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Jul/Aug 2010
Volume 6, Issue 7

The Revolution in Digital Impressioning

Nathan S. Birnbaum, DDS

CE Articles
Feature Stories
Roundtable
Viewpoint

Editorial Categories
CAD/CAM
Diagnosis & Treatment
Planning
Digital Imaging
Endodontics
Implantology
Infection Control
Magnication
Materials

In only the past few years, the revolution in digital impressioning

restorative dentistry that began in 1985 with Sironas CEREC has
progressed exponentially, with marked advances in the number
available devices, their accuracy, indications for their application
ease of use, synchronization with laboratory systems, and the n
dentists and laboratories worldwide utilizing the technology. Tw
ago, there were four major systems available for restorative den
Sironas CEREC 3D and D4Ds E4D, and dedicated impressioning
and 3M ESPEs Lava C.O.S.
Todayin addition to the CEREC AC Powered by Bluecam and in
Studio; the iTero; and the Lava C.O.S.newer systems have eme
FastScan; Densys3Ds Solution; and Hint-ELs/Fraunhofers direc
The CEREC and E4D systems began as dental ofce-based CAD
capture of data could be converted into a milled denitive restor
inclusion in both systems of laboratory software, hardware, and
the dental ofce and laboratory was a tacit acknowledgement th
devote the extra time and effort needed to design, mill, and char
The iTero and Lava C.O.S. systems were solely intended from th
that could convert the data into highly accurate CAD/CAM mille
resin models which, in turn, would be sent to the laboratory of th
In addition to the CEREC and E4D laboratory systems, a number
eld of creating working models either from dentist-submitted s
laboratory from dentist-submitted impressions or models poure
laboratory systems include, among others, Zahns Dental Wings
3Shapes D700 Adaptive Impression Scanner.
Digital impressions have been used successfully for a number o
including Cadents IOC/OrthoCad, DENTSPLY/GACs OrthoPlex,
EMS RapidForm.
Indications for the type of restorations that can be made from d

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Occlusion
Oral Medicine
Orthodontics
Pain Management
Pediatric Dentistry
Periodontics
Practice Management
Prevention
Prosthodontics
Restorative Direct
Restorative Indirect

Related Articles
3D Digital Scanners - A High-Tech
Approach to More Accurate Dental
Impressions
Inside Dentistry, April 2009

Digital Dental Impression Systems

Inside Dentistry, February 2011

Digital Impressioning
Inside Dentistry, Jul/Aug 2011

systems cited include inlays, onlays, crowns, xed bridges and e

and orthodontic appliances. Research is currently underway by s
fabrication of full and partial dentures, as well as implant restora
In a June 2009 survey conducted by Dental Products Report
claimed to have some type of digital impressioning device in the
increased signicantly since then. In fact, Lee Culp, CDT, had pre
years, most dentists will be taking digital impressions.1
The integration of an impressioning system into a dental practic
technologically, need not be problematical. The site at which the
impression is prepared in much the same way as for an elastom
Proper tooth preparation and tissue retraction are essential and
impressioning systems require that the sites being scanned rs
reective titanium dioxide, while others only require the sites to
of the operative and opposing sites, along with an occlusal regis
in less time than it takes to obtain elastomeric impressions and
One of the most valuable advantages of digital impressions is th
observe a magnied image of the tooth preparation, in some sys
allow the dentist to hone his or her skills, but also enables corre
completing the scan. With elastomeric impressions, such imper
impression is taken, and often retaken, which is costly in terms o
At rst glance, the learning curve may appear difcult, as digital
away from the dentists comfort zone. Fortunately, most of the s
outstanding learning and assistance programs ranging from a fe
dentists and team members at the companys facility, to trainers
sessions in the dentists own ofce; from courses conducted at
tutorials and courses and service through telephone help lines. C
integration of digital impressioning devices into the dentists pra
With recent advances in the quality of digital impressioning syst
pervasiveness of the digital platform in the dental laboratory spa
nished restoration process is becoming ever more streamlined
communication. Transmitted impression data can be viewed an
by both the dentist and technician while the patient is still seate
have fewer problems than elastomeric impressions in terms of i
better marginal accuracy and fewer remakes. The nished resto
interproximal and occlusal contacts, which saves time in seating
From the patients perspective, digital impressions eliminate gag
goop. The patient also views the dentist as being more cutting-e
with the patients friends and colleagues. The dentist and staff a
time in clean-up following the impression appointment (ie, no st
of impression guns and syringes). Eliminating elastomeric mate
eliminates cross-contamination zones, and saves the ofce the
disposable goods.
The bottom line is important to all dental ofces. Although muc
the cost of materials, the biggest obstacle to dentists has been
systems themselves, that of submitting data, and of the product
working hard to bring down all of those costs.
One company, Clon3D, will be launching a new business model i
laboratories lease out the companys scanner to dentists for a m
attached to any computer with a USB cable, and the accompany
into a clean, usable STL (ie, a format used by stereolithography
needed to produce 3-D models on stereolithography machines)

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laboratory to create an accurate working model.

The digital impressioning revolution has been underway for man

References
1. Culp L. Lecture. New England Academy of Cosmetic Dentistry

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