Artificial Intelligence Theraputics

AI system to evaluate dental restoration

The patent “Enhanced Techniques for Determination of Dental Margins in Intraoral Scans” covers a machine learning process applied in Smart Margin and Prep Assess

Source: Pearl gets patent for AI system used in dental restoration

Great, as if dentists aren’t critical enough of each other we will soon have an artificial intelligence telling us how bad our restorations are.

The developers claim that 80% of dental restorations are “sub optimal” and this algorithm will help find out why.

Despite my snark, I like the concept and will be interested to see if it actually works.

3D Printing CAD CAM Theraputics

XJet and Straumann partner to scale up ceramic Additive Manufacturing for dentistry

From 3D Printing Industry:

Material jetting specialist XJet has announced a global partnership with dentistry leader Straumann to advance the capabilities of its AM technology for dentistry applications. The duo intends to develop the XJet Carmel 1400 system currently used at the Straumann headquarters in Basel, Switzerland to begin producing end-use ceramic parts.

Source: XJet and Straumann partner to scale up ceramic Additive Manufacturing for dentistry – 3D Printing Industry

A step toward 3D printed ceramic restorations.

CAD CAM Digital Impressions Scanners

An In Vitro Study Comparing Five Intraoral Scanners

A study looking into the accuracy of digital scanning devices. Primescan and CS3700 were the most accurate.

A careful statistical analysis was performed. Results. PRIMESCAN® showed the highest congruence between SB MEs and LF, with the lowest mean absolute deviation (25.5 ± 5.0 μm), immediately followed by CS 3700® (27.0 ± 4.3 μm); the difference between them was not significant (p = 0.1235).

Source: JCM | Free Full-Text | Congruence between Meshes and Library Files of Implant Scanbodies: An In Vitro Study Comparing Five Intraoral Scanners | HTML

CAD CAM Management Paperless Radiography

The Captive Dentist

Imagine a world in which—if you owned a Volkswagen­—you could only fill up at a Volkswagen gas station using Volkswagen gas. Ford gas won’t work. You can only drive in the Volkswagen lane and take the Volkswagen off ramp. If the Volkswagen off ramp is closed for repairs, you can’t take the Ford or Toyota off ramp. That whole scenario is ridiculous but it is basically what happens when we use closed proprietary dental systems.

Interoperability is the ability of different systems from different vendors to work together. The opposite is proprietary, where users are restricted to one vendor’s products.

Dental management systems with electronic records, digital radiographs and digital impression systems are all highly proprietary. That is the user can not transfer a patient record from one office another electronically. Radiographic sensors are limited to specific software and some vendors even restrict which transfer system a user can use to send and impression over the Internet.

When shopping for a digital product, tell the vendors that an open system is an important buying factor. Ask the sales person if you can transfer the digital impression to any lab of your choice or if you can load the impression into design software of your choice. In most cases, the answer will be no. Let the sales person—or, better yet, the sales managers and product managers—know that you won’t buy a closed system.

Vendors love closed systems that keep dentists captive. They will not change until the dentists buying the systems demand a change.

CAD CAM Future Tech General Internet Management Paperless Radiography Software

A GREAT new resource from Carestream Dental

Download free educational materials, infographics and more to share the Digital Dentistry Difference story, and see the difference it makes for your patients and your business.

Source: Home – Carestream Dental

Management Paperless Theraputics

 Using Electronic Prescriptions for Dentrix Users

From The Dentrix Office Manager Blog:

Using Electronic Prescriptions: In Florida, and as of January 1, 2020, a new law became effective that requires prescribing doctors to send all prescriptions electronically. Arizona, Iowa, Massachusetts, North Carolina, Oklahoma, and Rhode Island also have mandates that took effect January 1, 2020; and in September 2018, California passed a law that requires electronic prescribing for all medications.

