Noah Levine

Articles

Rounding up some of the top CBCT units on the market. 


Seeing the same dimensions as we operate

	Whether it’s bold and in your face demanding of attention or subtle and nested into the environment, design is all around us in our personal and professional lives. It’s intentional, impactful and capable of influencing our physical, mental and emotional lives.

	In short, design has a role to play in just about everything. An instrument handle that perfectly fits your hand, a room that just feels right to be in and even a software interface that’s intuitive to navigate through are all the results of thoughtful design.

	That’s the thing; whether we put an effort into the design of our lives and practices or just leave things to chance, the shape they take is a form of design. Whether you’re setting up a room in a new house, planning a vacation, restoring a patient’s tooth, or building a brand-new dental practice, paying attention and directing the design leads to a better, more enjoyable result.

Trending article: Break out of your restorative rut

	This issue of Dental Products Report looks at the concept of design and tries to unlock the ways dental professionals can design things in their professional lives. We cover the ways physical and digital systems can be used to design restorations,and best practices for building a dental practice as well as the ways software can design a workflow so patients and clinicians move smoothly through every appointment.

Good design is not static. A well-designed space or system grows, adapts and changes to meet new needs. This is true of dental techniques, dental practices and, yes, even dental magazines.

	While working on content about design in dental practices, the Dental Products Report team is putting those same principles to work to evolve the publication’s look, feel and focus. Our goal is to create a  better resource to help you discover dental innovations, adopt products that best fit your practice, and succeed clinically and as a business.
	Before I share our plans, and the ways you can help, I should probably take a step back and reintroduce myself. I recently took over as the editorial director for Dental Products Report, but I’m by no means new. I’m a journalist by training, and more than a decade ago this publication served as my entrance to the dental industry.

	I’ve held editorial leadership roles on several dental publications over the years, and I’m thrilled about this opportunity at the helm of Dental Products Report.

	Designing a practice where all the products fit into place like puzzle pieces is a key to success. My aim is to fit all of our content pieces together into that same puzzle, so we can serve as a resource for in-depth information on what’s new, how things work, and how you can make them work for you, your practice and your patients.

	If you’re reading this in print, you might have noticed one of these improvements as the magazine looks and feels more substantial. We invested in a heavier paper for both the cover and the inside pages, so we can provide a more robust magazine that is built to better showcase dental products and techniques.

Read more: Why your dental office design matters

	Changes also are underway inside the magazine. Articles are being designed with more visual appeal to showcase more quick, accessible, actionable information. The next phase of our efforts includes a more inviting style for the cover and new touches to the article formats we include in every issue.

If we’re going to do this right, we need your help. We recently completed a reader survey to learn what you like and don’t like about Dental Products Report. I want to extend a sincere thank you to everyone who responded to the survey. The results are helping us improve the content you want more of, replace things you don’t find valuable and build new content formats you’ve asked for.

	I hope these open lines of communication can become a true strength of Dental Products Report. Last month our ergonomics columnist Dr. Bethany Valachi debuted a Question and Answer format for her monthly column. Ask us questions. Other columnists also are accessible to directly address the real-world situations you and your colleagues face.

	But these questions don’t have to stop with our columnists. Our editorial team is here to help you find solutions. Ask us questions you have about dental products, services, systems and running your practice. We’ll do our best to find you answers. We want to showcase innovation but with a healthy skepticism to present what’s new, the best of the tried and true as well as the things that need improvement.

	We believe our independent and unbiased coverage will show through, but we need your help to keep us on track. Let us know what’s making the biggest impact on your practices and patients. Tell us when we succeed, but more importantly point out when we miss the mark, fail to dive deep enough, or otherwise fall short. We’ll work to do better.

	We’re extremely excited about what’s ahead and look forward to working hand in hand with you as we design the future of Dental Products Report together. Thank you for being a part of this.

The story behind our plans to enhance this publication.


Designing a better dental products resource for you

	We live and treat patients in a three-dimensional world, so there’s always a bit of problem when using two-dimensional imaging for diagnostics and treatment planning. Sure, 2D intraoral and panoramic radiographs provide a wealth of diagnostic detail and clinical information, but there’s only so much that can be derived from a 2D capture of a 3D structure.

