practice”: An interview with Dr Mahfuz Rahman
/ Industry news: 3Shape presents new AI workflows
/ Manufacturer news: SprintRay revolutionises chairside 3D-printing workflows
/ Meetings: Dentsply Sirona connects dental professionals at the Implant Solutions World Summit 2024 in Miami, MIS unveils plans for its global conference in Palma de Mallorca
/ International events
/ Submission guidelines
/ Imprint
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[1] =>
1/24
issn 2193-4673 • Vol. 5 • Issue 1/2024
U
case report
Fully digital full arch? Continued advancements
in full-arch implant restoration
RS
O
0 YEA
& 2
IA
OF
E
D
R
The balance between innovation and tradition
IB
EA
interview
F
. • 30 Y
Digital fuel—what is propelling the markets
for 3D printers and other CAD/CAM devices?
N TA L T R
INT
S
international magazine of digital dentistry
news
DE
N
E
digital
OEMUS
M
[2] =>
THE FASTEST 3D PRINTING
ECOSYSTEM JUST GOT FASTER
PRO S
ULTIMATE
SPEED
UPGRADE
F E A T U R I N G
ARCH KIT
AVAIBALE
APRIL
2 0 2 4
THE ARCH KIT PRINT PACK
The Pro S Arch Kit (an exclusive accessory for
SprintRay Pro S printers) includes a compact build
platform and resin tank for use on the Pro S series
printers and provides up to 2X faster prints on all full
arch applications such as night guards. Includes Arch
Kit Build Platform and Arch Kit Resin Tank. The new
feature including optical polish, a Revolution.
Pro S Arch Kit Build Platform with Resin Tank
SPRINTRAY.COM | SPRINTRAY EUROPE GMBH, BRUNNENWEG 11, 64331 WEITERSTADT, GERMANY | INFO.EU@SPRINTRAY.COM
[3] =>
editorial
|
Dr Scott D. Ganz
Editor-in-Chief
Artificial intelligence—
do we need to be smarter?
Artificial intelligence (AI) has become the new buzzword
that for many represents the future of commerce, inventory control, product design, weather pattern prediction,
customer service, data analysis and automation of repetitive tasks. AI can allow a human to play chess against
a computer, which can analyse millions of data points in
seconds to find all possible moves and related outcomes,
or it can manage all the permutations necessary for self-
driving cars to navigate our local streets and major highways. AI can also track your personal data to aid in making
personalised decisions on future purchases based on past
online practices. In the recent Adobe Photoshop release,
AI provides users with an interface to create images just by
entering text phrases. Apps like ChatGPT, originally developed to mimic human conversation, have helped students
write research and term papers with minimal effort and can
compose music, write poetry, debug computer programs,
and much more.
How does this happen? Machine learning is a field of AI that
focuses on enabling computers to learn from and make decisions based on data. Deep learning, a subset of machine
learning, attempts to mimic the way the human brain works
in order to perform complex tasks with increasing accuracy.
Natural language processing uses machine learning techniques to enable computers to understand, interpret and
generate human language. The computer “learns” from experience by constantly adjusting to the data it processes.
Therefore, utilising advanced technologies, computers and
associated devices can be trained to complete certain tasks
by recognising patterns in the data they process at lightning
speed, saving time and potentially minimising human error.
Of course, there are disadvantages, such as the high cost
of development and implementation, potential loss of jobs
for humans who perform these tasks, and serious calculation errors that could cause loss of property and lives, such
as when a self-driving car crashes.
When AI is properly utilised in the fields of medicine and
dentistry, it can offer a number of uses and is especially
beneficial in improving communication, often employing
voice recognition technology, for example in dictation and
the transcription of notes, as well as in remote patient treatment. Among its many other uses are the development of
new drugs and diagnosis of patients.
Two most recent examples in the dental field include the
tracing of the inferior alveolar nerve in the mandible and the
labour-intensive task of segmenting CBCT scan data to help
recognise anatomical entities based on density values. Both
would be part of the diagnostic phase related to identifying
pathology, recognising vital structures and identifying variations
in normal anatomy. The automation of these tasks saves time
for clinicians and dental auxiliaries, improving efficiencies in
the diagnosis and treatment planning phase of patient care.
This can also affect the cost of healthcare for the future.
However, this raises the essential question of who checks to
see if the AI program’s conclusions are correct?
Therefore, when it comes to the health and welfare of a patient,
it is my opinion that we must be smarter than the computer. We
must have the ability to assess the outcomes of AI processes
in order to evaluate and possibly question the results. Was the
inferior alveolar nerve properly traced so that an accurate assess
ment can be determined when dental implants are being
considered for the posterior mandible? We accept that AI will
continue to be developed towards improved diagnostic capabilities. Humans need the knowledge, experience and skill set to
make the final determination for patient care. We have lots of
great information in this first issue of digital for 2024. Enjoy!
Respectfully,
Dr Scott D. Ganz
Editor-in-Chief
1 2024
03
[4] =>
| content
editorial
Artificial intelligence—do we need to be smarter?
03
news
page 28
Dentistry digests a volatile 2023
06
Intra-oral scanners helpful in paediatric dental communication—study 10
Digital fuel—what is propelling the markets
for 3D printers and other CAD/CAM devices?
12
trends & applications
3D face scanning: Affordable and user-friendly
14
interview
Potential of AI as an assistant in oral surgery
considering accuracy and legal aspects
16
An interview with Prof. Víctor Díaz-Flores García
page 46
“Our vision is to accelerate access to oral care globally”
18
An interview with Dr Amir Mansouri
The balance between innovation and tradition
20
An interview with Dr Christoph Reinschmidt and Albin Gygli
user report
3D-printing inlays, onlays and overlays with SprintRay:
A revolutionary approach to dental restorations
22
page 54
case report
Immediate loading of the posterior maxilla
with two abutment-level bridges produced in a digital workflow
26
Guided implant placement and restoration: A comprehensive approach 28
Fully digital full arch? Continued advancements in full-arch implant restoration 34
feature
“Photography is absolutely critical for the modern dental practice”
Cover image courtesy of
Leoniverse/Shutterstock.com
Splash template courtesy of
© gfx_nazim – stock.adobe.com
1/24
issn 2193-4673 • Vol. 5 • Issue 1/2024
DE
F
N TA L T R
IB
U
E
RS
N
O
digital
R
OF
E
D
EA
IA
& 2
. • 30 Y
0 YEA
INT
S
OEMUS
M
international magazine of digital dentistry
industry news
3Shape presents new AI workflows
for improved dental laboratory efficiency
48
manufacturer news
50
meetings
Dentsply Sirona connects dental professionals
at the Implant Solutions World Summit 2024 in Miami
52
MIS unveils plans for its global conference in Palma de Mallorca
54
International events
56
about the publisher
news
Digital fuel—what is propelling the markets
for 3D printers and other CAD/CAM devices?
interview
The balance between innovation and tradition
case report
Fully digital full arch? Continued advancements
in full-arch implant restoration
04
46
1 2024
submission guidelines
international imprint
57
58
[5] =>
dental-tribune.com
dtstudyclub.com
E-newsletter
For 20 years,, Dental Tribune
International has been at the
forefront of dental media, education,
and events, shaping the global
landscape of dental knowledge
dissemination. With a presence
in over 90 countries,
countries Dental
Tribune International stands as
the world’s largest dental
network, connecting profesThe global voice in essential dental media
sionals and industry representatives across the globe. Our
commitment to providing
essential information to the dental
community is unwavering. Since our
inception in Leipzig, Germany, in
2003, Dental Tribune International
has flourished into
a powerhouse.
Our integrated approach merges print,
digital, and educational media,
offering a myriad of marketing
channels to engage with the vast
dental community
worldwide. As we celebrate this
milestone, we proudly
merge our anniversary with our esteemed German forerunner
company, OEMUS MEDIA. With roots dating back to 1994, OEMUS
MEDIA has evolved into a pivotal player and trusted partner in the dental
landscape, setting trends and standards in the German-speaking markets.
Together, Dental Tribune International and OEMUS MEDIA bring forth over
50 years of collective industry expertise, reflecting our commitment to
14
15
innovation, quality, and service excellence.
Celebrating 20 years of
16
Interview
Prof. Phoebus
Madianos discloses
tendees can look
what atforward to at
this year’s
EuroPerio.
News
The European
Federation of
Periodontology
has made sustainab
ility a central
EuroPerio10.
focus of
» page 4
EFP welcomes
attendees
to EuroPerio1
0 in Copenhage
More
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than 130
to present on advancespeakers from over 30 countrie
s
s in periodontics
and implant dentistr
y
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» page 6
terstock.com
Products
EuroPerio offers
the opportunity
to see and
try out the most
current innovation
s in periodontics and implant
dentistry.
» pages 17–20
“We aim to insp
ire excellence
during this yea
r’s EuroPerio”
Holger Essig, chief
marketing
n
An interview with
stock.com
officer of BioHoriz
THE GLOBAL DENTAL CE COMMUNITY
Organised by
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Federation of
As dental profession
(EFP), EuroPeri
dontics and implant
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held from 15
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up for EuroPerio
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[6] =>
© Nokwan007/Shutterstock.com
| news
Dentistry digests a volatile 2023
By Jeremy Booth, Dental Tribune International
Global dental markets proved their resilience during the
SARS-CoV-2 pandemic; however, the real test may have
been yet to come. In the closing months of 2023, the
lingering shadow of the pandemic finally put the lights
out at SmileDirectClub (SDC), and ongoing geopolitical
conflicts in Europe and the Middle East further darkened
consumer confidence in key dental markets. Fourth-
quarter results from the giants of dentistry reflected
caution by private dental clinics and dental support
organisations and financial restraint by patients, and the
period was not without its surprises.
The results of global distributor Henry Schein typically
offer a pulse check on dentistry. In the fourth quarter,
they reminded us that dental markets remain at the
mercy of external forces. A cybersecurity incident that
was announced in October hampered Henry Schein’s
fourth-quarter result to the tune of US$8.0 million
(net of tax; €7.3 million) for professional fees relating to the
incident and caused an estimated revenue reduction of
US$350 million to US$400 million.* The company’s dental sales for the fourth quarter, totalling US$1.8 billion,
06
1 2024
were down by 10.9% year on year. According to the
HIPAA Journal, there were 725 significant cyberattacks
on healthcare companies in 2023, up from 277 ten years
earlier.
The period was also marked by the dull thud of
SDC s huttering its global direct-to-consumer (DTC) clear
aligner business. The self-proclaimed democratiser of
orthodontic care ended operations in December.
Founded in 2014, SDC had been on a strong upward
trajectory until the onset of the pandemic and had become
one of the largest users of 3D-printing technology in the
US. Its closure ended a year of softening demand for
adult orthodontic therapy and left thousands of patients
in the lurch. The effects of the closure on the competitive
landscape for aligner therapy remain to be seen.
Align Technology beats
its own expectations
Aligner shipments from Align Technology in the fourth
quarter totalled 592,635 units—a year-on-year slip
[7] =>
news
of 0.6% and a sequential decrease of 1.6%. The company
had warned analysts in October that it expected sluggish
case starts to linger into the fourth quarter, owing to what
CEO Joseph Hogan described as “deteriorating trends,
including decreased patient visits and increased patient
cancellations, along with fewer orthodontic case starts
overall, especially among adult patients”. Hogan said in
a press release that results for the period were better
than expected, “primarily reflecting a sequential increase
in clear aligner volume for adults and non-comprehensive
cases, growth in Canada and the EMEA (Europe, Middle
East and Africa) region, as well as increased revenues
from systems and services”. Hogan clarified to analysts
that fourth-quarter aligner volumes were down year on
year in the Americas and EMEA region and up in the
Asia Pacific region. Net revenues for the period totalled
US$957 million, a year-on-year increase of 6.1%—made
up of aligner sales of US$782 million, up by 6.9%, and
imaging systems and CAD/CAM services revenue of
US$175 million, up by 2.9%.
For the full year, sales of US$3.9 billion represented
a 3.4% year-on-year gain, helped by a 4.1% increase
in aligner revenues and modest increases in aligner
shipments (0.4%) and in revenues from sales of imaging
systems and CAD/CAM services (0.1%).
Hogan told analysts that Align began offering discounts
in the fourth quarter to patients in the US and a selection
of other markets who had been affected by the recent
bankruptcy of a DTC aligner company. Without n
aming
SDC, Hogan said the bankruptcy event had caused
“many consumers to reach out to Invisalign providers
to address their unmet needs, including helping those
DTC patients with incomplete treatments”.
Dentsply Sirona reports growth in dental
implants and orthodontics
The fourth quarter ended a transitional year for Dentsply
Sirona and marked the first anniversary of its new leadership team. Fourth-quarter sales totalled US$1 billion—
up by 2.9% year on year, or by 1.9% on an organic basis, despite tepid US dental market conditions. US sales
were down by 0.4% (a 1.2% organic drop), and those in
Europe and the rest of the world increased by 5.3% and
4.3%, respectively.
Looking at the company’s business segments, orthodontic and dental implant sales increased by 10.3%,
bolstered by SureSmile aligner sales, which grew by
13.0%. Chief Financial Officer Glenn Coleman told analysts that double-digit growth in the company’s dental implant sales had been a bright spot in the period,
driven by 35% growth in China and higher demand
in Europe. “Globally, premium and value implants saw
similar growth rates. Our US implants business was
|
[...] results from the giants
of dentistry reflected caution
by private dental clinics
and dental support
organisations [...].
down slightly in the quarter, but showed less of a decline than previous quarters, and we anticipate a return
to growth in 2024,” Coleman said. Sales in the company’s
essential dental solutions business, which is made up
of endodontic, restorative and preventive products,
increased by 4.5%. CEO Simon Campion said that
a 7% drop in sales of connected technology solutions had
been “more than expected, mainly due to equipment
and instruments with softness in imaging, which we
anticipate will continue in 2024”.
For the full year, Dentsply Sirona posted net sales of just
under US$4 billion (a 1.1% increase), and the company
ended the year with an operating loss of US$85 million—
a substantial improvement on its operating loss of
US$937 million from 2022.