Check the laws for your state. Is your practice required by law to send prescriptions electronically? It may be time to think about how your practice is going to implement this requirement into your daily workflow. You will need to use a service to electronically submit prescriptions to pharmacies. I recommend using Henry Schein One ePrescribe, which allows you to send electronic prescriptions directly through Dentrix.

Source:  The Dentrix Office Manager Blog: Using Electronic Prescriptions

Hardware Management Radiography Theraputics

What to buy before year end?

Where should you spend your one million dollars of section 179 money before the end of the year?

Section 179 is the tax law provision that allows businesses to expense certain capital investments. For details regarding the law look here.

Complete or upgrade your technology infrastructure. If you still do not have computers in every treatment room linked to a server do that now. Every other high-tech system is dependent on a complete network. If you have a network but it is more than four years old, it needs upgrading. ($25,000 or less)

An alternative is to use XaaS. With this system the service company provides all the computers and networking and the dentist simply pays a monthly fee for the service. There are definite advantages to this however XaaS does not qualify for section 179.

Radiography. There is no excuse not to be exclusively using digital radiography in 2020. If you do not have a basic sensor system get one now. You only need one basic sensor linked to you practice management system. ($4,000)

If you have a sensor then consider a digital panoramic machine. You will be able to see and diagnose more effectively and it will pay for itself in less than a year. ($10,000)

If you are a surgeon or if you place implants then consider a Cone Beam CT. ($80,000)

An interesting alternative to x-rays for interproximal caries detection is the CariVu from Dexis.

Once these basics are taken care of you are ready to consider more advanced systems starting with digital impressions. You can start with an impression scanner only; you do not need to get a full CAD-CAM system with a mill. However, be sure you can add a mill in the future if you want. ($23,000)

Next look at getting a laser. Start with a soft tissue diode laser. You will be amazed at all you can do with one of these inexpensive lasers, starting with tissue troughing around preps. You will never need to pack cord again. ($1,800)

If you have everything on the list so far and are looking to take the next step, consider a hard tissue laser. My favorite is the Solea. They just introduced a new improved version. ($100,000)

As always you would be a fool to consider this tax or legal advice consult your CPA etc. etc. etc.


Convergent Dental Announces New Agreement with Henry Schein


Source: Convergent Dental Announces New Agreement with Henry Schein, Making the Solea® Dental Laser Available to More US Dental Professionals | Convergent Dental

The Solea hard tissue laser is remarkable.

3D Printing CAD CAM Digital Impressions Future Tech

Digital Workflow Experience takes dentists through ‘office of now’

From ADA News:

Dentists can experience firsthand how to integrate digital technology into their practices as part of the Digital Workflow Experience at the ADA FDI World Dental Congress this September in San Francisco.

Source: Digital Workflow Experience takes dentists through ‘office of now’

I was intrigued by the title “Digital Workflow Experience” as that has become a major interest of mine. However the FDI exhibit is focused on clinical procedures such as digital impressions. That is fine however I see digital workflow as more a function of the business side of the office.

Nevertheless if you are going to FDI in September check it out.

Future Tech Telemedicine Theraputics

Robotic health care is coming. How do you feel about that?

From The Conversation:

Robots can do a lot, but people don’t necessarily accept them in those new roles. A lot depends on how easy the robot is to interact with and the patient’s own views about new technology and the emotions they’re feeling, such as fear about an upcoming medical procedure.

A human-like robot can be more acceptable – but only if it’s not too similar to a real person, because the differences can seem creepy and unsettling. That can discourage people from trusting and interacting with the robot.

Another factor is the invasiveness of the surgery. Our research investigating patients’ willingness to undergo robotic dentistry found that the complexity of the procedure matters. Two-thirds of our respondents said they would not want a robot to handle an invasive procedure like a root canal; 32% said they would decline robotic cleaning and whitening.

However, price is a factor. When patients were told a robotic procedure would cost just half as much as one done by a person, 83% said they would accept a robotic cleaning and whitening.

