Table of Contents

Cover Story
Endodontics

Inside Dentistry

May 2008, Volume 4, Issue 5
Published by AEGIS Communications

3D Summit On Digital Dentistry

Sirona Dental Systems (Charlotte, NC) and the Scottsdale Center for Dentistry (Scottsdale, AZ) hosted the first annual 3D Summit on Digital Dentistry. The comprehensive symposium featured discussions, lectures, and a live-patient case showcasing the latest advancements in 3D digital dentistry. An in-depth curriculum provided continuing education credits for instructional sessions designed to enhance treatment outcomes in general dentistry, oral surgery, implantology, prosthodontics, periodontics, and orthodontics using up-to-date diagnostic imaging technologies and complimentary treatment applications.

The opening lecture, 3D Radiography—Current Technology and Future Direction, was given by Don Tyndall, DDS, chair of the Scientific Affairs Committee of the American Association of Oral Maxillofacial Radiologists, and a professor in the Department of Diagnostic Sciences and General Dentistry at the University of North Carolina at Chapel Hill. His presentation was an overview of current technologies, providing a better understanding of 3D imaging including its benefits, applications, and use in improving patient care. Using multiple examples, he highlighted the improvements these technologies are giving to multiple dental disciplines. The talk was an excellent gateway to the bulk of the symposium, which was organized around a live-patient case.

A LIVE DEMONSTRATION

The 3D Summit patient case study marked the first time a dental learning symposium has provided on-site learning during a live dental surgery using 3D x-ray technology, software-guided implant planning and surgery, and placement of CAD/CAM-designed prosthetics. The case began with diagnosis using Galileos 3D imaging, demonstrated implant site assessment and implant surgery using SiCAT computer-planned surgical guides, and finished with surgery preparation and placing a CEREC-designed crown over a customized zirconia abutment.

The live procedure and lecture team included Dr. Tyndall; Jay Reznick, DMD, MD; Sameer Puri, DDS; and Armen Mirzayan, DDS. Dr. Reznick is the director of the Southern California Center for Oral and Facial Surgery in Tarzana, California, and a leader in the integration of digital and 3D imaging in clinical practice. Dr. Puri is the director of CAD/CAM Dentistry for the Scottsdale Center for Dentistry. Dr. Mirzayan is on the faculty of the Scottsdale Center’s CAD/CAM Dentistry Department.

In the diagnostic portion of the live-case presentation, the patient was scanned using the Galileos 3D Conebeam X-ray Imaging System. The scan was evaluated by Drs. Tyndall and Reznick, who assessed a previously grafted implant site. The site was a challenging one, being very narrow because of proximal tooth movement. During the scan, the patient wore a radiographic stent that included glass fiduciary markers. A Galileos scan takes 14 seconds and a panoramic, lateral cephalometric, and 3D MPR image are created automatically during the reconstruction cycle. Multiple cross-sectional views were updated in real time as the clinicians scanned through the image using the patented evaluation window to explore the pan and 3D images. This allowed the clinicians to do a quick, accurate assessment of the planned implant site.

During the surgical and implant planning stage, Dr. Reznick used the Galileos implant software scan to perform virtual implant planning directly in the patient’s 3D scan (Figure 1). This saves time as there is no need to send the file out to be converted to another format. This plan was then indexed against the image of the stent’s fiduciary markers and a surgical guide was created using master cylinders to accommodate a multistep surgical process. This surgical guide was then double checked against the analog implant in the stone model and the zirconia abutment was planned and modified to fit the specific application.

On the second day of the 3D Summit program, Dr. Reznick performed the surgery portion of the live-patient case presentation. With a surgical guide in place, the mucosa over the implant site was removed using a tissue punch and the excess tissue was cleaned with a SIROlaser. The pilot drill was drilled through the surgical guide using a 2-mm insert. The insert was removed, and the final implant hole was drilled to the correct depth and angulation. The implant was placed and indexed through the surgical guide and the guide was removed. At this point, the abutment was mounted to the implant in preparation for the CEREC scan, and the soft tissue margin was cleaned using the SIROlaser. The screw access hole was filled using temporary composite.

The final stage of the procedure was performed by Dr. Mirzayan. The abutment and proximal teeth were powdered and scanned using the CEREC chairside. The crown was created using the CEREC MCXL Milling Unit, glazed, fired, and cemented onto the abutment in just minutes.

The patient was excited to walk out of the presentation after a procedure that took less than 1 hour of chair time and was pleased with how easy it had been to achieve his new smile. Summit attendees were impressed with the precision, time savings, and ultimately better patient outcome gained through use of the latest advancements in 3D imaging and CEREC technologies.

OTHER NOTEWORTHY PRESENTATIONS

While the live-patient case was an impressive learning opportunity, several other lectures and break-out sessions added to what can only be described as a truly unique and remarkable dental learning experience.

James Mah, DDS, DMSc, associate clinical professor at the University of Southern California and director of the Red-mond Imaging Center and Craniofacial Virtual Reality Laboratory, presented an excellent summary of current 3D applications and research. This summary also went further to provide a preview of 3D imaging and treatment applications that will be used to enhance dental treatment well into the future.

One of the most intriguing presentations of the 3D Summit was given by Erick Dierks, MD, DMD, of Portland’s Head and Neck Surgical Associates. Dr. Dierks specializes in craniomaxillofacial trauma, and head and neck tumor surgery. His lecture, Improving Oral Surgery Outcomes Using 3D Imaging, was designed to help attendees understand how 3D imaging helps achieve greater surgical precision and reduced operating time in oral maxillofacial surgery. This in-depth discussion of the intricate maxillofacial anatomy covered orthognathic, craniofacial, traumatic, and oncology cases explaining technologies ranging from straight-forward to complex. Dr. Dierks presented surgical techniques that he uses in practice, including oral surgery and craniofacial procedures, biomedical modeling, and surgical fixture design made possible through advancements in 3D imaging.

The 3D Summit also featured break-out sessions designed to provide instruction specific to various areas of practice. Attendees could choose from 10 different lectures to design an educational experience tailored to their needs (Figure 2). The break-out topics were varied and addressed technological advances in general dentistry, esthetic dentistry, implantology, dental radiology, periodontics, oral maxillofacial surgery, orthodontics, and prosthodontics.

A One-of-a-Kind Experience

The 3D Summit learning experience was greatly enhanced by the Scottsdale Center for Dentistry, a one-of-a-kind learning facility. Summit attendees and presenters stayed at the nearby Fairmont Princess Hotel, and Sirona kicked off the weekend by hosting a golf tournament at the PGA Tournament Players Club Golf Course.

Reviews by attendees of the first annual 3D Summit were highly complementary. One dentist wrote, "Outstanding program and the facilities were exceptional! In fact, I’ve not attended a program that equaled this quality, thanks!" Another shared, "Very informative and helpful meeting. Wonderful faculty, wonderful facility. The meeting exceeded my expectations!"

Sirona will soon announce the dates for the next 3D Summit, to be held in 2009.

Figure 1 Dr. Jay Reznick explains to the audience the benefits of using 3D dental technology during implant surgery. Figure 2 3D Summit attendees participated in multiple lectures to improve treatment outcomes using the latest in 3D dental technology.