This is where Cone Beam Computed Tomography-better known as CBCT or Cone Beam imaging-offers a vast improvement. These computer-assisted images use a series of captured radiographic information to build an accurate 3D model of a patient’s internal structures, including teeth, bones, nerves and more. With a digital 3D model that can be measured, rotated and integrated with other digital dental applications, a clinician can more accurately diagnose a range of conditions, more precisely plan treatments and more confidently provide care to patients.

Trending article: Top innovations announced at CDA Presents Anaheim 2019

	These detailed images generally require a greater radiation exposure for patients, so they shouldn’t be taken without a clinical reason. However, when the appropriate clinical situation presents itself, a CBCT image can be a pathway to a higher standard of clinical care.

	Click through the slides to see the products.

		A lightweight , compact , wall-mounted system that can fit into the smallest of spaces

		Combines 2D and 3D technologies, and with the use of a single sensor, the practitioner can quickly and easily switch between modes

		Offers a wide range of panoramic (24) and CBCT (32) options, covering many clinical applications, including implantology, endodontics, TMJ and sinus imaging

	ACTEON North America
	877-4ACTEON  |  

		Video cameras provide live positioning feedback on the built-in SmartPad

		Metal artifact reduction algorithms (CS MAR) are included, which reportedly lead to better image quality and allow users to compare images live and without a filter

		The 120 kV high-power generator captures images at a dose equivalent to the standard 90 kV acquisition but with increased image quality

		All diagnostic imaging tools are accessible via the SIDEXIS 4 software, which is said to allow for an efficient and seamless workflow

		A single 14-second scan is all that’s required to provide clinical views necessary for diagnoses and treatment plans

		The SICAT function with real 3D jaw motion allows for treatment planning and practice on a virtual patient

		With its patented design, it’s said to allow for one of the smallest footprints available

		Equipped with core components manufactured in-house, it has dedicated sensors that automatically switch for each mode (panoramic, cephalometric, CBCT) for convenient use.

		The PAPAYA 3D unit provides a wide range of field of view (FOVs) from 4x4 cm up to 14x14 cm

	Genoray America, Inc.
	855-GENORAY  |  

		The Dentri family of CBCT is said to be renowned for its crisp, ultra-HD imagery and the Dentri a series is designed for clinicians to see more and treat more

		“Ongoing “ software technology development is said to create striking contrast and sharp images

		Provides a field of view of 16x14.5 cm, allowing for expanded views of the facial structures, sinus, TMJ and dentition

	HDX WILL North America
	888-850-8810  |  

		Said to be the industry’s first line of upgradeable dedicated 3D CBCT systems to allow for a seamless expansion into new areas

		Features three maximum field of views, V8, V10 and V17, featuring the option to scale or collimate the scan height within these sizes

		Enhanced low-dose imaging options, dedicated 2D panoramic capabilities and Tx STUDIO software are also provided

		Even with X-era’s largest FOV size (156x79 mm), a full 360-degree 3D scan reportedly takes as little as 12 seconds, reducing the risk of patient movement

		Incorporating one of the smallest focal sizes in the industry, 0.2 mm, ultra high-definition images with less blurring are said to be created

		Switching between panoramic and 3D is easy, as is positioning the patient with a 55-degree arm angle

This multifunctional unit offering 3D, panoramic and cephalometric X-ray self-adjusts to optimize image quality during acquisition

		For 3D imaging, a horizontal beam minimizes distortion and reduces metal artifacts

		This unit offers 11 fields of view for dental and maxillofacial areas, features a voxel size as small as 80 µm and a resolution of 2.5 LP/mm

		The ORTHOPANTOMOGRAPH™ OP 3D PRO’s 3-in-1 platform is said to deliver high-quality images with a versatile selection of volumes and resolutions

		Features automatic dose control technology with 3D and SMARTVIEW™ for accurate FOV positioning

		A large, easy-to-use, 10-inch user interface and intuitive patient positioning are also included



We live and treat patients in a three-dimensional world, so there’s always a bit of problem when using two-dimensional imaging for diagnostics and treatment planning. Sure, 2D intraoral and panoramic radiographs provide a wealth of diagnostic detail and clinical information, but there’s only so much that can be derived from a 2D capture of a 3D structure.

Check out the products and innovations you missed at this year’s meeting. 

Top innovations announced at CDA Presents Anaheim 2019

 designed and sized for easy handling so the right amount can be dispensed each time with a consistent paste-paste ratio.
	
	

faster cleanup with a new tack light cure option

-the only resin modified glass ionomer cement to offer this feature.

, making it well suited for caries-prone patients.
	
	4. Guarantees virtually no 

 such as PFMs and zirconia, as well as metal and pediatric crowns.

1. Allows flexible dosing through a convenient automix syringe designed and sized for easy handling so the right amount can be dispensed each time with a consistent paste-paste ratio.

5 Reasons to Buy RelyX™ Luting Plus: Easy just got easier

Here are five reasons you should consider the 3M ESPE Elipar™ S10 LED Curing Light.

 provides a comfortable grip that best fits your technique.
	
	

 The wider, 10 mm light guide illuminates up to 80% more curing surface for a 

 system with one cure mode used for all indications.
	
	

 The more focused light output produces up to 3 times more intensity at the clinically relevant distance of 7 mm, resulting in a 

05 Stainless steel exterior is virtually unbreakable

 and sealed against contamination for the best in hygiene control.

3M ESPE’s Elipar™ S10 LED Curing Light: Hold one and you'll want one

Align Technology's iTero Intraoral Scanner

A vast improvement over PVS impressions, the iTero™ intraoral scanner 

provides increased impression accuracy for better fitting aligners and restorations

. Only 0.4% of intraoral scans are rejected compared to 4% of PVS impressions with seven times fewer fit issues.*
	
	Doctors report 

, saving 23-33 minutes per patient, and higher accuracy helps reduce chairside adjustment time, saving restorative dentists 28-38 minutes per case while providing production increases from $116,000 to $158,000 per year.

The iTero scanner captures all elements and materials found in the mouth without messy powder or gag-inducing PVS impression material for an 

C&B, orthodontics and implants, it provides exclusive Invisalign connectivity

. iTero open format STL files also can be integrated with third party CAD/CAM systems, CT scan files and digital orthodontic services allowing development of surgical guides and same-day temporization.
	
	Digital scans can be directly sent to a lab, 

improving communication and enabling digital workflows

. Doctors can easily collaborate online with labs and Align, download ClinCheck, and eliminate packaging, writing lab scripts and shipping to significantly improve productivity.

Align Technology's iTero Intraoral Scanner provides accuracy, efficiency.

Top 5 benefits of Align Technology's iTero Intraoral Scanner

What to know about radiation from cone beam computed tomography and how to explain the scans to your patients.

scan in Imaging Sciences International's i-CAT cone beam system

. Experts say 3D scanning technology such as this should only be used when there is a clinical need.

Diagnostic imaging-especially the stunning 3-dimensional pictures provided by cone beam computed tomography (CBCT) scans-offers incomparable advantages to dentists planning and delivering a wide range of treatments, but the scans do involve exposing patients to small but not-insignificant amounts of radiation.

X-rays have been common in medicine and dentistry for many years and CT scans of one variety or another have become far more common in recent years. However, a recent string of news reports such as the 

series “The Radiation Boom” have raised public concern about the risks and misuse of the technology in medical settings.

While the rewards of properly used CBCT technology certainly outweigh the risks, it is important for clinicians to only use them when the information provided is key to the case being treated and to use them in a way that limits patient exposure to radiation as much as possible. Clinicians also need to be prepared to explain to their patients why the scan is needed and how the radiation exposure is being limited.

“There has to be risk within reason. The dose is low, but there has to be a need,” said Dr. Allan G. Farman, President of the American Academy of Oral and Maxillofacial Radiology (AAOMR).

CBCT systems emit a cone-shaped beam of radiation at the targeted area. The beam is circled around the target with a receptor on the other side ready to receive beam. Dr. Bruce Howerton, a specialist in Oral and Maxillofacial Radiology and expert in CBCT who runs Carolina OMF Imaging, explained that CBCT is very different than medical CT scans where a thin “fan” beam of radiation is used to scan the patient and a larger tissue volume often is exposed to capture the necessary information to create a useful diagnostic image dataset.