Campion told analysts that Dentsply Sirona had executed critical transformational initiatives during the
year, including cost-saving initiatives and an e
xpansion
of training and education: “In 2023, we were proud
to offer over 9,200 training and education courses
globally through live, online and hybrid formats, which
reflects about a 30% increase compared to the prior
year,” Campion said.
Emerging markets perform strongly
for Straumann Group
Fourth-quarter sales at Straumann Group totalled
CHF 624 million (€669 million), a year-on-year increase
of 5.5%, or 13.2% on an organic reporting basis. Sales
in North America decreased by 2.0% during the p
eriod,
and those in the EMEA region increased by 0.4%.
The Asia Pacific and Latin America regions were
stronger, showing sales increases of 26.7% and 16.1%,
respectively.
Latin America performed strongest for Straumann
in 2023, having 16.3% sales growth for the full year;
however, full-year sales performance was more subdued
in the EMEA and North America regions, which together
account for some 70% of the company’s total business.
EMEA sales for 2023 reached CHF1.05 billion, a yearon-year increase of 3.7%, and North American sales of
1 2024
07
[8] =>
| news
“Latin America performed strongest for Straumann in 2023,
having 16.3% sales growth for the full year;
however, full-year sales performance was more subdued
in the EMEA and North America regions […].”
CHF689.00 million represented an increase of less than
one percentage point. Straumann banked CHF2.4 billion
in 2023, an increase of 3.9%, or 9.8% on an organic reporting basis, and Chief Financial Officer Yang Xu pointed
out that the negative impact of foreign exchange rates on
Straumann’s bottom line in 2023 was three times greater
than it had been in the prior year.
The company posted an operating loss of US$203 million
for the quarter, owing to a non-cash charge of over
US$258 million related to impairment of goodwill and
intangible assets. Keller explained to analysts: “This
impairment was primarily the result of an increase in the
discount rate driven by sustained higher interest rates and
the impact of a more volatile macro-environment.”
Xu told analysts that Straumann gained market share
in all regions where it operated in 2023—this despite
the North American dental market having experienced
consumer weakness, particularly in implant-based
restorations. Patient flows were steadier in Europe, and
volume-based procurement of dental implants in China
had a positive impact on the company’s sales in Asia.
During the company’s earnings conference, CEO Guillaume
Daniellot described gains made in China in 2023 as having
been of critical importance to its total sales of premium
and challenger implant brands in Asia.
Envista announced in late February that it had begun
a process to find a successor for CEO Amir Aghdaei,
who over a tenure of ten years led Danaher Corp.’s dental
platform and its spin-off to Envista.
Envista Holdings says the North American
market is down by double digits
Fourth-quarter revenue at Envista Holdings Corp. generated
US$646 million and core sales declined by 2% year on
year. The company’s specialty products and technologies segment performed strongly; however, P
rincipal
Financial Officer Stephen Keller explained that this gain
was more than offset by a decline in sales of equipment and consumables. “Geographically, our developed markets declined by 4.8% [and] strong growth in
Western Europe [was] offset by a double-digit decline in
North America,” Keller told analysts. At US$2.57 billion,
earnings for the full year at Envista declined by less than
1% compared with 2022.
Orthodontics continued to be a bright spot in E
nvista’s
portfolio, and Keller explained that the category had
expanded by nearly 15% during the quarter, boosted
by strong sales of brackets and archwires in emerging
markets and continual growth in sales of the Spark aligner
system. During the full year, Spark grew by over 50%.
Another highlight was the company’s intra-oral scanner
business, which grew by 30% during the quarter, driven
by strong demand for DEXIS intra-oral scanners. Envista’s
dental implant business saw a modest decline in the
period, and Keller commented that strong sales in China
were offset by underperformance in North America.
08
1 2024
Job cuts at Ivoclar foreshadow
challenging first quarter
The dental industry has begun 2024 with caution.
Dentsply Sirona conducted a survey of customers in
12 geographies in January and found that US dentists
were feeling slightly more upbeat about the future of the
industry and their practices. Campion warned analysts,
however, that the negative outlook shown by Dentsply
Sirona customers in Germany and Australia in the fourth
quarter had persisted into the new year and that patient
demand in China was continuing at reduced levels.
The difficulties presently facing dental companies were
hammered home by an announcement this month that
the Ivoclar Group will reduce its global headcount by
around 6% in 2024. The Liechtenstein company with
around 3,700 staff said that adverse currency impacts on
its 2023 revenues of CHF856 million (€918 million) had
led to an overall year-on-year fall, despite sales increases
in all regions where it operated. Some 240 jobs are set to
be cut at Ivoclar, and a redundancy scheme has already
been established.
Ivoclar CEO Markus Heinz commented in a press release
that the cost-cutting measures are essential for the future
success of the company. “We have an obligation to act
in the face of this extremely difficult currency situation,
the unfavourable geopolitical and economic developments
and the associated costs that have risen disproportionately,”
Heinz said.
* All conversions were calculated on the OANDA platform
for the last day of trading in 2023 or in the fourth quarter
of 2023.
[9] =>
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[10] =>
© Inna photographer/Shutterstock.com
| news
The researchers behind a recent study on the use of intra-oral scanners in paediatric dental care say that the technology “can clearly be recommended
as a visual aid to improve the communication of dental findings”.
Intra-oral scanners helpful in paediatric
dental communication—study
By Dental Tribune International
Researchers in Germany have studied the efficacy of
intra-oral scanners as a communication tool in paediatric
dentistry by comparing the comprehension of information
provided in verbal explanations with that supplemented
by a scan of the patient’s mouth. According to the researchers, the technology had a positive effect, and the
use of intra-oral scans could lead to greater treatment
acceptance among primary guardians.
In the study, a total of 60 children received a dental
examination and half of them had their mouths scanned
using a TRIOS 4 intra-oral scanner. Information about
the patients’ dentition and proposed treatment plans
was e
xplained verbally to primary guardians in the control group, and intra-oral scans were used as a visual aid
in addition to a verbal explanation for the study group.
The primary guardians then completed a questionnaire
about the children’s diagnoses, proposed treatment
needs and oral hygiene.
The patients presented with 441 permanent teeth and
276 primary teeth. In the primary dentition, a total of
114 teeth had caries, 13 were missing and 24 had been
filled. Of the permanent teeth, 42 showed carious lesions,
three were missing and 35 were filled. Molar incisor
hypomineralisation was observed in 28 teeth, and there
were two cases of lateral occlusion.
10
1 2024
The researchers noted a significant difference between
the questionnaire responses from the two groups. The
study group was able to answer 85.5 of the questions
correctly, compared with 57.2 correct answers in the
control group. In particular, it was observed that the control group had difficulty answering questions concerning
treatment needs and proposed therapy.
The researchers explained that the members of the study
group demonstrated a significantly greater comprehension of their children’s oral health and that using intra-oral
scans as visual aids had enabled the treating dentist to
detail more specifically the affected teeth or areas requiring
improved oral hygiene. “The conditions that caused the
planned treatment were understood better, which may
result in better treatment acceptance,” they wrote.
“[An intra-oral scan] can clearly be recommended as a
v isual aid to improve the communication of dental findings
with [primary guardians] in paediatric dentistry as it significantly increases comprehension, especially regarding
treatment issues,” the authors concluded.
Editorial note: The study, titled “Improving the communication of dental findings in pediatric dentistry by using
intraoral scans as a visual aid: A randomized clinical trial”,
was published on 17 January 2024 in Dentistry Journal.
[11] =>
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[12] =>
| news
Digital fuel—what is propelling
the markets for 3D printers
and other CAD/CAM devices?
By Donna Santos and Dr Kamran Zamanian, Canada
© Monster Ztudio/Shutterstock.com
availability of 3D-printing materials cleared by the US Food
and Drug Administration (FDA), has collectively transformed the market dynamics. Digital fabrication currently
only represents a small percentage of dental prosthesis
production and is largely limited to certain segments;1
however, given the ongoing advancements in digital
dentistry and the steady shift toward digitisation, it is only
a matter of time before digital manufacturing captures
a sizeable portion of the market. The US digital dentistry
market was valued at over $1.2 billion in 2023 and is
projected to reach a valuation of $1.8 billion by 2030.
Ageing population spurring growth
of dental prosthesis markets
In 2020, nearly 17% of the US population were aged
65 years or older. This demographic is expected to
grow by 22% by 2040.2 Furthermore, it is estimated that
20% of US adults aged 65 years or older are completely
edentulous.3 Dental services are in high demand in this
demographic, and an ageing population will increase
the demand for dental prostheses. As demand for
restorations such as crowns, partial and complete
dentures, inlays and onlays increases, the potential for
leveraging digital fabrication techniques will increase
correspondingly.
Dental support organisations
Digital fabrication in dentistry encompasses new and
old technologies—3D printing being in its early stages
of development and other CAD/CAM systems having
reached the ripe old age of 50. Given the tremendous
shift towards digitisation that is taking place in dentistry,
these technologies are expected to capture a broader
swathe of dental prosthesis markets in the coming years.
This article considers the factors that will fuel growth
in the US markets for CAD/CAM devices, including
3D printers.
Over the past decade, the dental industry has undergone
significant evolution, marked by the integration of the
processes and workflows of digital dentistry. Continuous
innovation in CAD/CAM materials and devices, including
the emergence of 3D printers, coupled with the widespread
12
1 2024
Although the majority of dental laboratories have incorporated CAD/CAM milling devices and 3D printers in their
workflows, there is still room for growth and expansion.
In 2023, 77% of dental laboratories in the US had incorporated 3D printing in their production.2 Conversely,
dental practices still present untapped potential in the
adoption of these technologies. It is estimated that there
are over 200,000 dentists practising in the US, and in
2022, 13% of US dentists were already affiliated with
a dental support organisation (DSO).4 This represents
a more than 10% increase compared with the situation
in 2019.4 Moreover, according to the American Dental
Association Health Policy Institute, younger dentists are
now more likely to work in group practices than in solo
practices, and this trend is expected to continue.4
[13] =>
news
The expansion of DSOs is playing a vital role in the
adoption of digital dentistry. DSOs can negotiate costs
with vendors5 and thus mitigate the factor of cost for
dentists looking to incorporate CAD/CAM workflows.
Most DSOs also provide continuing education for
the dentists affiliated with them,5 making it easier for
clinicians to transition to digital workflows. Moreover,
DSOs typically provide access to financial resources
and can thus drive the demand for CAD/CAM in the
chairside market.
Improving the patient experience
Traditional dentures and other restorations often require
multiple patient visits, and the former, in particular, are
known for requiring as many as five visits to the dental
office.6 Digital dentures, which can be produced using
a fully digital workflow, involving milling, 3D-printing
technology or a combination of the two, offer a low-cost
solution that can be provided in just three patient visits or
even fewer.7 3D printing also allows for the production of
same-day provisional restorations. This is especially crucial for conventional loading protocols in implant dentistry
to allow for osseointegration over a three- to six-month
healing period after implant placement.8 This improves
the patient experience and allows dentists to see
more patients, thus increasing the demand for digitally
produced prostheses.
Technological innovations
and development of new materials
Technological innovations are propelling growth in the
CAD/CAM device market by enhancing both material
quality and system efficiency for restorations, and even
some older clinical practices are being superseded.
Advancements in near-infrared imaging (NIRI) technology,
for example, have resulted in fewer dentists applying
powder to patients’ mouths before intra-oral scanning.9
NIRI technology is a non-ionising imaging technology
that leverages differences in infrared light scattering and
absorption depending on the degree of mineralisation.10
Moreover, when equipped with NIRI technology, intraoral scanners can be used for caries detection.11 Beyond
the core function of intra-oral scanners, recent inno
vations and upgrades are bolstering market demand.
Examples of this are the transition from powder-based
to powder-free, the ongoing shift from wired to wireless,
the progression from closed to open systems and the
integration of supplementary features such as artificial
intelligence and cloud connectivity, combined with
sleeker and more compact designs.
Within the 3D printer market, compact digital light
processing, stereolithography and liquid crystal display
printers designed for dental clinics and small to medium-
sized laboratories continue to strongly influence the
|
market, and the introduction of a mid-range PolyJet
3D printer is expected to have a notable impact in the US.
The expansion of applications enabled by new
FDA-cleared materials, particularly for 3D-printed partial
and complete dentures, as well as crowns, has led to
an increase in demand for 3D printers. This momentum
is being further augmented by the introduction of
ceramic-filled and ceramic-fused resins, which are paving
the way to attaining the target aesthetics. Major leaders
in the CAD/CAM device market have integrated
3D printers into their product portfolios, and the expansion
of FDA-cleared 3D-printing materials and collaborative
initiatives among competitors in the 3D printer market,
bolstered by the continuous release of improved products,
have yielded advantages for all.
The revolution will take time
Overall, despite the significant progress being made in
the field of digital dentistry, it will take time for full market
saturation and the complete digitisation of modern
dentistry to become realities. Until then, the factors
that are fuelling growth in digital industry, such as the
increasing use of dental prostheses in an ageing pop
ulation, the rising number and expansion of DSOs, the
demand for improvement in the patient experience and
the continuous development of technological innovations, will continue to propel the market valuation for
CAD/CAM devices, including 3D printers.
Editorial note: Please scan the QR code for
the list of references.
about
Donna Santos is a research analyst at
iData Research, specialising in the dental
industry. She is responsible for s pearheading
research projects relative to the US,
Europe and global dental prosthetics
and digital dentistry. She has years of
experience as a marketing analyst,
a bachelor’s degree in engineering and
a postgraduate diploma in data analytics.
Dr Kamran Zamanian is CEO and
founding partner of iData Research.
He has spent over 20 years working
in the market research industry
with a dedication to the study of
dental implants, dental bone grafting
substitutes, prosthetics, as well as
other dental devices used in the health
of patients all over the globe.
1 2024
13
[14] =>
| trends & applications
3D face scanning:
Affordable and user-friendly
Ronen Horovitz & Dr George Freedman, Israel & Canada
1a
1b
1c
1d
Figs. 1a–d: Comparison of a 2D photograph (a) and 3D face scanning, specifically regarding the various angles it captures (b–d).
In dental diagnostics and restorative treatment, the precise
mapping of 3D spatial relationships between the hard dental and
facial structures and the soft tissue of the face is a critical factor
in achieving both functional and aesthetic outcomes. This is
particularly important for orthodontic and orthognathic patients.
In the former, it is essential to preview the facial ramifications of
localised tooth movement, and in the latter, precise assessment
of the maxillary and mandibular arch positions is required to
forecast the outcomes and guide the surgical process.
Traditional before and after 2D photographs and slides, while
useful, are limited by head posture, head angulation and camera
orientation, among other factors (Fig. 1). They provide only a fractional, incomplete picture and may thus be misleading in terms
of spatial and dimensional investigation and analysis. In comparison,
3D face scanning allows for a comprehensive 3D view of the face
that includes the position of the maxillary and mandibular arches
in relation to facial soft tissues and is thus a game-changing
technology for the twenty-first century. The leading scanning software, Qlone, has been created by EyeCue Vision Technologies,
a developer of custom vision recognition-based solutions.
The innovative Qlone technology bridges the communication gap
between the clinic and the dental laboratory, enabling dentists
to easily and quickly collect comprehensive 3D data that is used
to design restorations in the context of the patient’s face. After all,
a smile is far more than just a set of teeth: it is the cumulative sum
of a person’s face, comprising numerous hard and soft tissue
components that are viewed from multiple angles. Assisted by
3D face scanning, dentists can readily and quickly show patients
their own simulated smiles from various perspectives, enhancing
patient motivation and promoting treatment acceptance. By facilitating and rationalising the digital dental workflow, 3D face scanning
offers a new level of visualisation that not only improves the d esign
process, but also reduces the need for costly adjustments and
remakes, offering more efficient and effective dental care.
The world is a 3D world not a flat canvas. People relate to this
3D world through their senses. Unlike traditional 2D images,
3D models offer a photorealistic representation of objects,
capturing every minute detail with stunning accuracy. The
3D models are rendered from every angle, providing a comprehensive view that 2D images simply cannot match. This multidimensional perspective makes 3D models feel more natural to
experience, mirroring the way the world is perceived in daily life.
Thus, 3D models bridge the gap between digital representation
and real-world experience, offering a new level of visualisation
that is immersive, interactive and incredibly lifelike.
4
2
3
Figs. 2 & 3: Qlone face scan example. Fig. 4: Qlone face mesh image.
14
1 2024
[15] =>
5
6
Fig. 5: Qlone exocad example image. Fig. 6: User-friendly interface, providing real-time coverage of the scanning process.
While the benefits of 3D face scanning in dentistry are clear,
the adoption of this technology is hindered by two major factors: the high costs of scanning equipment and the technological complexity associated with scanning operations. Most of
the currently available systems are expensive hardware-based
scanners that are challenging to operate. The significant financial investment required to acquire these scanning devices and
the time and effort required to learn to use them are a major
deterrent to dental clinics integrating them into their daily routine.
The high cost of these scanners makes them inaccessible to
most clinics operating on a tight budget. As a result, despite
the potential advantages, the use of 3D face scanning technology remains significantly limited in the dental field. These
issues highlight the need for more affordable and user-friendly
solutions that can bring the power of 3D face scanning into the
mainstream dental practice.
The Qlone 3D Scanner app is a revolutionary solution that
brings the power of 3D face scanning to the iPhone (Figs. 2 & 3).
This groundbreaking app is designed with a user-friendly interface that makes 3D scanning as easy as taking a selfie. The app
itself is simple, but encompasses many useful tools. The Qlone
app is packed with advanced features that make it a powerful
tool for dental professionals. These include an extensive suite of
built-in editing tools for cleaning, smoothing, sculpting, simplifying and enhancing the 3D models (Fig. 4). The all-in-one app
also includes an instant augmented reality view mode, which
allows examination of the 3D model in the local environment,
and an advanced artificial intelligence-supported search function, which allows easy navigation through the 3D model gallery.
Possibly the most important feature of the Qlone app is its focus
on patient privacy. Unlike other solutions that store data on external servers, the app ensures that patient data remains confidential;
no images or 3D data are stored on external servers. Qlone offers
a variety of export options in popular formats, such as OBJ, PLY
and STL, making it easy to integrate with existing dental CAD software,
such as exocad, 3Shape, Medit and Blue Sky Bio (Fig. 5).
The face scanning feature of the Qlone 3D Scanner app is revo
lutionary. Qlone utilises a highly optimised process to capture
detailed and clear face scans. The user-friendly interface provides
real-time coverage of the scanning process, making it easy for
users to ensure that they are capturing all the necessary data
(Fig. 6). A significant part of the technology lies in selecting the
appropriate set of images for the technology that creates the
3D models of the faces. This is based on a fusion of state-of-the-art
computer vision algorithms that perform various functions, including fine-tuning the camera’s exposure settings to make sure
no motion blur is introduced and automatic selection of the
optimal blend of angles to achieve the best overall result.
Dental technicians have begun incorporating the Qlone app into
their digital workflows. Qlone’s low cost and seamless integration
capabilities make it an attractive solution for clinics looking to
enhance their services without breaking the bank. Users can
download the iPhone version and test its most basic features free.
The face scanning feature, scanning in 4K resolution and exporting
the 3D models require a single one-time premium upgrade fee. The
Android version does not yet support the face scanning feature.
The Qlone 3D Scanner app is far more than just a cost-effective
scanning solution. It is a comprehensive tool that empowers
dental professionals to provide better care for their patients.
By bringing 3D face scanning to the iPhone, the app makes
advanced dental technology accessible to clinics around
the world. With its commitment to patient privacy and ease
of use, the company sets a new standard for 3D scanning
in the field of dentistry. More information about Qlone is
available on its website, and a video of the app demonstrating
a dental use case is available on YouTube.
about
Ronen Horovitz is the founder and
CEO of EyeCue Vision Technologies
in Yokne’am Illit in Israel. He has a
BSc in electrical engineering and an
MBA, both from the Technion—Israel
Institute of Technology in Haifa in Israel.
A computer geek and expert in image
processing, Horovitz focuses on computer
vision technologies that provide
enhanced interaction between the physical and digital domains.
Dr George Freedman is a founder and
past president of the American Academy
of Cosmetic Dentistry, a co-founder
of the Canadian Academy for Esthetic
Dentistry, a regent and fellow of the
International Academy for Dental-Facial
Esthetics, and a diplomate and chair
of the American Board of Aesthetic
Dentistry. He is an adjunct professor
of dental medicine at Western University of Health Sciences
in Pomona in California in the US. He is the author of
14 textbooks, including C
ontemporary Esthetic D
entistry
(Elsevier, 2012), and over 900 dental articles.
Dr Freedman is an editor-in-chief of 3D printing and serves on
the editorial boards of Oral Health magazine and
Dental Asia. He is an internationally well-known lecturer
on 3D printing, aesthetic restorative materials, adhesion,
implants, veneers and dental technologies.
1 2024
15
[16] =>
© Have a nice day Photo/Shutterstock.com
| interview
Although artificial intelligence has immeasurable potential for changing medicine, it is still a tool in training according to expert research.
Potential of AI as an assistant
in oral surgery considering
accuracy and legal aspects
An interview with Prof. Víctor Díaz-Flores García
By Anisha Hall Hoppe, Dental Tribune International
In many areas of the world, the population growth has
outpaced the availability of clinicians, prolonging waiting
times and placing greater demands on already full
clinical schedules. Dental Tribune International spoke with
Prof. Víctor Díaz-Flores García, an endodontist who also
holds a law degree, about his research which indicates that
artificial intelligence (AI) may be heralded as a technological
hero to the rescue.
Prof. Díaz-Flores García, what is the focus of your
research group at the European University of Madrid?
16
1 2024
I, along with my co-workers Yolanda Freire Ana Suarez and
Margarita Gómez Sánchez, am a part of the Transformative
Research in AI and New Enhancements for Dentistry, or
TRAINED, group. We are exploring the possibilities of AI in
the field of dentistry, focusing particularly on patient safety.
The emergence of AI in the field of medicine as a whole is overwhelming, and it is necessary to study and understand how it can
be useful not only for clinicians but more importantly for patients
and the general population. Our group has published other papers
on this topic, and our aim is to continue working in this area.
[17] =>
interview
|
a valuable tool. As a working group, we have observed
that there are protocols of great clinical value that can
be very useful both for general dentists and for those
who specialise in a particular field, so it is essential to
have a tool that directly provides accurate information
to questions posed to it.
For clinicians just learning about AI in dentistry,
what would be some very basic principles for them
to know to better understand the impact of research
like yours?
As I indicated before, it is important to be aware of the
limitations that text generation systems such as ChatGPT
currently have in the sense that not all the information
provided is accurate. This is the key point that a clinician
needs to be aware of today. Nowadays, there are tools to
train AI systems ourselves so that the information p
rovided
is adequate for the purpose for which it is c
onsulted,
but this should not preclude the dental professional
being up to date scientifically speaking, such as by attending
congresses and courses to keep up to date and reading
relevant scientific literature.
Were there any aspects of your findings that were
unexpected? What do you feel are the key takeaways
of your research as they apply to AI in dentistry going
forward?
The use of ChatGPT, or any other app that uses large
language models, must currently be understood as a tool
in its infancy. Not all the information given to us is correct,
so it is necessary to train the system to give increasingly
correct answers. In the studies we have carried out with
ChatGPT, we have seen a promising consistency in the
responses to clinical protocols, but this must always be
checked by the health professional when using these
tools as a basis for diagnosis or treatment. It is obvious
that in the near future these tools will be present in our
daily treatment, but today we must understand that they
are untrained systems that must be taken into account in
their proper measure when making clinical decisions.
Your team’s publication indicated that AI could become an incredibly reliable assistant in oral surgery,
particularly in areas of the world where dental specialisations are not yet recognised. What inspired
you as researchers to explore AI’s capabilities in this
direction?
Access to information is essential for decision-making.
The availability of up-to-date protocols of clinical actions
is a benefit for the patient and can avoid safety problems in many aspects (use of medicines, application of certain materials, etc). An AI program trained by professionals specialised in a specific branch of dentistry would be
Because large language models and really all AI programs
rely on big data, what encouragement would you o
ffer
clinicians concerned about data usage?
States and international organisations are taking a
ction
through specific legislation in this area. As a group based
in the EU, we are closely monitoring this legislation.
Particular attention must be paid to the use of patients’
personal data when training an AI, as this data is sensitive
and we could potentially be in breach of data protection
laws and face serious legal consequences. Patients
should also be aware of these issues and take care to
avoid exposing their data to apps or systems that have
nothing to do with genuine medical assistance, especially
those that aim to commercialise such data.
Editorial note: The study, titled “Beyond the scalpel:
Assessing ChatGPT’s potential as an auxiliary intelligent
virtual assistant in oral surgery”, was published for the
December 2024 issue (in progress) of Computational
and Structural Biotechnology Journal.
about
Prof. Víctor Díaz-Flores García
holds a PhD in dentistry, an MS in
advanced endodontics and a bachelor’s
degree in law. He is professor of dentistry
at the European University of Madrid in
Spain, where he is part of the research
group Transformative Research in
AI and New Enhancements for Dentistry.
1 2024
17
[18] =>
| interview
“Our vision is to accelerate access
to oral care globally”
An interview with Dr Amir Mansouri, CEO of SprintRay
By Dental Tribune International
SprintRay has long held the unique position of being
an additive manufacturing business with a single focus:
dentistry. Dental Tribune International spoke with
SprintRay CEO Dr Amir Mansouri about the company’s
continued success and the value of converting an
analogue practice into a streamlined, digital enterprise.
Dr Mansouri, SprintRay has been incredibly productive
throughout the past year. Which innovation do you
SprintRay CEO and co-founder Dr Amir Mansouri. (Images: © SprintRay)
18
expect will draw attention of dental professionals
this year?
Research and development and advancing innovations are our core focus. We never take our market
position for granted and are always working to dis
rupt our own product lines and position by introducing
new innovations. Our emphasis is heavily on materials
and artificial intelligence (AI)—materials to broaden
the current applications in dental practices and AI to
[19] =>
interview
|
The SprintRay 3D-printing ecosystem was designed for the needs of dental professionals.
“Unlike our competitors who treat dentistry
as a secondary market or 3D printing as a sideline,
we are dedicated solely to dentistry.
This focus has driven us to make decisions aligned
with community needs.”
aid in treatment planning for our community—and that’s
what we think dental professionals will want to learn
more about.
What is your company’s vision at the beginning of
2024?
Our vision is to accelerate access to oral care globally,
and we believe that 3D printing can give millions of
patients faster and more affordable access to oral treatments.
Clinicians have their choice of production tech
nologies, which can be overwhelming for some.
How does a SprintRay ecosystem simplify the process
of in-house production?
We offer a streamlined workflow, superior materials,
easy design solutions and a community of thousands of
collaborating clinicians. SprintRay is the only company
exclusively focused on dental 3D printing, offering clinicians a partner whose sole mission is to improve dental
3D printing every day.
On the topic of choices, even in 2024, there are
dental practitioners who are still hesitant to switch
to an additive manufacturing process. What are the
long-term benefits of giving up traditional methods
and switching to a digital workflow?
Every day that clinicians delay adopting this technology,
they fall behind in their professional development and
competitiveness. 3D printing offers more control and
versatility in treatment options, providing a competitive
edge in their market. Offering a same-day crown or night
guard increases the likelihood of patient acceptance.
What decisions have kept SprintRay so successful
across the European market and indeed worldwide?
Our focus on dentistry without deviation has been key. Unlike
our competitors who treat dentistry as a secondary market or
3D printing as a sideline, we are dedicated solely to dentistry.
This focus has driven us to make decisions aligned with community needs. We’ve developed game-changing materials,
software, AI and more, making 3D printing more accessible,
affordable and exciting for clinicians and dental labs.
