In a series of editorial articles, we have heard from Dr. Paul Weigl about his thoughts on and experience with the digital implant workflow. In this last article in the series, let’s sum up by looking at the future and key trends.
What key trends do you see in a digital implant workflow?
I see two workflows for implant dentistry: chairside and clinic-to-laboratory. In my opinion, the laboratory-based workflow is easier to use for beginners because it does not involve a major investment and you do not have to be highly trained to use the software for planning. It’s easy to adopt and to get started, because a lot of the work can be outsourced. What is left for you to do is to approve the planning and the treatment, after which you can have everything pre-delivered. That means you get the template for guided surgery, you get the customized abutment and you get the temporary restoration when you place the implant.
Could you walk us through an example of a clinic-to-laboratory workflow?
To begin with, you take a CBCT and an intraoral scan to virtualize the patient. Those files are then sent to Dentsply Sirona and a planning proposal will be designed and sent back to the clinician for validation and approval. After the final approval, the surgical guide will be manufactured by Dentsply Sirona and sent to the clinician. The clinician can then transfer the virtual planning to the real implant surgery. Once healing is finished, the clinician scans intraorally and sends the information regarding the prosthetic restoration to the dental technician who finalizes the order and sends it to Dentsply Sirona. The design of the patient-specific solution is viewed, approved and manufactured and the dental technician finalizes the case and sends it back to the clinician.
And an example of a chairside workflow?
The chairside workflow offers you a more spontaneous workflow, allowing you to act immediately. In the same way as the clinic-to-laboratory workflow, you begin by taking a CBCT and an intraoral scan to virtualize the patient. The surgical guide can be fabricated directly in the clinic and after the implant placement you scan the position of the implant by using an intraoral scanner. On the very same day you can make the customized abutment and the temporary restoration with a chairside device. This workflow will involve a bigger investment and more education that focuses on using the software because you do it yourself in-house, without outsourcing. I would say, the chairside workflow is not for beginners in digital implant workflow dentistry.
Final thoughts on the digital implant workflow, clinic-to-laboratory and chairside, in three bullet points?
First, the laboratory workflow is outsourced so it is very easy to use. A smaller investment is required and you have a very steep learning curve so you can easily get the results you are after. You can even outsource the software which means you only need to give your approval. Second, the drawbacks of this technology are that you do not get all the results and abutments on the same day. And third, the chairside digital workflow offers you significant advantages, including allowing you to act immediately. Let us say a tooth is fractured and you have to extract it and immediately place the implant to save the emergence profile and so on. In such a scenario, you use the chairside workflow because after placement you can immediately fabricate the CAD/CAM customized abutment and the temporary restoration. Of course, depending on the situation, both workflow models have their own advantages and challenges.
If you want to find out more about the digital implant workflow, read the full article series: