The Transition to Digital Dentistry – Part 1 

October 18, 2023 John Cranham, DDS

When dentists are considering the purchase of a new digital technology for implementation in their clinical practice, they usually have three primary considerations:

  • Will it increase accuracy?
  • Will it increase consistency?
  • Is it possible to increase efficiency without sacrificing quality?

Often the cost is a major consideration, and I will come back to the question of cost later in this two-part series.

Twenty years ago, with first-generation CEREC, the results were not close to what we could do in the analog world. But I jumped into using chairside CAD/CAM because, at the time, I was teaching with Dr. Peter Dawson and many doctors were buying the technology. We needed to be able to talk about how it fit with complete-care dentistry.

It was a difficult time because while we could do crowns (usually one or two at a time) in maximum intercuspation or on equilibrated patients in CR, the software was not sophisticated enough to do any kind of case planning. It did, however, provide me with the first glimpse at scanning and 3D digital technology, and I became excited about the possibilities. I started to think about the ability to scan mouths for diagnostic purposes and to do waxups. Virtual articulation was not there, and we didn’t have 3D printing to print our “outputs” so I continued to wait.

As recently as four years ago, my son would spend a day mounting stone models for me. Today, he has digital models mounted on a virtual articulator before the patient leaves their appointment. Digital and AI software platforms are evolving quickly. They enable more dentists and lab technicians to visualize optimal dentistry and design occlusions and beautiful smiles easily. For implant dentistry and orthodontics, these digital and AI software platforms remove obstacles and inaccuracies.

The ability to “stack” data sets on top of one another (pre-op model, waxup, CBCT, Face Scans, photos) allows us to see things in ways I could have never imagined. The things I dreamed about 15 years ago are here now and evolving at warp speed. I honestly don’t remember a time when I was more excited about day-to-day dentistry. A special shout out to Lee Culp (Sculpture Studios), who introduced me to these workflows, and continues to lead dentistry into the digital era.

In the digital world, we can make digital impressions, face-bows, and waxups to see if we need to equilibrate, orthodontically move teeth, or change the shape/contour of the teeth. Technology allows us an efficient, accurate workflow. An experienced digital team can mount models and a virtual articulator, in CR, in 10-15 minutes. The ability to scan in CR, MI, or any treatment position can be accomplished with ease. Trial equilibrations or diagnostic designs (waxups) also can be accomplished far more rapidly, with beautiful results.

As digital workflows take hold in mainstream dentistry, one of the great challenges we face is how the next generations of dentists will learn. In treatment planning, I have the benefit of having 30-plus years of experience working in analog. I have solidified the concepts of centric relation, anterior guidance, posterior disclusion, crossover, envelope of function, incisal edge position, and all the things that go along with visualizing optimum care for your patent. This knowledge was my foundation for determining if these technologies had evolved enough to make the shift to the digital realm.

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Functional Esthetic Excellence Utilizing 100% Digital Workflow

DATE: June 13 2024 @ 8:00 am - June 15 2024 @ 2:00 pm

Location: The Pankey Institute

CE HOURS: 25

Regular Tuition: $ 2995

night with private bath: $ 290

This Course Is Sold Out! Embracing Digital Dentistry This course will introduce each participant to the possibilities of complex case planning utilizing 100% digital workflows. Special emphasis will be placed…