1 2024
19
[20] =>
| interview
The balance between
innovation and tradition
An interview with Dr Christoph Reinschmidt and Albin Gygli
By Dental Tribune International
innovative oral care company. Consequently, we deeply
recognise that innovation has to be aligned with tradition and clinical evidence. We pursue a combination
of in-house innovations as well as strategic acquisitions as a way forward. On the one hand, products like
Straumann’s iEXCEL, which will be presented during the
ITI World Symposium in Singapore from 9 to 11 May,
showcase our internal research and development capabilities. On the other hand, acquisitions of brands
like GalvoSurge demonstrate our openness to integrating external expertise into our portfolio. It is also worth
mentioning that innovation is not confined to a single
brand within the Straumann Group. We ensure that
all our brands incorporate cutting-edge technologies,
maintaining a high standard of excellence across our
entire product portfolio. This inclusive approach ensures
that practitioners have access to innovation regardless of
their brand preferences.
1
2
Fig. 1: Dr Christoph Reinschmidt, the Straumann Group’s head of distributor
markets in the Europe, Middle East and Africa region. Fig. 2: Albin Gygli,
head of digital hub Switzerland, eastern Europe and emerging markets.
(Images: © Straumann)
A recent surge of innovations has sparked a transformative wave in the field of dentistry, reshaping the landscape of oral healthcare. In this interview, Dr Christoph
Reinschmidt, the Straumann Group’s head of distributor
markets in the Europe, Middle East and Africa region,
and Albin Gygli, head of digital hub Switzerland, eastern
Europe and emerging markets, talk about the multibrand dental company’s approach to and philosophy
regarding introducing new digital solutions and identify
future trends in dentistry, as well as how the company is
strategically positioned to adapt to changes.
While innovation is crucial, practitioners often rely on
established techniques. How does the Straumann Group
harmonise introducing innovative features with
ensuring compatibility for practitioners accustomed
to conventional methods?
Dr Reinschmidt: At the Straumann Group, we are
committed to being the most customer-focused and
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1 2024
Obviously, we also acknowledge the importance of
established clinical procedures in ensuring patient safety
and successful outcomes. Our approach involves a
balance between introducing innovations and respecting
the well-documented, trusted methods that practitioners
rely on. New products are also introduced in a structured
manner, accompanied by offering the necessary training
and education to our customers.
How has digital technology transformed dental
practices, and what are the key innovations that have
significantly influenced the field?
Gygli: Digital technology and its workflows have revolutionised dentistry, enhancing efficiency, precision and
patient care. Key innovations in diagnostics, treatment
planning and communication have reshaped
dental
practices. The crucial element in any digital workflow—be it for clear aligner treatment, implantology
or restorative dentistry—is the digital impression of a
patient’s teeth. The intra-oral scanner is the entry point
to digital treatment, playing a pivotal role in transforming
treatment processes in clinics. Its significance is
undeniable, marking a paradigm shift in dental practices and ensuring a more streamlined and patient-
centric approach.
[21] =>
|
© Boule/Shutterstock.com
interview
Straumann’s iEXCEL will be presented during the ITI World Symposium in Singapore from 9 to 11 May.
Given the diverse populations in different regions with
varying dental needs, how does the Straumann Group
cater to the specific requirements of different communities and demographics?
Dr Reinschmidt: One of the key pillars of our strategy
involves our multi-brand approach, acknowledging that
different communities and demographics may have unique
preferences and requirements. The Straumann Group
encompasses a range of brands, each tailored to cater
to specific market segments and needs. To support our
multi-brand strategy and cater to diverse philosophies,
the Straumann Group invests significantly in global education and training programmes, allowing practitioners
from various regions to access the latest knowledge,
techniques and best practices.
We also understand that dental practitioners may follow diverse treatment philosophies based on their
training, cultural backgrounds and regional practices.
The Straumann Group’s product development and educational initiatives take these differences into account.
What challenges do dental professionals face in
adopting digital solutions, and how does Straumann
address these challenges to enhance the overall user
experience?
Gygli: Dental professionals often grapple with the challenges of transitioning to digital solutions, including concerns about costs, training requirements and workflow
integration. By addressing these challenges, we enhance
the overall user experience, making digital integration with
Straumann a practical and beneficial choice for modern
dental practices. Our commitment to user-friendly interfaces ensures a smooth transition, empowering dental
professionals to embrace digital technology effortlessly.
We alleviate hurdles by providing cost-effective digital
solutions, including intra-oral scanners and treatment
planning software; practical resources and training pro-
grammes, facilitating seamless integration into existing
workflows. We offer accessible education and guidance,
including online modules, hands-on workshops and personalised coaching to support practitioners in integrating
digital tools into their daily practice, contributing to improved patient care and practice efficiency.
As dentistry continues to evolve, what future trends
and technological advancements do you foresee
playing a crucial role in shaping the landscape, and
how is the Straumann Group positioned to adapt to
these changes?
Dr Reinschmidt: As dentistry undergoes its continued
evolution, several future trends and technological advancements are playing an important role. The demand
for immediate results in dental procedures is increasing,
in implantology in particular. Patients and practitioners
alike are seeking solutions that minimise treatment time
and the number of visits and eventually enhance treatment satisfaction.
Digitalisation continues to change our business fundamentally. The Straumann Group directly offers solutions
for intra-oral scanning, treatment planning, patient communication, assisted or navigated surgery and the production of final restorations. The adoption of these technologies is fundamental for the future success of dental
healthcare companies as well for practitioners.
The shift towards patient-centric care is a prevailing
trend in dentistry. Patients are increasingly involved
in their treatment decisions, seeking personalised experiences and convenient communication channels.
We recently added Smilecloud to our portfolio, software
that allows clinicians to design virtual mock-up smiles for
patients supported by artificial intelligence technology and
3D biometric libraries. This platform facilitates communication
between practitioners and patients, enabling a more
collaborative and transparent treatment journey.
1 2024
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[22] =>
| user report
3D-printing inlays, onlays and
overlays with SprintRay:
A revolutionary approach
to dental restorations
Dr Miloš Ljubičič, Serbia
1
2
3
4
Introduction
(Figs. 1–4). Traditionally, such restorations would require
several appointments, numerous impressions and temporary restorations before the final ones were ready.
This process is not only time-consuming but also
frustrating for the patient. However, with innovative
3D-printing capabilities, the patient’s experience can be
drastically improved.
Dentistry has undergone a remarkable transformation
with the advent of 3D-printing technology. Gone are
the days when patients had to endure multiple visits for
restorative procedures. With cutting-edge 3D-printing
solutions, dental professionals can now offer patients
a more efficient and convenient experience. This article
explores the use of 3D-printing technology to create inlays,
onlays and overlays in a single visit, revolutionising the
way we approach dental restorations.
The patient’s dilemma
Imagine a patient walking into a dental office looking to
have old fillings replaced and carious tissue restored
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1 2024
The solution
A good range of 3D printers specifically designed for
dental applications are available. Those from SprintRay
utilise advanced materials and high-resolution printing
technology, enabling dental professionals to craft precise and durable dental restorations in a fraction of the
time compared with traditional methods.
[23] =>
user report
|
6
5
7a
7b
7c
“With cutting-edge 3D-printing solutions,
dental professionals can now offer patients
a more efficient and convenient experience.”
Creating hybrid restorations in one visit
With the help of SprintRay’s 3D printers and the unique
SprintRay Crown Kit, dental professionals can now
8
9
create inlays, onlays and overlays using the latest hybrid
resin materials (SprintRay Crown) in a single visit. The
process is relatively straightforward and time-efficient, sparing
patients the inconvenience of multiple appointments.
10
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| user report
11
12
13
14
Here is how it works:
4. Washing and drying: After approximately 20 minutes
of printing, thanks to the SprintRay Crown Kit, which
speeds up the process, the dental professional
carefully removes the restoration from the printer.
The printed restoration is then placed in the SprintRay
Pro Wash/Dry unit, where it undergoes thorough washing
with isopropyl alcohol to remove any excess resin and
ensure optimal cleanliness.
5. Finishing: The dental professional makes any necessary final adjustments and polishing to guarantee a
perfect fit and natural appearance of the restoration
(Figs. 8–10).
6. P
ost-polymerising: Once the adjustments have
been made, the restoration is transferred to the
SprintRay ProCure 2 unit for the final polymerisation
process. ProCure 2 utilises advanced technology
to polymerise the resin fully, enhancing the strength
and durability of the restoration. This step is crucial
in ensuring that the restoration is ready for imme
diate use once it has been taken out of the poly
merising unit.
7. Cementation: The restoration is securely bonded in
place using G-CEM ONE universal self-adhesive resin
cement with dual-polymerising ability, designed to
provide strong and durable bonding of indirect restorations. This ensures a long-lasting and reliable outcome for the patient’s dental health and satisfaction
(Figs. 11–15).
1. Digital scanning: The patient’s teeth are digitally
scanned using an intra-oral scanner (Medit i700 wireless). This 3D scan creates a highly accurate virtual
model of the patient’s dentition, eliminating the need
for messy traditional impressions (Fig. 5).
2. C
AD: The virtual model is imported into CAD software
(Medit ClinicCAD), where the dental professional custom-
designs the inlay, onlay or overlay to precisely fit the
patient’s tooth (Fig. 6).
3. 3
D printing: Once the design has been completed, the
digital file is sent to the SprintRay Pro 95S 3D printer.
Using the chosen hybrid resin material (SprintRay Crown),
the printer begins the additive manufacturing process,
layer by layer, until the restoration has been completed
(Fig. 7).
The advantages
for patients and dentists
The integration of SprintRay’s 3D-printing technology in
dental practices offers numerous benefits:
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[25] =>
user report
– Time efficient: Patients can have their restorations
completed in a single visit, saving them valuable time
by reducing the number of appointments required.
– Enhanced precision: 3D printing ensures a high level
of accuracy and a perfect fit for each patient’s unique
dental anatomy, leading to improved longevity and
functionality of the restoration.
– Improved aesthetics: The hybrid materials used in
3D printing closely mimic the appearance of natural
teeth, providing patients with aesthetically pleasing and
discreet restorations.
– Streamlined workflow: Dental professionals can
optimise their workflow, reducing chair time and increasing patient throughput, ultimately benefiting both
the practice and the patients.
Conclusion
3D-printing technology has revolutionised the field of
dentistry, offering patients a streamlined and efficient
experience when it comes to restorative dental procedures. By using innovative solutions, such as SprintRay
Crown workflow, dental professionals can now provide
high-quality, precise and aesthetically pleasing inlays,
|
onlays and overlays in a single visit, bringing a new era
of convenience and excellence to dental restorations.
about
Dr Miloš Ljubičič is a resident in
prosthodontics at the University of
Belgrade in Serbia and is well known
for his expertise in aesthetic and digital
dentistry, having made significant
contributions to the evolution of
CAD/CAM systems in the dental practice.
Dr Ljubičič is also the creator of the
Bigger Picture international course
in dental photography, which has set new standards and
protocols in this field. In 2019, he was nominated as the most
promising young member at the annual European Society of
Cosmetic Dentistry (ESCD) conference. His expertise in dental
photography too earned him accolades in dental photography
contests at the International Dental Show in Cologne in Germany
and the annual ESCD meeting in 2019. As a lecturer, Dr Ljubičič
has shared his knowledge and insights with his peers through his
involvement with the American Society of Cosmetic Dentistry and
the ESCD. He is a key opinion leader for Medit, GC and SprintRay.
AD
THE GLOBAL DENTAL CE COMMUNITY
REGISTER FOR FREE
www.dtstudyclub.com
DT Study Club – e-learning community
@DTStudyClub
Tribune Group is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA
CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.This continuing education activity has been planned and implemented in
accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between Tribune Group and Dental Tribune Int. GmbH.
[26] =>
| case report
Immediate loading of the posterior
maxilla with two abutment-level
bridges produced in a digital workflow
Dr Marco Degidi & Gianluca Sighinolfi, Italy
1
2
3
4
Fig. 1: Pre-op radiograph. Fig. 2: Implant placement. Fig. 3: Implants and immediately positioned MultiBase Abutments EV. Fig. 4: Immediately placed temporary bridges.
Introduction
premolars and molars in the maxillary arch using a
digital workflow.
Dental implants are widely acknowledged for their
success in replacing missing teeth. Several factors influence the effectiveness of implant treatment, including
design, surgical technique, bone quality and patient
factors. This case report aims to present the step-bystep process of implant treatment and restoration with
two abutment-level bridges for a patient who had lost
5
6
9
10
Case presentation
Owing to chronic periodontal disease, the 65-year-old
female patient had lost premolars and molars in the
maxillary arch (Fig. 1). It had been decided to perform
her treatment with dental implants.
7
11
8
12
Fig. 5: Post-op radiograph. Fig. 6: Soft-tissue healing after six months. Fig. 7: Soft-tissue scan, allowing design of the Atlantis BridgeBase for proper cleaning. Fig. 8:
Atlantis IO FLO-S scan bodies seated on MultiBase Abutments EV. Fig. 9: Intra-oral scan with the Atlantis IO FLO-S scan bodies inserted. Fig. 10: Temporary restoration
after six months of healing. Fig. 11: Digital merging of the temporary bridge and tissue scans. Fig. 12: Atlantis Scan Upload with Atlantis BridgeBase core files.
26
1 2024
[27] =>
case report
13
14
16
|
15
17
18
Fig. 13: Atlantis BridgeBase frameworks with angulated screw access holes at the second maxillary molar positions on both constructions. Fig. 14: Zirconia shells designed on
the core file. Fig. 15: Zirconia shells cemented extra-orally on to the Atlantis BridgeBase frameworks. Fig. 16: Final bridges. Fig. 17: Final radiograph. Fig. 18: Final restoration.
PrimeTaper EV implants (Dentsply Sirona) were placed
in the maxillary premolar and molar positions (Fig. 2).
MultiBase Abutments EV (Dentsply Sirona) were positioned and temporary screw-retained bridges loaded
immediately (Figs. 3 & 4). To ensure that the implant
positions were correct, a postoperative radiograph was
performed (Fig. 5).
After a healing period of six months (Fig. 6), an intra-oral
scan was performed at abutment level together with
a scan of the existing temporary bridges in relation to
the opposing arch (Figs. 7–11). All files were imported into
Atlantis Scan Upload for ordering of the Atlantis BridgeBase
frameworks (Dentsply Sirona; Fig. 12).
