Simple, Predictable, Digital Denture Workflows (With or Without a Scanner)

Episode #345 with Dr. Wendy AuClair Clark (Covid Conference)

Dr. Wendy AuClair Clark loves digital dentures. And according to pilot studies, patients do too! Going digital speeds up fabrication, cuts down chair time, and can be less expensive. It’s not just the dentist’s workflow that improves, but also access to care for the denture population. What's not to love? If you're still not convinced, Dr. Clark demonstrates how the digital denture workflow is easy, predictable, and very low stakes. For more reasons to try digital today, listen to Episode 345 of The Best Practices Show!

Main Takeaways:

There is no longer just one workflow. Any step can now be digitized.

Every single stage of your diagnostics is preserved with digital.

Printing is generally a faster, less expensive way to digitally fabricate.

Milling is usually stronger and more aesthetic.

Milled PMMA will minimize staining, porosity, and fracture risk.

You can reline, rebase, and repair milled PMMA dentures the same as conventional ones.

The average digital denture workflow is about 2.65 visits versus 5 for conventional.

With milled, there are fewer postoperative adjustments with digital versus conventional.

In pilot studies, patients preferred every aspect of digital dentures over conventional.

Digital can help close the access-to-care gap for older, edentulous patients.

One downside is there are only short-term studies on first-generation printing.

Quotes:

“I heard a lab tech, Josh Jakson from Evolve, who really laid it out as simply as I've ever seen. And it’s so true, that every aspect of digital dentistry can be put in one of three buckets: data acquisition, design, or fabrication. So, digital dentistry really is an easy thing. And you could take any aspect, so whether it’s making a CEREC crown, you scan for the acquisition, you design it, and you mill it. And it’s the same for digital dentures.” (03:44—04:09)

“The other thing that I like people to be aware of is that there's not one workflow anymore, that truly any step can be digitized. And so, if you want to do a whole analog workflow and digitize one step, that's fine. If you want to do digital start to finish, that's fine too. So, it shouldn't be as exclusive, I think, as we tend to make it sometimes.” (04:20—04:40)

“Printing, in general, is a faster, less expensive way to digitally fabricate, so the CAM portion of CAD/CAM. And milling is usually stronger and usually more aesthetic. But there are exceptions to every rule. So, this is just the basic blocks that they would fall into. Printing is going to be additive, so you're building it up. You have uncured resin that you're building in layers to create something. Milling is subtractive. I would say it’s like when Michelangelo had a block of marble and he chiseled out David. That's what we’re doing with our dentures. We’re chiseling out these PMMA works of art.” (05:06—05:41)

“For a milled denture, you can have a monolithic option. And they have a block from AvaDent, Ivoclar has a block as well, where basically the white and the pink are housed in the same puck of acrylic. So, it’s kind of like an Oreo, is how it was described to me by the rep, where they have the pink on both sides, and the white in the middle. And the mill is aware of where the pink and white sit within that puck. And so, it’s built in in the software to mill it out precisely. So, the teeth are white, the base is pink, but it’s all monolithic. There's nothing bonded, nothing individual. It’s a block of a denture. So, this is going to be your strongest and maximized tensile forces and functional forces. You could also have a bonded denture where you're going to have the bases milled, and then the teeth are bonded...