The Transition to Digital Dentistry Part 2

January 17, 2024 John Cranham, DDS

When my daughter Kaitlyn (currently in through E2 at Pankey) finished dental school in 2020, I strongly recommended that she learn analog first, then once mastered, make the transition to digital. This lasted about four months. I learned rapidly that this generation sees things in the digital realm far better than we do. She reminded me that “she grew up with a screen in her hand.” 

We began to focus on her learning the concepts of occlusion, esthetics, biology, tooth-by-tooth structural integrity, and visualizing and planning in the virtual (digital world). We quickly learned that, although she could easily visualize things on the computer, the patient is ultimately analog. We began to utilize an analog articulator for her to learn the hand skills of what we would do on the patient. 

A great example of this is equilibration. A “trial equilibration” on a virtual articulator is a 5-minute process that lets us determine if equilibration is an appropriate treatment option. The problem is that, unlike analog, you do not learn the brush strokes that will be required to perform this skill in the mouth. I have performed hundreds if not thousands of equilibrations. I know the brush strokes. For me, once I see on the virtual articulator that I can do the equilibration without too much tooth structure removal, I am ready to go to the mouth. For Kaitlyn, who has very limited equilibration experience, once visualized on the virtual articulator, then it’s time to go back to analog. She mounts the printed models on an analog articulator to perform a traditional trial equilibration. In this way, she learns the brushstrokes of this incredibly important procedure. 

I think it is extremely important that dentists, who are learning to equilibrate intraorally, work on mounted analog models to develop their equilibration skills. 

Returning to the consideration of the financial cost of bringing new technology into your practice—input devices (scanners and CBCTs), output devices (printers and mills), and software to manipulate the data all cost money. Doctors that are going down this road usually like technology and consider the dramatic increases in efficiency to ultimately increase the productivity and profitability of the practice. This is certainly something I have seen. The bottom line is dental stone will go away. We all must make the decision when it is appropriate to make the jump. 

Dr. Lee Ann Brady has invited me to audit all the Pankey Essentials courses over the next year. I am super excited about this. She has asked me to recommend ways to appropriately implement examples of digital technologies and workflows into these core classes. While younger dentists are drawn to digital information, it is important for us to remind them that our patients are ANALOG. We are training dentists to perform complex procedures on patients, not on computers. This requires great study and a commitment to understand timeless concepts, while simultaneously developing the hand skills to accomplish these procedures accurately and use digital workflows to make things more efficient. 

In 2024, The Pankey Institute is also implementing a digital hands-on course for those doctors who would like to make the transition over to virtual articulation and digital workflows—something that I am excited to be part of. Dentistry is in a great transition. I look forward to making sure the concepts that we have all built our practices around do not get lost in the digital world. 

Related Course

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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High Engagement Leadership…The Ripple Effect 

December 9, 2019 Dennis Stiles DDS

After my presentation on High Engagement Leadership at the September 2019 Pankey Annual Meeting, a few people asked me about a term that I used in the presentation, VUCA. The acronym VUCA stands for volatility, uncertainty, complexity, and ambiguity—the challenges that we face in today’s world. The term originated in the late 1980s from a thought leader named Warren Bennis. Bennis was known for shaping the concept of authentic leadership, which at its center is the value of being true to one’s self.  

VUCA = Volatility, Uncertainty, Complexity, and Ambiguity 

Complexity in our culture and rapid change are our challenges as leaders. How shall we use all our creative gifts and talents to develop as leaders and influencers in a world that thrives on VUCA? 

The answer might be to start by deepening the trust we have in ourselves. Our ability to navigate through the noise and distractions of today requires high trust in self and a willingness to believe that others will follow us. 

In his recent book ‘Deep Work‘, Cal Newport describes the value of quiet focus in a formula defined by Adam Grant:  

High-Quality Work Produced = (Time Spent) X (Intensity of Focus) 

Slowing things down and eliminating the distractions around us can increase our productivity exponentially. As with exercising, when we commit to uninterrupted focus time, we tend to develop a resilience muscle that is strong when times are complex and distracting. When we are more focused and stay calm in our role as leaders, others appreciate this gift we bring to them—and there is likely to be another ripple effect, development of trust in ourselves.  

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E1: Aesthetic & Functional Treatment Planning

DATE: July 17 2025 @ 8:00 am - July 20 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 39

Dentist Tuition: $ 6800

Single Occupancy with Ensuite Private Bath (Per Night): $ 345

Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

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About Author

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Dennis Stiles DDS

Dr. Dennis Stiles, a native of Amherst, MA, has called upper Montgomery County home since 1986. Dr. Stiles is currently a member of the American Dental Association, the American Academy of Cosmetic Dentistry, the The American Academy of Dental Sleep Medicine, the Maryland Society of Sleep Medicine, the American Academy of Implant Dentistry and has received fellowship in the the American College of Dentists, the International College of Dentists and the Academy of General Dentistry. In 2017 he received Diplomate status in the American Board of Dental Sleep Medicine (ABDSM). He also served as past president of the American Prosthodontic Society (2006) and currently is serving the president of the APS Foundation. In 2009 Dr. Stiles was appointed to serve as a dean's faculty member at the University of Maryland School of Dentistry. In 2016 Dr. Stiles was elected to serve a three year term as a board member of the LD Pankey Institute through 2019.

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