After approval of the Atlantis BridgeBase and core file
designs, the Atlantis BridgeBase frameworks and zirconia
shells were manufactured (Figs. 13–16). After a c
linical
try-in, the Atlantis BridgeBase frameworks were cemented to the zirconia shells and delivered to the p
atient
(Figs. 17 & 18).
Conclusion
This report highlights a case of successful PrimeTaper
EV implant placement in a patient with maxillary posterior
tooth loss. Utilising an intra-oral scanner and specialised
components facilitated precise treatment planning within
a digital workflow. The combination of the P
rimeTaper
system together with zirconia shells cemented on to
the Atlantis BridgeBase frameworks enabled efficient
prosthodontic treatment.
Editorial note: This case report is published as inspiration
for readers, and the treatment approach and m
ethodology
are not necessarily recommended by Dentsply Sirona.
about
Dr Marco Degidi is an adjunct
professor in the master’s degree
programme in clinical implantology
at the University of Bologna in Italy
and runs a private practice in Bologna
focusing on implant surgery and
prosthetics. He is the inventor of the
WeldOne and Conometric concepts.
WeldOne is a complete, proven and
sophisticated concept for intra-oral welding based on the
resistance spot welding principle. The Conometric concept
employs friction instead of cement or screws to retain crowns.
Dr Degidi is an active member of the Academy of Osseointegration
and a diplomate of the International Congress of Oral Implantologists.
He has published over 100 articles in peer-reviewed journals and received
numerous awards. Dr Degidi lectures throughout the world on immediate
loading, primary stability, biomaterials and aesthetic dentistry.
Gianluca Sighinolfi is an
experienced dental technician
working in a private laboratory
in Bologna in Italy.
1 2024
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[28] =>
| case report
Guided implant placement
and restoration:
A comprehensive approach
Dr Adam Nulty, UK
28
1
2
Introduction
Case presentation
The evolution of digital dentistry has revolutionised the
way dental procedures are planned and executed. This
case highlights the integration of various digital tools
and techniques to achieve a predictable and satisfactory
outcome.
Upon initial examination, a 67-year-old female patient,
in good health and with no known medical issues, presented with a failing bridge extending from tooth #14 to
tooth #17, anchored on teeth #14 and 17 (Figs. 1 & 2).
This case report describes the successful management
of a failing maxillary right bridge using advanced digital dentistry techniques. The process involved virtual
extraction, CBCT planning, guided surgery and in-house
milling of the final prosthesis.
Virtual extraction
Using the Medit Design tool, the bridge and abutment
teeth were removed, employing a precise scan obtained
from the Medit i700 intra-oral scanner (Figs. 3 & 4). This
initial step laid the foundation for the subsequent phases
of treatment, ensuring accurate planning and execution.
3
4
1 2024
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case report
5
|
6
Implant planning
The implant planning phase was conducted utilising both
CBCT scans and the intra-oral scan for comprehensive assessment. Using SMOP guided surgery software
(Swissmeda), a detailed plan was prepared. This plan included the placement of Axiom X3 implants (Anthogyr),
strategically positioned to effectively support a four-unit
bridge (Figs. 5–7).
Surgical guide fabrication
For precise execution of the implant placement, a
surgical guide was fabricated. The guide was printed on
a MAX UV printer (Asiga) with KeyGuide resin (Keystone
Industries; Figs. 8–10). After washing, INTEGRAL sleeves
8
11
7
(Anthogyr) were placed before the final post-processing
polymerisation (Figs. 11 & 12).
9
10
12
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[30] =>
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13
14
15
16
17
Implant placement
On the day of implant surgery, the bridge and abutment
teeth (teeth #14 and 17) were removed (Figs. 13–17). The
implant placement procedure was carried out with the
aid of the surgical guide and the INTEGRAL guided surgery kit. Immediate implant placement was followed by
the placement of healing abutments. The sockets were
augmented using bovine xenograft.
Results
Restoration
After an eight-week healing period, the scan bodies for
accurate digital impressions were seated, and a digital impression was taken (Figs. 18 & 19). Custom gold-
anodised titanium abutments and a cement-retained
lithium disilicate bridge (Prometa Kronos) were designed
(Figs. 20–31). The custom abutments were milled by
Simeda. However, I completed the surgical guide planning
and the CAD of the final bridge and milled the final bridge
in-house.
The integration of digital dentistry into clinical practice
has been a transformative evolution in the field. The case
presented here underscores the importance of a comprehensive digital workflow in modern implant dentistry. The use
of virtual planning, guided surgery and in-house milling
ensured precision and reduced the overall treatment time.
18
19
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1 2024
The patient achieved a functional and aesthetically pleasing
result with the new bridge (Figs. 32–36). The integration
of advanced digital techniques ensured a predictable and
satisfactory outcome (Figs. 37–41).
Discussion
Virtual planning and guided surgery
The utilisation of virtual planning tools, such as Medit D
esign
and SMOP, allows for a more predictable surgical outcome.
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case report
20
21
22
20
|
23
25
24
27
26
29
28
30
31
“Digital dentistry [...] can offer patients a swift and precise treatment plan.”
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[32] =>
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32
33
34
35
Digital impressions and in-house milling
The Medit i700 scanner was instrumental in obtaining
accurate digital impressions. According to Nulty, the
trueness and precision of digital scanners, including the
Medit i700, are remarkable, ensuring that the final prosthesis fits perfectly.3 Furthermore, in-house milling, as
done in this case, provides the clinician with greater control
over the design and fit of the final prosthesis, leading to
improved patient satisfaction.4
36
Mangano et al. highlight that digital workflows, including
virtual planning and guided surgery, improve the accuracy of implant placement, reduce surgical time and
minimise postoperative complications.1 This precision
ensures that the implant is placed in the most optimal
position, reducing the risk of complications and ensuring
the longevity of the implant.
Immediate implant placement
Immediate implant placement, as executed in this case,
has its advantages. Chen and Buser emphasise the
benefits of immediate implant placement, including reduced treatment time, preservation of soft and hard
tissue, and improved aesthetic outcomes.2 This method
not only speeds up the treatment process but also results
in greater patient satisfaction owing to the reduced number
of visits and faster recovery.
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3D printing and accuracy
Nulty compared the trueness and precision of various
3D printers, including the MAX UV, and found them to be
highly accurate.5 The MAX UV was statistically superior
to the others, having an overall trueness of under 35 μm,
ensuring that the printed surgical guides fit precisely
during surgery.5 The accuracy of such printers is crucial
in ensuring that the surgical guide aligns perfectly with
the patient’s anatomy, supporting successful implant
placement.
Material selection
The choice of bovine xenograft for socket augmentation
is supported by studies that have shown its efficacy in
preserving alveolar ridge dimensions after extraction.6
Additionally, the use of lithium disilicate, known for its
excellent aesthetic properties and durability, for the
final bridge aligns with the current trend in restorative
dentistry.7
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case report
37
38
39
40
|
41
“The case presented here underscores
the importance of a comprehensive digital workflow
in modern implant dentistry.”
Collaborative approach
Collaboration between different digital tools, materials
and experts, as seen in this case, is a testament to the
multidisciplinary nature of modern dentistry. Such an
approach ensures that patients receive the best possible
care, combining expertise from various domains.
Primary stability and implant design
One of the critical aspects of successful dental implant
placement is achieving excellent primary stability. P
rimary
stability refers to the mechanical stability of an implant
immediately after placement, and it is a crucial factor
in determining the success of osseointegration and the
overall outcome of the implant procedure. The Axiom X3
implant, having a unique design, has been recognised for
providing exceptional primary stability. Primary stability
ensures that the implant securely anchors in the bone,
reducing micro-movements that can hinder the osseo
integration process. This stability is not just beneficial
for the immediate postoperative period but also plays a
pivotal role in the long-term success of the implant.8
Conclusion
Digital dentistry, when used comprehensively, can offer
patients a swift and precise treatment plan, leading to
predictable outcomes. This case serves as a testament
to the advancements in the field and their practical
applications.
In conclusion, the advancements in digital dentistry,
as demonstrated in this case, offer a holistic approach
to patient care. By integrating various digital tools and
techniques, clinicians can achieve predictable, efficient
and aesthetically pleasing outcomes.
Editorial note: Please scan the QR code for
the list of references.
about
Dr Adam Nulty is a highly
experienced clinician and lecturer
known for his excellence in digital
dentistry. He has completed several
postgraduate courses, holds an MSc
in restorative dentistry and is currently
undertaking a PhD at the University
of Leeds in the UK. He has won a
number of awards for his clinical work
and is an associate professor of digital dentistry at the College
of Medicine and Dentistry, associated with Ulster University,
in Birmingham in the UK. Dr Nulty is president of the
International Digital Dental Academy.
1 2024
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[34] =>
| case report
Fully digital full arch?
Continued advancements in
full-arch implant restoration
Drs Isaac D. Tawil & Scott D. Ganz, US
1a
1b
1c
Figs. 1a–c: Rubber bands (a & b) or composite applied directly to the tissue (c) to aid intra-oral scanners in acquiring accurate data.
Introduction
Full-arch implant-supported reconstruction continues to
provide viable solutions to restore and improve function,
enhance aesthetics and change quality of life for our
patients. All-on-X implant reconstruction has benefited
from new advancements and technical innovations. In
this article, we continue the journey of navigating through
new developments which impact on the full-arch analogue
and digital workflows.
Our previous articles introduced several elements to aid
the clinician in both the surgical and restorative phases of
full-arch replacement, including the use of CBCT-guided
surgical apps1 and how CBCT has greatly improved the
assessment for implant placement relative to the desired
restorative position for provisional and final restorations
while reducing implant complications.
2a
2b
We have previously described an ancillary surgical protocol utilising extracted teeth as an autologous solution
for bone grafting, which has greatly enhanced healing
and long-term alveolar stability, providing ample graft
volume while significantly reducing biomaterial costs.2
Subsequent publications also reported on improving
the restorative time and treatment outcome utilising iJIG
technology3 and employing small hole technology (C2F)
to enhance the physical integrity and anatomy of milled
or 3D-printed provisional restorations4 and to improve
inter-arch alignment and occlusion.
The goal of these articles was to improve time, efficiency,
costs and long-term results for the benefit of clinicians,
laboratory technicians and patients. This latest article endeavours to provide updates on the acquisition
of data necessary to complete the restorations and
addresses improvements in full-arch screw-retained
2c
Figs. 2a–c: Photogrammetry. Manufacturer-specific scan bodies (a). Extra-oral light source (iCam4D; b). Photogrammetry software (iMetric 4D; c).
34
1 2024
[35] =>
case report
|
3a
Figs. 3a & b: Grammetry components for splinting for increased accuracy and stability (a). Completed Grammetry intra-oral structure secured to MUAs
with conventional screws (b).
monolithic restorations which incorporate multi-unit
abutments (MUAs).
Data acquisition
As the dental industry continues to strive for fully
digital solutions, the development and improvement
of intra-oral data devices and acquisition technology
has con
tinued to evolve. Intra-oral scanning (IOS)
speeds and accuracies have made intra-oral scanners
a viable replacement for direct analogue impressions.
Native IOS software apps now provide several impressive features which enhance and streamline complete
digital protocols. However, owing to inherent logistical
limitations, using IOS technology for full-arch dental
implant restorations has presented difficulties and
inaccuracies, requiring additional apps to achieve fully
digital solutions.
All-on-X surgical and restorative protocols require the
placement of four or more implants with a favourable
anterior–posterior spread to achieve the necessary longterm support. Capturing the positions of these implants
with accurate cross-arch IOS, especially in the mandible,
has been one of the major struggles for clinicians and
dental laboratory technicians to overcome.
IOS technology requires a stable environment for data
to be stitched and captured accurately. Several techniques have emerged to aid the clinician in scanning
these difficult environments, characterised by improper
retraction, salivary flow, lack of stable keratinised soft
tissue and large distances between scanned objects.
The splinting of scan bodies with elastic bands or wires
(Figs. 1a & b), for example, has facilitated the ability of
scanners to continue a scan without interruption by
creating a linear path for data capture.5 Innovative
techniques such as the sigma composite curve (Fig. 1c)
and fiducial markers fixated to the bone have also helped
improve the scanning flow.6 While these processes work
for some and not for others, developers have created
alternative workflows to aid in the acquisition of accurate
intra-oral data.
Photogrammetry in dentistry is a relatively new development that has revolutionised capture and positional
analysis.7 Photogrammetry is a diagnostic and research
method that uses an extra-oral capture device with specific photogrammetry scan bodies to acquire measurements from 2D digital images (Figs. 2a & b). Photogrammetry scans allow dental clinicians to acquire precise
measurements of the individual scan bodies (Fig. 2c) secured to the dental implants either at the time of surgical
placement or after the implants have been uncovered.8
While extremely accurate for recording the positioning
of the implants, photogrammetry does not acquire the
topography of the soft tissue. Therefore, a second scan
is required with an intra-oral scanner. The IOS data can
then be used to fabricate a virtual 3D model used to
measure various parameters of the implant analogues.9
The software correlation of these measurements can be
used to assess and validate the correct positioning of
implants and the alignment of the patient’s occlusion,
regarding tooth size, distance and angle.
The combination of IOS and photogrammetry data
provides the CAD software with all the necessary information to virtually create a provisional prosthesis or a final
3b
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[36] =>
| case report
model for production or verification purposes. Although
these impressive devices are extremely accurate, the
initial purchase costs and availability of sensitive component materials has been an issue of concern.
4
Fig. 4: Grammetry scan body with vertical and horizontal extensions to aid
in bonding to the mesh frame. IOS = intra-oral scanning; OEM = original
equipment manufacturer.
To obviate the expense of photogrammetry, alternative
fully digital workflows have been developed, such
as Dr Jonathan Abenaim’s XCell process to facilitate
and streamline data acquisitions, avoiding the need for
photogrammetry.10 This proprietary workflow protocol
requires education therein and the use of proprietary
scan bodies. To maintain consistency and accuracy,
the protocol recommends a specific intra-oral scanner
and CAM unit. Additionally, the workflow recommends
use of Dr Abenaim’s Powerball screw to complete
the production of the final restoration. Although the
recommendations are not mandatory, there is limited
support when not utilising the components indicated.