“Whereas with cone beam computed tomography, all the radiation emitted to the source, is captured by the receptor, therefore not as much radiation is required,” he said.

In terms of how much radiation is required for a typical CBCT scan, Dr. Howerton said it is the equivalent to the exposure required to take three to four dental panoramic images. To explain this in terms patients might understand, Dr. Howerton said one CBCT scan exposes the subject to approximately four days worth of the background radiation people experience every day from the sun, cell phones and other radiation emitting technologies and materials.

Knowing those basics can be helpful, but Dr. Farman said it is important to realize that not all CBCT systems are the same in terms of the radiation they use. He said it is important to look at the newer system generations as many of them use lower radiation doses, and this can be limited even more by using a system that allows the beam to be suitably collimated.

“While it is the truth that with most cone beam CT systems one can reduce the dose by at least one order of magnitude in comparison with medical multi-slice CT, and even further than that to maybe two orders of magnitude with some of the limited area cone beam CT systems, some of the earlier machines were relatively high dose,” he said.

While the dose is smaller than a typical medical multislice CT scan, CBCT should still be used only for cases where the information from the scan volume will benefit the patient. Dr. Farman said this concept should apply to all dental imaging, not just CBCT. The key is to take an image with a specific use in mind rather than taking a 3D scan of a patient just so there is a 3D record of that patient’s oral anatomy on file.

“That would be like taking radiographs of your feet every time you buy a pair of shoes. It doesn’t make any sense,” Dr. Farman said. “I would say, having read radiographic volumes that have been sent to me, that some practitioners are indeed taking more radiographs than they need to, and when I make reports, I tell them that.”

The AAOMR is currently working with the American Association of Endodontists and the American Association of Orthodontists to develop position papers and guidelines on proper use of CBCT scans in dentistry. Dr. Farman hopes the guidelines will be ready by the fall because they should help clear up questions from dentists about whether they are using their CBCT systems appropriately.

While some diagnostic situations are ideal for the scans, other cases are as yet ambiguous. Dr. Farman said CBCT scans should be the standard of care for implant cases both because of their benefits to treatment planning and because the implant patient population tends to be older, and thus the risks from radiation exposure are reduced. However, when it comes to orthodontic patients who tend to be younger, the risks can be much greater, and 3D imaging selection criteria guidelines could greatly benefit dentists using the technology.

“We would like to have better evidence that CBCT images are necessary when we are increasing the dose in a patient population which is highly sensitive to radiation,” he said. “For sure in those cases where one really didn’t need a two-dimensional image, one certainly doesn’t need a three-dimensional image. No radiographs should be made merely as a routine.”

Knowing the clinical reasons why a CBCT scan is needed is important, but knowing how to explain those reasons to a patient can be just as critical. Dr. Howerton said clinicians should follow the ALARA or As Low As Reasonably Achievable principle when it comes to the radiation doses being used and that should be explained to patients and referring practitioners.

While patients should be informed that there is some radiation exposure, it can be very helpful to be able to explain to them all the ways the exposure and risks are being limited. This means lead aprons and when appropriate thyroid collars should be used, and staff should wear dosimeter badges to track their cumulative exposure.

It also is important to make sure the CBCT system is working properly. It is quite possible that a patient might ask when the machine was last serviced; so being ready with an answer can be helpful. Calibration should be conducted per the manufacturer’s recommendation and differs machine to machine, but is likely to be around once a week. Similarly, regulations on the systems differ from state to state. It is absolutely critical to service a machine if any problem arises, and the system should not be used while it is waiting to be serviced.

“If there’s any problem with the machine the images will not look similar to images that have been seen in the past,” Dr. Howerton said.

Patients should be given a clear reason for the scan and made comfortable about the safety of the procedure. Both Drs. Howerton and Farman said it is important for CBCT technology not to be overused or scans to be conducted as “fishing expeditions” looking for general problems. However, there may be times when the scan captures more anatomy than the dentist intended, or the scan volume contains pathologies that the dentist does not recognize. In those cases, it is to the patient’s benefit to have all the data examined by an expert.