Source: Robotic health care is coming to a hospital near you

The article lists several robots already in use in hospitals ranging in complexity from meal delivery to surgical assistant. It is worth a click and read just for that. The interesting part is the acceptance of robots by people. As expected there is a wide spectrum of acceptance depending on what is being proposed. People fear a malfunction.

Never the less I believe we will be seeing more robots in our future.

3D Printing Future Tech Theraputics

German scientists create see-through human organs

From Reuters:

Researchers in Germany have created transparent human organs using a new technology that could pave the way to print three-dimensional body parts such as kidneys for transplants.

Source: German scientists create see-through human organs – Reuters

If we can print a kidney I am sure we can print a tooth.

Future Tech Theraputics

Wearable Device Scrubs Cancer Cells from Blood

From IEEE Spectrum:

A new wearable device, tested on animals, can capture and remove tumor cells circulating in the bloodstream. With further development, the blood-filtering gadget could be used to diagnose, and perhaps treat, metastatic cancer in humans.

Source: Wearable Device Scrubs Cancer Cells from Blood – IEEE Spectrum

3D Printing Theraputics

Heart 3D-printed with human tissue

A team of Israeli scientists “printed” a heart with a patient’s own cells in a world first, researchers say.Past researchers had been able to print simple tissues without blood vessels, the team said. This development was the first time “anyone anywhere has successfully engineered and printed an entire heart replete with cells, blood vessels, ventricles and chambers,”

…Because the heart is made from the patient’s own biological material, it reduces the chance the transplant would fail, according to the research paper.

Source: Heart 3D-printed with human tissue in world first by Israel scientists

WOW…I mean just WOW.

The future is coming and it will be amazing!

Diagnostics Internet Mobile Theraputics

One Drop integrates with iPhone’s health records


The company’s mobile app enables people with type 1 or type 2 diabetes to track blood sugar, medications, meals and physical activity through their iPhone, according to the company. It also allows people to set daily goals and view progress as well as connect with a broader community and personal coaches.

Source: One Drop integrates with iPhone’s health records

Another interesting diagnostic that uses the power of a smart phone and leverages the communication and network capabilities of the Internet to improve treatment and results for patients with a chronic medical condition.

CAD CAM Future Tech Management

Technology and You

From New Dentist Blog:

These three questions. Does it improve the ease of care? Does it make the patient more comfortable? And does it improve quality? Are all essential when evaluating new technologies?

Source: Technology and You – New Dentist Blog

The linked article by Dr. William van Dyk is mostly concerned with clinical technology, CAD CAM, implants and digital radiography. He points out that early CAD CAM restorations were compromised. Dentists should begin their evaluation of new technology by examining how it ultimately effects the patient.

There is no question that this is important. It is totally inappropriate for dentists to be “experimenting” with new devices on patients. Or to compromise quality in order to use an exciting techno gizmo. On the other hand you always and forever do not know what you do not know.

It is all too easy to fall into the “That’s the way we have always done it” mentality.

Management Theraputics

Old Masters

I was speaking with a dentist a few years ago (not as many as you might imagine) who was telling me about the insane levels of precision he was learning in a gold study club. There were very precise measurements of powder and liquid, temperatures were carefully controlled to create just the exact amount of shrinkage for die stones, investments and all the rest. The dentists and technicians had devoted a lifetime to becoming masters of this process and were understandably very proud of what they had accomplished.

Here is the part that is hard to take. Once you graduate to a digital impression system, like the CS 3600 all that skill knowledge and mastery becomes obsolete. It is like being a master typewriter maker in a world of word processors. Nobody needs what you have spent so much time and effort learning to master.

We see this concern often when new technology is introduced. Staff people fear that what they have learned in the past, how they provide value to the doctor the patients and the practice will no longer have value. They fear losing status.

There is no easy way to tell someone they are obsolete. “Hey, the world changed, get over it,” doesn’t really help. What can help is to set new goals, accept that the new way is just as good (in fact usually better) and that by learning the new way the person will be even more valuable, have even more status and it will be an exciting and rewarding journey getting there.