The proven XCell process is extremely efficient and
paved the way for continued development of other
intra-oral imaging technology.
restoration to be 3D-printed or milled. The advanced
capability of this highly accurate technology generates
a fully digital workflow. There is little need for an analogue
Another very recent option, called Grammetry (ROE
Dental Laboratory), has been developed as an open
comprehensive surgical and restorative solution that
5a
5b
5c
5d
Figs. 5a–l: Chrome osteotomy drilling guide used for full-template guidance (a). Multi-unit abutments seated on to the implants (b). Provisional PMMA restoration
with holes to pick up the titanium cylinders (c). Provisional restoration placed over the graft and platelet-rich fibrin after suturing (d). Intra-oral view of
healed maxilla (e). OptiSplint after intra-oral luting (f). The scan of the provisional with the analogues attached (g). Virtual design of the Misch classification
FP-1 restoration in exocad (h & i). Model fabricated to test the fit of the OptiSplint and final restoration (j). Final metal-free monolithic zirconia restoration secured
with Powerball screws (k). Panoramic radiograph verifying the fit of the restoration and direct sealing with no gaps (l).
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case report
5e
5f
5g
5h
offers a very similar and straightforward process at a
significantly reduced cost. Whereas photogrammetry
requires the use of an expensive device and expensive
scan bodies, Grammetry allows the use of the dentist’s
existing intra-oral scanner along with special components
provided to the clinician for each case. The analogue–
digital process utilises MUA-compatible scan bodies (OptiSplint) designed to incorporate an aluminium
mesh frame (Fig. 3a) that can be customised chairside
(with the snipping tool included) as required by the intra-
oral location of the implants. This mesh frame comes in
small and large sizes to accommodate various mouth
5i
5j
5k
5l
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| case report
6a
6b
6c
Figs. 6a–c: Three methods of attaching zirconia restorations to implants. Conventional multi-unit abutment (a). Titanium bar (b). Titanium base (c).
sizes and MUA–implant positions. The workflow involves
inserting the scan bodies on to the MUAs intra-orally (Fig. 3b).
The proprietary scan bodies have extensions (Fig. 4)
to allow the mesh to seat and rotate in close proximity to
the extensions, which facilitate luting using a resin base
material (STELLAR DC Acrylic, Taub Products). The structure can then be digitised by scanning intra-orally with
an intra-oral scanner and extra-orally with an intra-oral
scanner or desktop scanner. The bonded splinting of the
scan bodies to the mesh frame allows for a simple un
interrupted scan path. The Grammetry process provides
the clinician with the fully digital benefits of photogrammetry while providing the capability to fabricate analogue
models that can be articulated as part of the prosthetic design process represented by the clinical workflow (Fig. 5).
Additionally, the Grammetry splint can be used as a model
verification jig. The fully digital Grammetry process communicates to the dental laboratory the necessary records
workflow to design and fabricate a full-arch prosthesis at
a significantly reduced cost. For those who have 3D printers
and wish to design and print the provisional prosthesis,
a calibration device is included in the Grammetry kit. This
device will ensure that the specific printer settings based
on the resin used will achieve a passive fit.
Ti base or not Ti base? That is the question
The desire for screw retention over cementation for fixed
prostheses has been debated for some time.11 As restorative components have evolved and CAM software and
7a
7b
hardware capabilities have improved dramatically, screw
retention utilising MUAs has become the preferred choice
for most full-arch restorations owing to the passivity
required for monolithic zirconia prostheses. The success
of full-arch screw-retained cross-splinted restorations
can be attributed to the elimination of subgingival cement
and the passivity of prosthesis seating.12
Screw-retained fixed implant prostheses have undergone many iterations over the past several decades.13
PMMA denture conversions proved too weak to withstand occlusal forces long term. To improve strength,
metal frame reinforcement was added to the acrylic,
but the end results still yielded a high level of long-term
prosthetic failures. Improvements in metal–ceramic
restorations yielded improved long-term aesthetics and
longevity; however, the associated costs became a factor
and fractures continued to occur. Owing to the improving
strength and diversity of materials and the continued
development of CAD/CAM technology, other material
choices have become more viable. Monolithic zirconia
has become the most widely used material for full-arch
implant-supported restorations.14, 15 The milled and sintered zirconia structure can be fabricated with a standard
MUA coping, a custom-milled titanium bar or a titanium
base (Fig. 6). These metal substructures are chemically
luted to the zirconia structure. Initially, while costs were
significantly reduced, fractures were still evident, most
notably from poor design. The fractures tended to occur
in distal extensions, attributed to poor anterior–posterior
7c
Figs. 7a–c: Dimensions of a standard multi-unit abutment screw head and the available zirconia (a & b), leading to fracture (c).
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[39] =>
spread, and in locations of screw access holes. Screw
access fractures can be attributed to insufficient zirconia
thickness at the crown–abutment interface. Conventional
prosthesis-retaining screws secured to MUAs have a
screw head that is 2.00 mm in diameter, only allowing for
0.25 mm of screw surface to engage the crown portion
(Fig. 7). This leaves only 0.4 mm between the head of
a conventional screw and the titanium base. Screw
loosening, screw fracture and debonding of titanium
bases from the zirconia structure have become a source
of difficulty and concern.16 As these complications and
avoidable remakes continue to persist, developers have
searched for alternative solutions.
To counter the effects of screw loosing, titanium base
debonding and screw access hole fracture, several new
screws have been developed. Over the past few years,
the continued refinement of these screws has led to
the evolution of metal-free full-arch monolithic zirconia restorations. As a result, in many cases, the need
for excessive bone reduction to accommodate the metallic portion has been eliminated, allowing for increased
potential for Misch classification FP-1 compared with
FP-3 restorations.17 Some of these screws allow for
increased thickness of zirconia between the MUA and
screw head. Allowing increased thickness in this susceptible region further reduces the risks of zirconia fracture
of the area of the screw access hole. Additionally, the
newer screws typically have a tapered or rounded screw
head, allowing for improved retention by applying pressure to the lateral walls in the apical direction, reducing
incidences of screw loosening.
A few of these newer screw designs can accommodate
angled screw access holes. Angled screw access hole
correction has become widely incorporated in single-
tooth implant restorations.18 Previously, correcting angulations for full-arch restorations on MUAs required using
an MUA with an increased degree of angulation. When
an MUA is secured to the implant and the scan data has
been captured, altering the screw access hole requires
removing and replacing the MUA with one with an increased angle. This becomes problematic when provisional or final restorations have already been designed,
and a positional tooth change is requested. Often, these
changes can leave access holes in aesthetic or potentially vulnerable areas (Fig. 8). Additionally, there are
angular limitations of MUAs, varying according to each
component manufacturer. Rather than changing the
MUA and dealing with the difficulties of temporisation,
some of the newer MUA screw technologies allow for the
MUA to remain in place and for angulation of the screw
access hole to as much as 25°. One screw in particular
that is uniquely designed in this regard is the Grammetry
Vortex LA VIS screw (Fig. 9). This screw can accommodate various vertical positional depths. This feature allows
for accommodation directly on the MUA, titanium base
8a
8b
Figs. 8a–c: Straight screw access hole (a). Angled screw access hole of up
to 15° (b). Straight vs angled screw access holes and variation in access hole
positions for improved strength and aesthetics in multi-unit abutments (c).
or titanium bar simply by adjusting the height position
of the screw. The adjustable vertical position allows for
more or less zirconia if desired, depending on the available interocclusal space. In addition to accommodating
angled screw access holes, the ideal screw access
position and depth can be achieved.
Therefore, utilising the innovative methods of data capture
and validation described in this article combined with
the newer screw technology, it is possible to accomplish
increased efficiency and accuracy of the fabrication
process. Additionally, it has been illustrated that screws
which can accommodate an angled screw access hole
will result in improved aesthetics (Fig. 10).
Case presentation
The following case exhibits the features and benefits of
utilising Grammetry in combination with innovative screw
technology. The 63-year-old male patient with a non-
contributory medical history presented with failing dentition in both arches. Diagnostic records were collected,
including full-mouth digital radiographs (RVG 6200,
8c
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[40] =>
| case report
9
Fig. 9: Grammetry Vortex LA VIS screw attached directly to the multi-unit abutment, allowing for increased thickness of zirconia dependent on the available
interocclusal space. (Image © Dr Danny Domingue)
arestream Dental; Fig. 11a), intra-oral scans (Medit i700
C
wireless; Figs. 11b & c), a large field of view CBCT scan
(Carestream 9600; Fig. 11d), and intra-oral and extra-oral
photographs (Fig. 11e). The mandible contained an impacted canine as well as several mobile and painful teeth.
The maxilla was in a similar condition, having deteriorating,
painfully mobile teeth, as well as extensive caries. While
the bone loss was significant in the mandible, the vertical
dimension of occlusion (VDO) allowed for both arches to
be treated with an FP-1 prosthesis.
Grammetry
Grammetry screw
Rosen screw
DESS 19.018-P10 screw
Powerball screw
Angled screw access hole
Outward pressure
Downward pressure
Downward & outward pressure
Downward and outward pressure
Wedge channel—tough to mill
Tight channel
Closed system
Variable height settings for materials
Right-angled seat
Breakaway driver at 17 Ncm
Wide channel
10
Fig. 10: New and innovative screw technology features and benefits with design and torque information.
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case report
|
11a
Figs. 11a–e: Full-mouth radiograph series revealing caries and periodontal defects (a). Maxillary and mandibular intra-oral scans (b & c). CBCT scan for
diagnosis and treatment planning (d). Pre-op photograph showing a reverse curve of the mandibular teeth and poor aesthetics (e).
Based on the assessment of the acquired data, several
treatment plans were developed and presented to the
patient. Treatment concepts that were considered
included salvaging those teeth deemed stable enough
to be utilised to retain removable restorations, implant
stabilisation with a combination of fixed and removable
prostheses, implant-supported overdentures and fullmouth reconstruction with implant therapy. After reviewing
the various treatment proposals, the patient elected
the last option.
11b
11c
11d
11e
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| case report
12a
12b
12c
13
Figs. 12a–c: Using extracted teeth to achieve autologous bone substitute using the Smart Dentin Grinder. Fig. 13: Guided osteotomy preparation using
a Universal Shaper drill with CHROME GuidedSMILE.
The collected data, along with preliminary plans for
potential implant receptor sites (Blue Sky Plan, Blue
Sky Bio), was submitted to the laboratory (ROE Dental
Laboratory) for review. The 3D data from the CBCT scan
was then merged with the IOS data set to aid in determining a restoratively driven solution for both arches.
The laboratory then designed provisional full-arch screw-
retained restorations utilising CAD software at the designated VDO required for the prostheses. The desired
tooth position as visualised with the 3D reconstructed
volume of bone helped to determine the most favourable
implant receptor sites. A virtual remote planning session
was held with the laboratory to finalise the full-template
14c
guided surgical plan (CHROME GuidedSMILE, ROE Dental
Laboratory), which incorporated a 2 mm increase in the
VDO, and the case was sent for production. The CHROME
GuidedSMILE protocol consists of several component
parts, which provide a stackable solution with metallic
scaffolding to control the bone reduction, the preparation
of the osteotomies, full-template guidance of the implants
into the bone, control of implant depth, trajectory and
rotational indexing, the positioning of the MUAs, and the
delivery of the provisional restorations.1
The surgery for both arches was completed in a single visit
under intravenous sedation. All the remaining teeth were
14a
14b
14d
14e
Figs. 14a–e: Retracted view of the provisional restorations (a) fabricated with C2F small hole technology (b). Two-week post-op smile (c). Two-week post-op
panoramic radiograph and intra-oral photograph showing excellent healing (d & e).
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case report
15a
|
15b
Figs. 15a–h: Facial scan for smile evaluation and midline assessment (a). Intra-oral scanning Grammetry workflow for transfer to the dental laboratory (b).
Photogrammetry scan bodies used to validate and confirm the Grammetry implant positions (c & d). 3D-printed maxillary and mandibular restorations
on verification casts (e & f). Grammetry OptiSplint used to capture implant positions for model fabrication (g & h).
15c
15d
15e
15f
15g
15h
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16a
16b
Figs. 16a & b: Panoramic radiograph showing printed restorations secured with Grammetry Vortex LA VIS screws (a). Retracted intra-oral view (b).
extracted, and selected teeth were then pulverised utilising
the Smart Dentin Grinder (KometaBio) and sterilised to be
used as autografting bone substitute2 (Fig. 12). A biologically
driven drilling system for anatomical alveolar sculpting
(Universal Shapers) was employed (Fig. 13). The alveolar bone was scalloped utilising the diamond shaper drills
for both implant and pontic sites to promote emergence
profiles for enhanced aesthetics according to the basic tooth size requirements assessed from the initial data
collection. The surgery was uneventful except for a mild
complication during the extraction of the impacted
mandibular canine. Implant stability was measured with
resonance frequency analysis (implant stability quotient)
to validate loading. MUAs were secured to each implant
based on the rotational positions predetermined by the
surgical planning. Deficient sites and residual tooth sockets were then grafted with the ground dentine autograft,
covered with platelet-rich fibrin membranes and sutured
around the healing abutments. Provisional restorations
were fabricated using the C2F protocol (Figs. 14a & b).4
After customisation and polishing, the provisional restorations
were inserted and allowed to heal (Figs. 14c–e).
During the subsequent postoperative visits, the patient
described being extremely happy with his newly rehabilitated mouth. As the preliminary provisional restorations
had been designed based on the desired virtual result, it
was possible to make changes as necessary for the final
17a
17b
17c
Figs. 17a–c: Final panoramic radiograph confirming seating of the zirconia
restorations (a). Retracted intra-oral view (b). Final patient smile showing
excellent aesthetics and a happy patient (c).