“Certainly there is anatomy captured in this data that can be outside the maxilla or the mandible,” Dr. Howerton said. “If a dentist captures data that they are not sure about or not familiar with, it is very easy and inexpensive to have the data analyzed by an oral maxillofacial radiologist.”

The potential benefits of CBCT scans often outweigh the risks, but that is not true in every case. Dentists using the systems need to be aware of how they work, and be ready to explain both the rewards and the risks to patients who will be scanned. With 3D imaging technology-like all dental technology-there must be a clear benefit to the patient before it is put into use.

“Cone beam computed tomography is changing how dentistry is performed in that it allows the dentist to see anatomy in three dimensions that practitioners have not been able to see in the past, but it is a modality that should be used only to capture information that is going to help the patient,” Dr. Howerton said.

What to know about radiation from cone beam computed tomography and how to explain the scans to your patients.              

Am I glowing yet? Explaining 3D scanning to patients

The divide between dentistry's technology enthusiasts and the general dental population is usually quite wide, but that gap appears to be shrinking as digital dental technologies are picking up momentum and gaining wider adoption and acceptance.

Evidence of this trend is clearly visible in both the results of the 2010 Dental Products Report Tech Census, and the products and categories honored as recipients of the second annual Pride Institute Best of Class Technology Awards.

In many cases, product categories showing increased adoption or on the wishlists of Tech Census respondents matched up with the categories and products honored with the Technology Awards, which were selected by an expert panel. The panel members selected the winners based on what they believe will have the greatest impact on the dental industry.

“Some of them are one-of-a-kind products, and some of them are products that have competitors but certainly are the best in that particular class,” said DPR Technology Editor Dr. John Flucke, who served on the selection panel “I think we did a good job of highlighting things that were so new they had no competition, and others that provide a great slant on an established idea.”

To choose the winners, the panel of seven dental technology experts met via conference call and had what several members described as a passionate discussion and debate over both what products are making a difference and what makes one of those products stand out from others in the same category.

“The fact that the winners were chosen by majority vote and none of them were a unanimous selection from the entire panel is a testament to the large number of high-quality technology products making inroads into the dental industry,” said Dr. Lou Shuman, President of the Pride Institute.

Dr. Shuman said he created the Technology Awards last year to help provide the dental community with a resource to turn to when exploring new technologies. He hopes the awards themselves bring attention to worthy products that can help dentists improve the care they provide, while the accompanying Technology Expo at the ADA Annual Session meeting will give dentists hands-on experience with the technologies in an environment free of sales pressure.

“The introduction of technologies into our space is exploding,” he said. “Because of both the amount of new technologies being introduced and the cost of some of these technologies, I felt there needed to be guidance that the dental community could trust and have faith in.”

Having a mix of writers, speakers, researchers and educators bringing different perspectives and clinical experiences with technology to the panel was a positive part of the process, said Dr. Titus Schleyer, who teaches at the University of Pittsburgh’s School of Dental Medicine.

The debate divided technologies into four categories-Foundational, Diagnostic, Therapeutic and Emerging-and the discussion did not begin or end with a set number of awards to hand out or even a set number or type of products to honor within each category. Dr. Shuman said the fact that only four of last year’s winners repeated this year speaks to the pace of innovation in the industry, and the six panel members interviewed for this article all said they are pleased with the final outcome of their efforts.

“That gives you an idea of the amount of introduction of new technologies, as well as the existing technologies focusing very hard to improve on an annual basis,” Dr. Shuman said. “The panel was very tough on the technologies. There was significant debate before they were chosen.”

Panel member and dental technology writer and speaker Dr. Larry Emmott said creating and handing out awards such as this is about more than just highlighting what a small group of people feel is the best of the best. Instead, he said the real purpose is to help drive the industry forward by educating and inspiring clinicians while encouraging quality and innovation from manufacturers.

“Part of the idea for this is to help the dental profession use technology effectively,” he said. “By focusing on both individual products and categories, the idea is to guide the development of new products in those areas, and to reward excellence.”