Dental Speaker Digital Impressions Future Tech General Theraputics

Dental Student Dilemmas

Do you teach for the present or for the future?

I spent a facinating day at the ADEA Dean’s Conference in La Jolla. Dental schools are very interested in using new digital technology and applying it to teaching methods. However at the same time they need to teach dental students how to function in the real world where the majority of dental offices do not have digital impressions or electronic records.

At some schools students are prepping  typodont teeth immediately as first year students, scanning the prep to create a digital impression which is evaluated against an ideal prep by a robot (AI) instructor. The feedback is immediate, it is objective (no human is telling the student they did it wrong) and the student can try again immediately with another typodont tooth.

The result is gameification. That is making a perfect prep becomes like a level on a video game. If the student fails, oh well he/she has plenty of other lives, just try again.

Students also learn to use 3D manipulation software with simulated teeth, placing virtual implants, aquilibrating teeth with virtual articulators and designing virtual restorations as part of their pre-clinical training so that when they actually prep a real tooth they can scan it and create a restoration immediately.

Very impressive.

Still other schools are using digital technology to break away from the traditional teaching methods of books and lectures.

We all know that knowledge is changing so fast that any traditionally printed textbook is out of date by the time it is published. The alternative is to provide bite size chunks of information that students can access any time, any where. The instructors can track each students progress. Students can display competency at any time by simply taking the tests that accompany each module. And the information in each learning module can be updated instantly for all students if needed. No wait for a new text book to be published some time next year.

The challenge here is accreditation and competency. If a wiz kid student can finish all the modules and prove his/her competency in three years can they graduate? So far no. Administration and accreditation agencies are cautious and have yet to sign off completely on these new methods. However change is in the air.

Future Tech Theraputics

At the Brigham, wound patch offers promise

From Boston Herald:

It mimics skin properties, removes bacteria, helps new cells grow and reduces inflammation. The patch is applied onto the wound like a bandage and stays on for two to eight weeks, depending on the severity of the wound. The patch can be easily applied by patients, and it becomes part of the skin.

Source: At the Brigham, wound patch offers promise | Boston Herald

Not dental and not digital, never the less it is amazing!

Diagnostics Future Tech Theraputics

Apple purchases augmented-reality glasses startup

From Becker’s:

Augmented reality enables a device — in this case, a set of glasses — to overlay digital information on the real world.

Source: Apple purchases augmented-reality glasses startup

Augmented reality is one of those technologies that holds so much potential yet has yet to take hold in any substantial way.

There are many potential uses for augmented reality in medicine and dentistry. At the most basic level the surgeon could use it to pull up the patients medical history or a procedure check list which he or she could review  – hands free – on the glasses with out needing to look away or touch a mouse. Slightly more advanced the surgeon or assistant could monitor the patients vitals while continuing to stay focused on the surgical site. (BTW I am of course including dental procedures in the generic surgical site example.)

At an even higher level the surgeon could see the patients bones and vessels, as determined by a 3D scan, superimposed on the actual patient as he/she does the surgery. This could be combined with a device like X-Nav  for real time guided implant placement.

A few years ago Google famously pushed Google Glass which made a splash then quietly went away. Facebook has Occulous Rift which so far remains mostly a gaming device. With Apple entering the arena we may see some movement toward true augmented reality in medicine. However so far it remains a tantalizing vision.

3D Printing CAD CAM

Accuracy evaluation of dental models manufactured by CAD/CAM milling method and 3D printing method

RESULTS The RMS value (152±52 µm) of the model manufactured by the milling method was significantly higher than the RMS value (52±9 µm) of the model produced by the 3D printing method.

CONCLUSION The accuracy of the 3D printing method is superior to that of the milling method, but at present, both methods are limited in their application as a work model for prosthesis manufacture.

Source: Accuracy evaluation of dental models manufactured by CAD/CAM milling method and 3D printing method