patient room at East Town Dental Group of Milwaukee offers
picturesque city views.
Much to the
patient’s advantage, emerging dental technologies are changing the
way in which procedures are performed. Efficiency is increased,
patient safety is improved, and cost is often decreased.
Hart and Steve Koutnik added a 3-D printer to their Shorewood practice
last year. Hart and Koutnik claim they are the first dentists in
Wisconsin to use 3-D print surgical guides on-site, and the
prosthodontists now create prints for select oral surgeons in the
Milwaukee area. The final print, which takes about two hours to
complete, is just as cost effective as it is efficient. For example,
making the print costs the practice just $14, while outsourcing a
similar handmade print would likely run upward of $3,000.
also use computer-guided implant surgery to replace fractured or
decayed teeth — a technology that has been used for more than a
decade, but is continually evolving and improving. A CT scan of the
affected tooth (or teeth) is performed, producing a 3-D X-ray of the
surrounding tissues, critical nerve, artery and sinuses. Then, a
plaster model of the tooth is digitally merged into the 3-D scan.
"We’re able to observe where the teeth and the tissue are, and
then we’re able to basically design where a tooth goes,"
explains Hart. "From there, we can perform a virtual surgery on
the computer that places the implant." Channels guide the dental
instruments and even the implant itself, ensuring its placement is
Steve Koutnik and Timothy Hart were the first dentists in the
state to print 3-D surgical guides on-site.
Hart says it is
possible to implant a tooth that functions well but doesn’t look
good — an aesthetic factor that may be permissible for a molar, but
highly undesirable for a more visible tooth. He says proper placement
to support surrounding gum tissue is key in avoiding this issue.
"Attention needs to be paid to placement to support the gum
tissue, and then the final restoration is indistinguishable from a
natural tooth," says Hart.
computer-guided implant surgery is more minimally invasive than
traditional procedures, which involve peeling back the gums. "By
combining the CT scan with the 3-D printed surgical template, the
surgery becomes very minimally invasive," explains Koutnik.
"It’s less invasive than extracting a tooth." Plus,
patients’ ability to have visual access to the elements of treatment
keeps them more informed.
East Town Dental
Group of Milwaukee even has its own surgical and prosthetic suite and
dental laboratory — a feature that allows its physicians to perform
All-on-4® immediate implant procedure. Generally reserved for
patients with failing dentition and those wearing some form of
removable dentures, the procedure, from extraction to implantation of
a fixed prototype bridge, can be completed in a single visit.
"Conventionally, if there was a case like this to be done, you
would see a prosthodontist for diagnostics, planning and fabrication
of surgical guides, then go to the remote imaging center for cat
scans, then to an oral surgeon for the surgery, and then return to the
prosthodontist who would design the teeth attached to the
implants," explains Dr. Daniel Domagala, a practice dentist
trained in prosthodontics and oral surgery. "Because we’ve
streamlined this entire process, everything is in one spot. The
patient doesn’t have to go from office to office."
importantly, conventional methods usually require patients to be
without teeth for up to six months after extraction and then for
another six months after the implant placement. "Because of the
unique design of our implant, in most patients we can place the
implants and place the teeth on the implants on the same day. The
patient is back to function virtually that same day," adds
Domagala. "Similar to hip and knee replacement procedures, the
teeth go into immediate function, and the patient heals while wearing
a fixed set of teeth, which don’t move or cause sore spots. The
recovery time is so much faster because of that."
Murphy, who operates her own practice in Glendale, equally understands
dental technology’s role in improving services. She began using the
CEREC® system, a technology used to create and place crowns, two
years ago. "What happened in the past was that a person would
come in, we would take an impression and that would get sent to a lab,
and it would take a lab a few weeks to make," explains Murphy.
With CEREC, a photo is taken with a digital camera (avoiding that
chalky impression paste), and then the system’s imaging software
designs a 3-D model of the crown. An on-site milling unit constructs
the crown from ceramic material, using the virtual model’s exact
specifications as a guide. The entire process, from the initial
digital photo to patient implementation, takes just two hours.
The system not
only reduces a patient’s required time commitment, but improves
safety too. "With digital X-rays, there’s much less radiation
for the patient," Murphy explains. "In a lot of different
ways, the technology is more convenient for patients but also
safer." So what’s next? Murphy says that new software advances
may allow CEREC to add Invisalign and braces to its imaging