MODERATORS: C. Mangano, E. Mijiritsky
In dentistry new digital tools such as intra and extra oral scanners, conebeam computed tomography (CBCT), software systems for computer-aided design and manufacturing (CAD / CAM) are used in our practices. Innovative manufacturing procedures, such as 3D printing and Laser Sintering are changing the way we treat our patients. As a result, clinical procedures are moving towards completely digital workflows, which can be useful in all fields of dentistry, from conservative and prosthetic, to implant surgery and orthodontics.
Digital technologies have an increasingly important impact on daily practice in the studio therefore, the knowledge of their potential and their use is now a reality necessary.
There is no doubt that the digital age we are experiencing is also involving a revolution within the organization of the dental practice, resulting in a radical transformation of workflows and work protocols that involve the entire Dental Team.
The knowledge of the new tools available, their various features, the interaction, theirs advantages and limitations can make a difference in improving the management of the dental office and implement its effectiveness in order to offer ever greater quality in terms of time and performance for our patients.
My presentation aims to answer a series of questions that todayaffect each Dental Team who wants to approach and understand what the digital transformation: Why start thinking digital? What are the advantages? How to get started? What changes will it have deal with the dental staff? How does the management of the dental practice change? Which benefits for our patients?
Imaging is rapidly evolving, meanwhile steadily moving towards the inner core of oral health care. Indeed, the introduction of 3D imaging (CBCT, digital impressions) and digital dentistry in general, has generated a new critical balance between various dental disciplines, with a crucial central role for dentomaxillofacial imaging. Also, the ongoing revolution is creating a paradigm shift, with traditional radiodiagnostics as the prime business of dentomaxillofacial radiologists nowadays being dispersed between a vast number of imaging-based tools and therapies fitting the digital oral health care model. Researchers and clinical specialists have consequently moved in the same direction. They nowadays need imaging more than ever and not only for prime diagnostics. The growing importance of maxillofacial imaging in oral health care creates new challenges for DMFR specialists worldwide. The virtual patient creation and artificial intelligence (radiomics) are around the corner. Thus, there might be a need to redefine clinical competences and to attempt making training more inclusive. Yet and for sure, some of the ground-breaking challenges may remain beyond imagination.
In the full arch implant impression, the use of intraoral scanners is still considered a challenge. However, today the use of intraoral scanners in full arch implant scanning is possible, provided the operator is familiar with the key factors in determining the quality of the impression. These factors are:
1. the intrinsic accuracy of the scanner;
2. the scanning strategy and operator experience;
3. the number, position, inclination and depth of the implants;
4. the environmental conditions;
5. the type of scanbody chosen;
6. the congruence between scanbody mesh and implant library.
In this lecture, the speaker will report on all these factors, and their influence in determining the final quality of the impression.
The introduction of advanced technological devices in implant rehabilitation procedures changed completely the way we approach our cases from the collection of the data to the execution of the dental treatments.
There is no doubt that the use of modern equipment like cone bean computer tomography, intraoral scanner, face scanner and software for digital planning helps the clinician to make a more predictable treatment in both functional and esthetic aspects. At the same time, it is extremely important to correctly learn the use of these advanced devices to take advantages of all their features.
A precise learning curve must be followed, the author will present some simple rules for a correct approach to these technologies.
In the gnathological rehabilitation of a patient, repositioning of the condyle may be crucial to avoid inappropriate loading on the retrodiscal area of the temporomandibular joint (TMJ). Establishing a new position of the condyle within the glenoid cavity is not a simple procedure, and several clinical indications exist in the literature. Digital techniques and 3D visualization using CBCT represent an interesting aid while the analysis of mandibular motion with a real time visualization completes a 4D managing approach. In this scenario, clinical procedures are described by speakers on the basis of the evidence-based concepts for gnathological approach, using the recently introduced digital technologies.
All digital dental technologies are validated by parameters of reliability, precision, accuracy and congruence. Artificial intelligence is a smart tool which plays a main role in many technologies, minimizing errors and shortening the procedures of planning , matching and manufacturing. The lecture will present the state of the art of contemporary data and studies as well as demonstrate their applications in complex clinical cases.
The presence of alveolar ridge deficiencies is considered the major limitation to achieve a implant-prosthetic restoration with high aesthetics and stability over time. Guided Bone Regeneration (GBR) can be considered a predictable solution for bone augmentation. Many authors demonstrated the predictability of non-resorbable membranes or titanium meshes for bone augmentation for alveolar deficiencies. The use of PTFE membranes or titanium meshes can be consider the gold standard for bone augmentation because of 3 main reasons: adaptability, efficiency, and predictability. However, the use of a barrier device is a procedure not lacking complications: it is skill-sensitive, experience-sensitive, operator-senstitive, and above all technique-sensitive. For these reasons, it is important to make the right choice about surgical approach and biomaterials. Recently, some authors introduced an advanced technology for GBR, that is custom-made titanium mesh. The features of these devices can be different in according to the defects’ morphology and severity and to clinicians’ preferences. What about the futher evolution of customized titanium meshes?
Today, dentistry is evolving more and more towards minimum invasiveness in every field, from surgery to prostheses through conservative, with the ultimate aim of safeguarding the originally healthy structures as much as possible.
With this in mind, planning the pre-treatment correction of any dental discrepancies by means of clear aligners allows the clinician to be as much conservative as possible.
The inclusion of such e method in a digital workflow allows the result to be displayed even before starting the treatment.
The speaker will discuss comprehensive treatment plans integrated with clear aligner therapy, thus giving patients even better results thanks to the help of digital technology.