While not every product brought to the table for consideration was honored, Dr. Parag Kachalia, who teaches restorative dentistry at University of the Pacific, said the end results found a good balance between recognizing well-established categories and brands while bringing attention to smaller innovations that are capable of making a big impact on the industry.

“I think there’s a little bit of a misconception that any piece of technology needs to be a $10,000 item to really make an impact, and that’s just not the case,” he said.

Still, many of the biggest companies and most-popular brands in the industry were presented with the awards, which is something Dr. Emmott said reflects the fact that while, “the industry leader isn’t always the best, it often is. People have chosen it for a reason.” Dr. Schleyer added that panels selecting the Technology Awards in the future have a great opportunity to put a spotlight on the innovations coming from smaller companies with great ideas but limited marketing and exposure.

For Dr. Flucke, the entire process was a great and validating experience. Based on participation guidelines, he was not allowed to vote in the category that included the Gendex GXCB-500 HD cone beam system he promotes, so he was excited to see it was selected as best of class along with other digital technologies he felt were important to recognize, and most importantly, he feels he now has more allies in his efforts to promote wider adoption of technology in dentistry.

“It’s an entire choir of voices out there saying how important these technologies are,” he said.

According to the results of the 2010 Tech Census, that message is starting to make real headway in the industry. Viewed as a whole, the survey shows a picture of relatively widespread adoption of core digital technologies, increasing numbers of dentists using bigger-ticket and specialized technologies, and many of the product categories spotlighted by the Pride Awards topping dentists’ wish lists.

In the Foundational category, the panel focused on core items that fit into every practice such as practice management software where Dentrix G4 was chosen, and digital radiography where the DEXIS Platinum digital sensor was honored. While not every practice has adopted those products or technologies, calling them “foundational” is no longer a stretch, as 87% of survey respondents said they own practice management software, while 58% own digital radiography systems with an additional 21% planning to purchase the technology.

Writer and speaker Dr. Marty Jablow said he feels honoring those technologies as foundational makes a lot of sense because they have the potential to change the way dentists practice on an everyday basis. Switching to digital radiography may require new training and infrastructure investments, but the benefits will quickly be realized and noticed throughout the practice.

“The investment is well worth the time because there are savings in various areas that continue on in personnel time, and it’s also greener,” Dr. Jablow said. “Most dentists don’t understand the benefits of some of these efficiencies.”

Dr. Schleyer agreed that those technologies truly are foundations for a practice, and said, “I cannot imagine how you can run a practice without that.” However, he cautioned that every technology will not be a fit for every practice, or for every patient who comes into a practice using the technology. Learning how and when to best use a technology is the key to getting the most from the investment.

The technologies honored in the Diagnostic category are some of the areas seeing the greatest growth with cone beam and CAD/CAM the two technologies most often cited when respondents were asked to name what technology they would add if money were not an issue.

According to the survey results, chairside CAD/CAM is now in 18% of practices, up from 15% in last year’s Tech Census. An additional 11% of respondents said they plan to adopt the technology, and Dr. Kachalia said this is good for the industry because the technology continues to expand in scope.

“We’re headed to a point where in-office CAD/CAM is going beyond simple single-unit restorations,” he said. “We’re thinking about it in much broader terms and treatment planning approaches.”

Caries detection technologies, such as the Best of Class Spectra from Air Technologies, also made significant headway in terms of adoption throughout the industry. Currently 42% of respondents say they have some kind of caries detection in their practice and if the 12% who plan to purchase follow through, the technology will be in place in more than half of American dental practices.

“The days of the explorer are gone. This technology is going to change the way we practice dentistry for the benefit of the patient and the practice,” Dr. Shuman said when discussing the potential of caries detection technologies.

Dr. Flucke agreed, and said while the systems will continue to improve, the technology is not something from the future, but a key tool for dentists today. Along with diode lasers, he believes caries detection systems can have some of the biggest impact on the care dentists can provide to patients and they are not devices coming in the future, but technologies ready for widespread use.

“These are things that are now. I’m using these devices everyday,” he said. “People need to avail themselves of these technologies and use them now, because they’re game changers.”