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About Author

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John Cranham, DDS

Dr. John Cranham practices in Chesapeake, Virginia focusing on esthetic dentistry, implant dentistry, occlusal reconstruction, TMJ/Facial Pain and solving complex problems with an interdisciplinary focus. He practices with his daughter Kaitlyn, who finished dental school in 2020. He is an honors graduate of The Medical College of Virginia in 1988. He served the school as a part time clinical instructor from 1991-1998 earning the student given part time faculty of the year twice during his stint at the university. After studying form the greats in occlusion (Pete Dawson & The Pankey Institute) and Cosmetic Dentistry (Nash, Dickerson, Hornbrook, Rosental, Spear, Kois) during the 1990’s, Dr. Cranham created a lecture in 1997 called The Cosmetic Occlusal Connection. This one day lecture kept him very busy presenting his workflows on these seemingly diametrically opposed ideas. In 2001 he created Cranham Dental Seminars which provided, both lecture, and intensive hands on opportunities to learn. In 2004 he began lecturing at the The Dawson Academy with his mentor Pete Dawson, which led to the merging of Cranham Dental Seminars with The Dawson Academy in 2007. He became a 1/3 partner and its acting Clinical Director and that held that position until September of 2020. His responsibilities included the standardization of the content & faculty within The Academy, teaching the Lecture Classes all over the world, overseeing the core curriculum, as well as constantly evolving the curriculum to stay up to pace with the ever evolving world of Dentistry. During his 25 years as an educator, he became one of the most sought after speakers in dentistry. To date he has presented over 1650 full days of continuing education all over the world. Today he has partnered with Lee Culp CDT, and their focus is on integrating sound occlusal, esthetic, and sound restorative principles into efficient digital workflows, and ultimately coaching doctors on how to integrate them into their practices. He does this under the new umbrella Cranham Culp Digital Dental. Dr. Cranham has published numerous articles on restorative dentistry and in 2018 released a book The Complete Dentist he co-authored with Pete Dawson. In 2011 He along with Dr. Drew Cobb created The Dawson Diagnostic Wizard treatment planning software that today it is known as the Smile Wizard. Additionally, He has served as a key opinion leader and on advisory boards with numerous dental companies. In 2020 he published a book entitled “The Cornell Effect-A Families Journey Toward Happiness, Fulfillment and Peace”. It is an up from the ashes story about his adopted son, who overcame incredible odds, and ultimately inspired the entire family to be better. In November of 2021 it climbed to #5 on the Amazon best seller list in its category. Of all the things he has done, he believes getting this story down on paper is having the greatest impact.

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Easy to Mount Printed Dental Models

February 14, 2022 Mark Kleive DDS

In my dental practice, we often use mounted models for diagnostics and restorative treatment planning. Three years ago, we began 3D printing these models.

One of the benefits of printed models is their higher durability compared to stone models. Also, long term, we do not need to save the printed models because we have the digital models saved in the patient’s file. But the greatest benefit has been the efficiency gained in mounting models on articulators. As a result, we have decreased our overhead and increased our mix of services.

What made this mounting efficiency possible is software called “Blue Sky Plan” from Blue Sky Bio. Blue Sky Plan is advanced dental treatment planning software used for milling and printing dental products. One of its applications is printing surgical implant guides, but it has many dental and medical applications for anatomical modeling, surface editing, and offsetting. It allows for CT scan importation and analysis, and export to STL format for 3D printing.

When dental models are printed, the interior can be hollow with a waffle pattern on the back that makes articulator mounting super easy. The process is as simple as opening the software, going to editing, importing your scan, and then selecting a hollow model with the waffle base. To print the waffle base on the model, you need to scan the entire pallet.

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Understanding that “form follows function” is critical for knowing how to blend what looks good with what predictably functions well. E3 is the phase of your Essentials journey in which…

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About Author

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Mark Kleive DDS

Dr. Mark Kleive earned his D.D.S. degree with distinction from the University of Minnesota School of Dentistry in 1997. Mark has had experience as an associate in a multi-clinic setting and as an owner of 2 different fee-for-service practices. For the last 6 years Mark has practiced in a beautiful area of the country – Asheville, North Carolina, where he lives with his wife Nicki and twin daughters Meighan and Emily. Mark has been passionate about advanced education since graduation. Mark is a Visiting Faculty member with The Pankey Institute and a 2015 inductee into the American College of Dentistry. He leads numerous small group study clubs, lectures nationally and offers his own small group programs. During the last 19 years of practice, Dr. Kleive has made a reputation for himself as a caring, comprehensive oral healthcare provider.

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