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restorations. A slight discrepancy was observed in initial
tooth size and midline position, and this was noted in order
to be corrected during finalisation of the monolithic zirconia
restorations. The patient tolerated the 2 mm increase in
VDO, and minimal adjustments to the occlusion were
accomplished through digital articulation (OccluSense,
Dr. Jean Bausch). Tissue healing was unremarkable
apart from minor loss in alveolar height and soft tissue in
the impacted canine extraction site.
After four months, the patient returned to complete the
process of finalising the prostheses. Final records were
taken, including new digital scans and photographs.
Photographs included the patient profile when smiling and
not smiling as well as intra-oral occlusion. The digital scans
included a facial scan acquired from the CBCT device,
maxillary and mandibular soft-tissue scans using scan
bodies (DESS), bite registration, an iJIG scan of the provisional restorations for tooth positions,3 photogrammetry
(iCam4D, iMetric 4D) and Grammetry scans (Fig. 15). The
Grammetry scans were scanned extra-orally with both
the intra-oral scanner and an extra-oral desktop scanner
(Medit T710) for comparison.
The data collected was sent through a scanning software
portal (Medit Scan for Clinics) to the dental laboratory with
requested changes for correction of the desired smile design.
Utilising advanced planning features in the design software
(exocad), the midline and tooth size changes were corrected.
3D-printed maxillary and mandibular PMMA restorations
were used for try-in using the direct-to-MUA screws
(Vortex LA VIS; Fig. 16a). Fit, phonetics, aesthetics and occlusion were evaluated and confirmed using digital articulation
(OccluSense; Fig. 16b). The patient was extremely satisfied
with the printed try-ins. Since no adjustments were required,
the patient was allowed to leave with the printed try-ins as
new provisional restorations made from extra-strong resin.
The new provisional restorations were worn for ten days
to confirm form and function. The final shade was chosen,
and metal-free monolithic zirconia restorations were then
fabricated by the laboratory.
The final restorations were passively and accurately seated
ten days later uneventfully using Vortex LA VIS screws.
Confirmation records were taken with photographs,
radiographs and digital articulation to recheck fit, function,
phonetics and occlusion (Fig. 17a). The patient was extremely satisfied with his final restorations, describing the
process as life-changing and surprisingly fast in comparison
with what he had heard about full-mouth implant therapy.
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case report
He was especially pleased with the speed at which the final
process was able to be completed (Figs. 17b & c).
Conclusion
With proper diagnosis and treatment planning, single-arch
or full-mouth implant reconstruction can be completed in
a timely manner under ideal circumstances. The implementation of restoratively driven guided surgery can improve
accuracy and ensure proper implant placement, including
depth and angulation. Data collection at either the time of
surgery or postoperatively can improve the accuracy and
speed at which finalisation can be completed.
The present case described digital and analogue protocols for capturing soft-tissue topography as well as
the use of iJIG provisional restorations essential to aligning and validating the intra-oral position of restorations,
as well as the use of Grammetry and photogrammetry.
Voids can be shown with accuracy and adjusted to be
filled in using design software. With incorporation of a
2D profile photograph or, better yet, a 3D facial scan,
tooth position, size and shape can be easily managed for
an improved try-in or final restoration.
In this case, three methods were utilised to capture data to
provide a basis of comparison. The first, photogrammetry,
has been acknowledged as the gold standard for implant
position accuracy. The second, Grammetry, utilised the new
OptiSplint analogue luting protocols. The third, digital capture,
utilised the Grammetry OptiSplint, in which the intra-oral
scanner and extra-oral desktop captures were analysed and
compared. The extra-oral desktop capture of the Grammetry
OptiSplint was almost identical to the photogrammetry capture when both data sets were superimposed. The extra-oral
desktop capture of the Grammetry splint yielded marginally
better results than the intra-oral scan captured extra-orally.
Although the results may be slightly less accurate due to the
human error associated with intra-oral scanners, they were
more than acceptable, as CAD/CAM unit tolerances prevent
milling beyond the results obtained. An added benefit of
using the Grammetry process is the possibility of producing
a physical model, allowing for an analogue try-in for producing
both printed try-in and final milled restorations.
In summary, there are various existing digital workflows
which can be successfully utilised to achieve consistent
and accurate results for full-arch implant-supported restorations. Currently, owing to supply chain shortages and
limitations, photogrammetry devices are on back order and
in short supply. Grammetry protocol components are both
available and less expensive. For the purposes of this case
presentation, it was found that the analogue–digital protocol
of Grammetry can be used as an effective, affordable and
equally accurate alternative to photogrammetry. In combination with the necessary records, Grammetry can provide
a fully digital capture of implant positions while providing
|
analogue models if desired for articulation and restoration
fabrication. Capturing data either on the day of surgery or
later on can greatly improve dental laboratory communication
and reduce final prosthesis production time while supporting
a high level of accuracy, enhancing the overall clinical and
patient experience. Future research on the protocols and
materials utilised for this case presentation is recommended,
as the search for the most economical and accurate digital
workflows continues to evolve.
Editorial note: This article originally appeared in Dentistry Today in May 2023,
and an edited version is provided here with
permission from Dentistry Today. Please
scan this QR code for the list of references.
about
Dr Isaac D. Tawil received his DDS
from the New York University College
of Dentistry and has a master’s
degree in biology from Long Island
University, both in the US. He is a
fellow of the International Congress of
Oral Implantologists and the Advanced
Dental Implant Academy, a diplomate
of the International Academy of Dental
Implantology and a co-director of Advanced Implant Education.
He has received recognition for outstanding achievement in
dental implants treatment from the Advanced Dental Implant
Academy, as well as the President’s Volunteer Service Award
for his volunteer work in places such as Honduras, Mexico,
the Dominican Republic, China and Peru. Dr Tawil lectures
internationally on advanced dental implant procedures using
the latest technology and teaches live surgery seminars in his
office and abroad, as well as hands-on courses globally.
He maintains a general private practice in New York,
where he focuses on implant therapy.
He can be reached at tawildental@gmail.com.
Dr Scott D. Ganz completed a 3-year
specialty in maxillofacial prosthetics
at the University of Texas MD
Anderson Cancer Center in Houston,
in the US, and this led to his focus
on the surgical and restorative
phases of implant dentistry. He has
contributed to 22 textbooks and over
150 publications, lectures globally,
is a diplomate of the Academy of Osseointegration, a fellow
of the International College of Dentists, and co-director of
Advanced Implant Education. He maintains private practices
in Fort Lee, in New Jersey, and Manhattan, in New York.
He can be reached at drganz@drganz.com.
1 2024
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[46] =>
© Anatoliy Cherkas/Shutterstock.com
| feature
1
Fig. 1: Dr Mahfuz Rahman believes that all dentists must be able to take high-quality aesthetic dental photographs.
“Photography is absolutely critical
for the modern dental practice”
An interview with Dr Mahfuz Rahman
By Iveta Ramonaite, Dental Tribune International
Dr Mahfuz Rahman is a dentist and founder of Frisco Dental
Studio in Texas in the US. He is also a dental photography
enthusiast and takes great pleasure in capturing his patients’ confidence and excitement after dental treatment.
He has recently shared his expertise in a webinar on dental
photography specifically tailored for dental professionals
on the Dentsply Sirona Academy Campus. In the run-up to
the event, Dental Tribune International had the pleasure of
speaking to Dr Rahman about the significance of taking great
clinical photographs in contemporary dental practice and
how it can help improve patient care and communication.
Dr Rahman, what are the core principles of dental
photography that every dentist should be aware of,
2
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Fig. 2: Dr Mahfuz Rahman is a fellow of the Academy of General Dentistry.
(Image: © Mahfuz Rahman)
[47] =>
feature
3
|
4
Figs. 3 & 4: Adding intra-oral photographs to patient files significantly enhances documentation. (Image: © Mahfuz Rahman)
“In the age of Instagram,
our social media pages are
the modern-day business
cards for dental offices.”
and what equipment should a dentist own in order to
capture high-quality dental images?
Every dentist should be able to take high-quality aesthetic dental photographs with proper retraction, lighting
and framing. They should also know the core principles
of the aperture or f-stop. Mastering this one aspect can
help dental professionals produce consistently beautiful
photographs every time.
Essential equipment includes digital single-lens reflex
(DSLR) cameras, macro lenses, external flashes mounted
on stands on dual-point flash brackets, and flash transmitters or receivers.
In your opinion, how important is it for modern dental
practices to master dental photography?
Photography is absolutely critical for modern dental
practice. In the age of Instagram, our social media pages
are the modern-day business cards for dental offices.
Aesthetic case photographs indicate to prospective
patients the type of dentistry that is done in that office
as well as the office’s commitment to quality and fine
detail.
What other topics will you discuss in your webinar?
We will examine different intra-oral and portrait set-ups
for large and small offices. We will consider how to position the patient effectively and which accessories to use.
We will also discuss how to use simple procedures for
a good clinical photograph so that any team member in
the office can take beautiful photographs.
Editorial note: Dr Mahfuz Rahman’s webinar, titled
“
Mastering dental photography: Elevate your practice
with compelling images” is available on demand. More
information about the Dentsply Sirona Academy Campus
can be found at https://campus.dentsplysirona.com.
What effect does dental photography have on patient
communication and case documentation?
Great photographs are a wonderful tool for communicating with patients and helping with case acceptance.
Photographs allow the patient and dental professional
to better articulate clinical concerns with each other.
They enable the dentist to better communicate with dental
laboratories and allow him or her to give patients something tangible they can reference during diagnosis.
Could you share some foolproof techniques for
capturing high-quality dental images?
Using a DSLR camera with a macro lens is an absolute
must. Dental professionals can then attach a dual-point
bracket to the camera and connect a dual-point flash
with soft boxes. Once that is done, the main thing to
master is the f-stop button on the camera. For intra-oral
photographs, f/25 to f/29 are used, and for portrait
photographs, f/13 to f/15.
5
Fig. 5: Dental photography is an excellent tool for case presentation and allows
the patient to visualise his or her smile after treatment. (Image: © Mahfuz Rahman)
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[48] =>
| industry news
New artificial intelligence-driven workflows in 3Shape’s laboratory software reduce time-consuming steps for laboratory technicians. (Images: © 3Shape)
3Shape presents new AI workflows
for improved dental laboratory efficiency
By 3Shape
3Shape has recently announced a series of new
workflows in its laboratory software that are driven by
artificial intelligence (AI). Additionally, the company has
announced that its laboratory management software,
3Shape Lab Management Software (LMS), is now fully
available to laboratories in North America.
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Dr Rune Fisker, senior vice president for product strategy
at 3Shape, commented: “With these new AI-driven
workflows, we are revolutionising the way labs work.
Rather than designing from scratch step by step, the
AI generates model and design proposals that technicians can inspect and make corrections to only if needed.
[49] =>
industry news
|
Dr Rune Fisker.
to its services. Automate allows laboratories to expand
their treatment capacity, supporting them during busy
periods, emergencies and employee absences. In 2023,
3Shape Automate delivered over two million crown designs, demonstrating its usefulness for laboratories.
New 3Shape scanning software uses AI
to trim gypsum model scans automatically
The software that drives the scanning process now reduces interactions and workflow time so that technicians
can spend more time designing. Users scan as always,
and the AI algorithm will present a trimming proposal that
they can edit or accept as is.
AI helps them to work more efficiently while also enabling
them to focus on the more complex aspects of their designs.”
New laboratory software solutions
Model Builder Express with AI-driven workflow
makes model production fast and easy
A completely new Model Builder Express for laboratories
enables stand-alone dies and automates many steps in
the workflows. The AI generates a model proposal that
users can inspect and correct only if needed.
Default settings in the app are now editable, and users
can take advantage of trimming toggle options for faster
model adjustments.
3Shape Automate now with anterior tooth design
3Shape Automate—3Shape’s remote digital design service powered by AI—has added anterior tooth design
Implant Studio with automatic outlining
in surgical guide design workflow
Implant Studio 2024.1 uses AI technology to analyse
the jaw and create the outline for a full-coverage surgical
guide. The software builds the outline automatically
without additional input. Users can easily edit the guide
outline or start over if they want a different design.
3Shape LMS is now available
for laboratories
3Shape LMS provides integrated workflow management for
all types of cases, digital and analogue. It empowers dental laboratories to be more efficient in everyday tasks while
nurturing client relationships built on better customer communications and improved tracking of orders, cases and invoices.
More information about the company can be found at
www.3shape.com.
Editorial note: The AI trimming proposal feature is only
available with 3Shape E4 and F8 laboratory scanners.
1 2024
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[50] =>
| manufacturer news
State-of-the-art hardware and materials
SprintRay revolutionises chairside 3D-printing workflows
SprintRay, a distinguished leader in 3D-printing solutions for
digital dentistry, is spearheading a transformative era in chairside
3D printing. Unveiling state-of-the-art hardware and materials,
the company is poised to redefine efficiency standards for dental
practices and laboratories across the globe.
At the core of the SprintRay 3D-printing ecosystem are
precision-engineered printers meticulously designed for dental
applications. These printers seamlessly integrate with the
automated ProWash S wash and dry system, featuring
advanced software and cloud capabilities that facilitate smooth
communication between various SprintRay devices. In addition,
the ProCure 2 polymerisation device sets a new industry benchmark, delivering dental model polymerisation in as little as
90 seconds.
Championing the cause of chairside 3D printing, SprintRay is
driving workflows to unprecedented speeds, supporting comprehensive treatments in a single appointment. The introduction of
the SprintRay Crown Kit to the company’s ecosystem further
amplifies speed.
By integrating the kit and its groundbreaking artificial intelligence
(AI) cloud design feature, SprintRay has positioned itself as the
industry’s first true chairside 3D-printing solution. SprintRay CEO
Amir Mansouri noted: “With the SprintRay Crown Kit, it is possible
to print definitive crowns in less than 15 minutes. With AI-driven
SprintRay Cloud Design, which designs crowns in under 5 minutes,
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the complete workflow from data capturing to delivery to the
patient can be done within an hour.”
Beyond cutting-edge hardware, SprintRay offers comprehensive
workflow solutions, encompassing the smart and AI-supported
nesting and slicing software RayWare, premium resins and design
services.
SprintRay’s commitment to innovation extends to groundbreaking
materials such as the durable and flexible SprintRay NightGuard
Flex 3D-printing resin. Patrick Thurm, general manager of
SprintRay Europe, affirmed: “We are pleased to offer our latest
night guard materials to our customers worldwide.”
Night guards and crowns represent only a fraction of SprintRay’s
extensive workflow capabilities. The company supports a
diverse range of dental applications, including dentures, surgical
guides and try-ins. The company’s design services further
simplify implementation, providing dental professionals with
case-by-case design options for the full spectrum of dental indications. Dental professionals can easily upload intra-oral scans
and treatment information and will receive ready-to-print
STL files. RayWare automates the placement of prints on the
platform and assists users with the set-up, ensuring a truly
smooth workflow.
www.sprintray.com
[51] =>
register at
www.roots-summit.com
9 to 12 May
DENTAL EXPERTS
Antonis Chaniotis
Juan Mesquida
Ruth Pérez-Alfayate
Ali Vahdati
Spyros Floratos
Matthias Zehnder
AND MORE...
THE GLOBAL DENTAL CE COMMUNITY
Tribune Group GmbH is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in
identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply
acceptance of credit hours by boards of dentistry. Tribune Group GmbH designates this activity for 18.5 continuing education credits. This continuing
education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP)
through joint efforts between Tribune Group GmbH and Dental Tribune International GmbH.
[52] =>
| meetings
Dentsply Sirona connects dental
professionals at the Implant S olutions
World Summit 2024 in Miami
By Dental Tribune International
The Implant Solutions World Summit is coming to
Miami in the US from 13 to 15 June and promises
to deliver inspiration, confidence and passion. This exclusive, state-of-the-art congress is focused on science
and implant dentistry and offers many networking
opportunities.
perts from around the world to share their expertise and
inspire the future of implant and prosthetic innovations,”
he continued.
With its commitment to advancing oral health and de
livering innovative solutions, Dentsply Sirona has put together an exceptional programme that features an array
of enlightening keynote presentations, engaging panel
discussions and interactive workshops. Attendees can
look forward to exploring the latest trends, research and
breakthroughs in the field of implant dentistry.
The Implant Solutions World Summit programme is
being developed together with the scientific chairs,
Prof. L
yndon F. Cooper, dean of Virginia Commonwealth
University School of Dentistry in the US, and Dr Malene
Hallund, a prominent oral and maxillofacial surgeon in
Denmark. Designed to empower dental professionals and
foster collaboration, the dynamic programme will feature
plenary sessions, breakout sessions and master classes.
Leading experts in implant dentistry, bone regeneration
and digital dentistry will share their knowledge and insights,
present their case studies and offer practical skills.
“It is an honour to host the Implant Solutions World S
ummit
again in 2024,” said Tony Susino, group vice president
of global implant and prosthetic solutions at Dentsply
Sirona. “This event reflects our commitment to ad
vancing implant dentistry through education, innovation
and collaboration. We are excited to bring together ex-
52
1 2024
A scientific programme featuring leading
experts in implant dentistry
The scientific sessions will cover several key areas in
implant treatment. First of all, the latest scientific research
[53] =>
meetings
and data will be presented to reassure dental professionals of the core commitment to clinical success, aesthetic
results and patient safety. Secondly, a great focus will be
placed on the role of bone augmentation and regeneration in implant treatment, including the management of
complications and risk factors. Lastly, the programme will
dive into the how and why of digital dentistry and examine
how it can improve an already great practice and boost
practice growth with digital implant workflows, from
single-tooth to full-arch.
Inspiration Hub exhibition area
for implant workflows and solutions
The Inspiration Hub exhibition area is where interaction,
inspiration, knowledge and passion come perfectly
together—it is the place to learn about implant workflows
and solutions. Attendees will be able to experience
the full implant treatment workflow first-hand and
at their own pace together with Dentsply Sirona
experts. They will learn more about the focus on scientific
expertise and commitment to long-term science and future innovation, and they will have the opportunity to build
their professional networks and be part of a fantastic community of implant professionals from all over the world.
The exhibition will feature Dentsply Sirona’s products,
solutions and treatment workflows, including the EV implant
family, OSSIX regenerative solutions and the cloud-based
DS Core platform.
|
“This event reflects our
commitment to advancing
implant dentistry through
education, innovation
and collaboration.”
in the field of implant dentistry. At the Implant Solutions
World Summit 2024, attendees will have the opportunity
to participate in one of eight parallel master classes designed to enhance knowledge and skill level in implant
dentistry. The master class programme will feature both
lectures and hands-on sessions, including a cadaver
course and a porcine jaw course. It will cover topics concerning practice growth and oral systemic health and
focus on digital advancements in clinical workflows
and the application of econometrics to dental practice
management and advanced aesthetic dentistry.
Implant Solutions World Summit 2024
Boosting knowledge with master classes
The Implant Solutions World Summit is an exclusive
state-of-the-art congress focused on science and implant dentistry. Attendees will meet prominent industry
leaders and international speakers in a scientific programme designed to provide inspiration and confidence
for the entire dental team.
Attending a master class is a great opportunity to expand
one’s knowledge under the guidance of leading experts
To find out more information about the event and to
register, visit www.dentsplysirona.com/worldsummit.
1 2024
53
[54] =>
| meetings
The next MIS Global Conference will be held in Palma de Mallorca in Spain.
MIS unveils plans for its global
conference in Palma de Mallorca
By Dental Tribune International
MIS Implants’ much-anticipated fifth
global conference will take place from 12 to
15 September on the picturesque Spanish
island of Mallorca. Geared to captivate
a large audience of dental professionals
from around the globe, the MIS Global
Conference is a leading event in the dental
implant industry, offering a comprehensive
scientific programme, high-level lectures
and fantastic entertainment.
intelligence expert focusing on leadership,
team building and high performance under
pressure, promising an enriching and educational experience for all attendees.
Prof. Lior Shapira, a distinguished member
of the scientific committee, expressed his
excitement about the conference venue,
stating: “We are thrilled that the next
MIS Global Conference will be held in
Palma de Mallorca in Spain. This beautiful
island is the perfect setting for a world-class
This year’s conference is poised to spotlight the latest trends and innovations in
dental event, continuing the 360° Implantology
implant dentistry. The two-day scientific
tradition. The scientific committee has crafted
programme boasts a comprehensive itinan inspiring programme, offering networking
erary, encompassing hot topics such as
opportunities with top-notch professionals.
Prof.
Lior
Shapira,
member
of
the
s
cientific
the smile zone, the digital workflow and
We eagerly anticipate welcoming dental
committee
of
the
conference.
tissue stability.
professionals worldwide to join us for an
unforgettable experience.”
Prominent experts in the field form an impressive speaker
line-up, featuring Dr Juan Arias Romero, Dr Serhat Aslan,
Call for clinical cases
Prof. Nitzan Bichacho, Dr Darko Božić, Dr Victor Clavijo,
Dr Tali Chackartchi, Dr Pablo Galindo, Prof. Moshe Goldstein,
In addition to the robust scientific programme, the conferDr Gustavo Giordani, Dr Galip Gurel, Hilal Kuday,
ence will host a clinical case competition for young clinicians
that will focus on various aspects of dental implantology in
Dr Stefan Koubi, Dr Alberto Monje, Dr Ariel J. Raigrodski,
Dr Ausra Ramanauskaite, Dr Isabella Rocchietta, Prof. Mariano
contemporary patient care, including clinical applications,
concepts, materials and technologies. Cases will be preSanz Alonso, Dr Ignacio Sanz Sánchez and Dr Ventseslav
sented in both video and e-poster formats, allowing dental
Stankov.
photographers to showcase their skills.
Highlights of the conference include a live surgery by
the well-known prosthodontist Dr Stavros Pelekanos and
For more information about the MIS Global Conference, please
a special appearance by Dr Mario Alonso Puig, a human
visit the official website at https://360.mis-implants.com.
54
1 2024
[55] =>
Register at
www.dds.berlin
Digital
Dentistry
Show
In collaboration with
Digital
Dentistry
Society
OF DENTISTRY
OF DENTISTRY
D I G I TA L D E N T I S T R Y S H O W • U N V E I L I N G T H E F U T U R E
DIGITAL
DENTISTRY
SHOW
D I G I TA L D E N T I S T R Y S H O W • U N V E I L I N G T H E F U T U R E
28 & 29 JUNE 2024
[56] =>
| meetings
International events
KRAKDENT 2024
ROOTS SUMMIT
11–13 April 2024
Krakow, Poland
www.krakdent.pl/en
9–12 May 2024
Athens, Greece
www.roots-summit.com/en
19–21 April 2024
Singapore
www.idem-singapore.com
56
1 2024
13–15 June 2024
Miami, USA
www.dentsplysirona.com/
worldsummit
IDEX 2024
DDS.Berlin
8–11 May 2024
Istanbul, Turkey
www.idex.org.tr
28–29 June 2024
Berlin, Germany
www.dds.berlin
exocad Insights 2024
6th MIS Global Conference
9–10 May 2024
Palma de Mallorca, Spain
www.exocad.com/insights2024
12–15 September 2024
Palma de Mallorca, Spain
www.mis-implants.com
ITI World Symposium 2024
CAD/CAM Digital
& Oral Facial Aesthetics
37th Int’l Dental
ConfEx
9–11 May 2024
Singapore
www.worldsymposium.iti.org
15–16 November 2024
Dubai, UAE
www.cappmea.com/confex2024
© 06photo/Shutterstock.com
IDEM Singapore 2024
Implant Solutions
World Summit 2024
[57] =>
|
© 32 pixels/Shutterstock.com
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Questions?
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(Managing Editor)
m.wojtkiewicz@dental-tribune.com
1 2024
57
[58] =>
| international imprint
Imprint
Publisher and Chief Executive Officer
Torsten R. Oemus
t.oemus@dental-tribune.com
Editor-in-Chief
Dr Scott D. Ganz
Managing Editor
Magda Wojtkiewicz
m.wojtkiewicz@dental-tribune.com
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Prof. Albert Mehl (Switzerland)
International Administration
International Headquarters
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Dental Tribune International GmbH
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General requests: info@dental-tribune.com
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Magazine
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All rights reserved. © 2024 Dental Tribune International GmbH. Reproduction in any manner in any language, in whole or in part, without the prior written permission of Dental Tribune International GmbH
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errors. The publisher also does not assume responsibility for product names, claims or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune
International GmbH.
58
1 2024
[59] =>
June 13–15, 2024
Inspiration, confidence and passion
Implant Solutions World Summit is coming to you in Miami,
Florida, USA, in 2024 – are you ready for inspiration, confidence
and passion delivered?
On June 13–15, you will discover cutting-edge science and the
latest innovations in implant solutions, digital dentistry and
bone regeneration and enjoy the company of world-renowned
speakers, colleagues and friends.
Join world-leading experts in implant dentistry
Implant Solutions World Summit is an exclusive, state-of-the-art
congress focused on science and implant dentistry. In Miami,
you will meet renowned industry leaders and outstanding
international speakers in a scientific program focused on
inspiration and confidence for you and your team.
If you are you passionate about implant dentistry and
committed to science, innovation, and education, then join us
in Miami and discover how you can provide your patients with
optimized treatment solutions.
Register now
dentsplysirona.com/worldsummit
#ImplantSolutionsWorldSummit
Follow Dentsply Sirona for
the latest in implant dentistry
dentsplysirona.com/implants
[60] =>
CONELOG®
PROGRESSIVE-LINE
conical performance [1, 2]
at bone level
Precise conical connection
Long conus for reduced micromovements
Superior positional stability in comparison to other
conical systems [1, 2]
Integrated platform switching supporting the preservation
of crestal bone
www.biohorizonscamlog.com/conelog
[1] Semper-Hogg, W, Kraft, S, Stiller, S et al. Analytical and experimental position stability of the abutment in different dental
implant systems with a conical implant–abutment connection Clin Oral Invest (2013) 17: 1017.
[2] Semper Hogg W, Zulauf K, Mehrhof J, Nelson K. The influence of torque tightening on the position stability of the
abutment in conical implant-abutment connections. Int J Prosthodont 2015;28:538-41.
CONELOG® is a registered trademark of CAMLOG Biotechnologies GmbH. It may however not be registered in all markets.
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/ Table of contents
/ Dentistry digests a volatile 2023: The fourth quarter of 2023 yielded mixed results for dental companies as the industry struggled with the ongoing effects of the SARS-CoV-2 pandemic.
/ News: Intra-oral scanners helpful in paediatric dental communication—study
/ Market report by Donna Santos and Dr Kamran Zamanian, iData Research: Digital fuel—what is propelling the markets for 3D printers and other CAD/CAM devices?
/ Clinical report by Ronen Horovitz & Dr George Freedman: 3D face scanning: Affordable and user-friendly
/ Potential of AI as an assistant in oral surgery considering accuracy and legal aspects: An interview with Prof. Víctor Díaz-Flores García
/ “Our vision is to accelerate access to oral care globally”: An interview with Dr Amir Mansouri, CEO of SprintRay
/ The balance between innovation and tradition: An interview with Dr Christoph Reinschmidt and Albin Gygli, Straumann Group
/ User report by Dr Miloš Ljubičič: 3D-printing inlays, onlays and overlays with SprintRay: A revolutionary approach to dental restorations
/ Case report by Dr Marco Degidi & Gianluca Sighinolfi: Immediate loading of the posterior maxilla with two abutment-level bridges produced in a digital workflow
/ Case report by Dr Adam Nulty: Guided implant placement and restoration: A comprehensive approach
/ Case report by Drs Isaac D. Tawil & Scott D. Ganz: Fully digital full arch? Continued advancements in full- arch implant restoration
/ “Photography is absolutely critical for the modern dental practice”: An interview with Dr Mahfuz Rahman
/ Industry news: 3Shape presents new AI workflows
/ Manufacturer news: SprintRay revolutionises chairside 3D-printing workflows
/ Meetings: Dentsply Sirona connects dental professionals at the Implant Solutions World Summit 2024 in Miami, MIS unveils plans for its global conference in Palma de Mallorca
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/ Submission guidelines
/ Imprint
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