For diode lasers it seems the general dental population is starting to catch on in a big way. In last year’s Tech Census, 17% of respondents said they owned a diode laser. This year, that number jumped to 30%, with an additional 18% of respondents saying they plan to purchase a laser for soft-tissue applications.

Every member of the panel said the recent drop in price for diode lasers is a big reason for greater adoption. While Dr. Kachalia said he thinks the prices have reached a point where the technology can become commonplace throughout the industry, Dr. Jablow said dentists still need to dedicate themselves to learning to use their technology investments.

“I think the price drop in diode lasers was a big deal,” he said. “I think the price drop has seen many more lasers come into the hands of dentists. But there is one caution. The training on these lasers has not caught up.”

Of course, not every technology is on the rise. While cone beam technology tops people’s wish lists, and the Technology Awards panel members all strongly believe in the diagnostic benefits of the detailed 3D images cone beam CT can provide, just 7% of survey respondents said they had already invested in a cone beam system.

Price is still the biggest hurdle to greater adoption of cone beam systems, and even if prices come down, not every general practitioner will have a regular need for cone beam imaging. Dr. Flucke said he believes dentists are very aware of the technology, but are still not fully grasping the potential of what it can do for their practice. However, Dr. Jablow said that will eventually change because the imaging benefits from cone beam are, “something that stands above everything else.”

“It just gives more information, and allows the dentists to have all the information when they’re talking about implants or surgical procedures, and in many cases, to be able to perform those procedures less traumatically,” he said. “More information allows you to be a better dentist.”

Improving dentistry is really the point behind adopting new technologies and the reason for creating and presenting the Technology Awards. Dr. Shuman said part of the panel’s discussions focused on not just what technologies are brand new and exciting, but on which of these technologies will have the longevity needed to provide lasting benefit to the dentists who adopt them.

Publicizing awarded technologies has the potential to impact buying habits, Dr. Shuman said. So as the Technology Awards establishes itself as an annual assessment of the state of the art in the industry and an informational resource for the dental community, he wants to make sure the selection panel looks at the technologies from a variety of perspectives, including the company and training behind the products, so the program can help improve the overall quality of care being provided.

“When you start to look at choosing technologies, those companies that train the best, service the best and plan upgradability will have significant impact on decision making,” he said.

To Dr. Flucke, that impact on the patient experience is the driving force behind his personal adoption of new technologies and his efforts to promote technology throughout the industry. He said providing the best care to his patients is always his goal, and technology is a vehicle that allows him to do just that.

“My determining factors on technology are if it allows me to provide better care, or the same level of care but provide it either faster or with less discomfort for the patient, that’s all I need to know to make a purchasing decision,” he said. “If you really have your patients’ best interests at heart, you’re going to embrace technology because that’s the engine that drives the world.”

A key factor that ties many of the technologies honored by the awards together is the ability to provide dentists with more detailed information about their patients. Dr. Jablow said better information at the start of a procedure can mean better outcomes and less invasive treatments for the patient.

So while every dentist doesn’t need to adopt every single new technological development, they should be aware of industry trends and staying within the middle ground in terms of adoption. Staying informed, researching new developments and moving to adopt the technologies that fit an individual practice will lead to an overall higher quality of dental care, Dr. Jablow added.

That is a message that seems to be getting across as 64% of Tech Census respondents describe their approach to technology as “a researcher” who looks for data and hands-on experience before purchasing. An additional 27% said a proven record of return on investment is the key factor triggering their technology purchases. Dr. Kachalia said those are the right approaches because not every technology will work for every practice, and having trusted sources for finding out about new technologies is critical so clinicians can truly understand the impact of their technology investments.

“At the end of the day, it doesn’t matter what technology you have if the patient’s experience or the doctor’s experience is not improving,” Dr. Kachalia said. “If there’s not an end clinical outcome change, efficiency change or greater patient comfort, it’s great to have but it’s not needed.”

Just knowing about the benefits of a new technology often is not enough to make an investment really pay off for a practice and its patients. Dentists need to have a good foundation of core technologies to maximize use, and Dr. Emmott said a big part of this is realizing computers are more than just business machines for the front office, and should be fully integrated throughout the practice with a presence in the operatories.

This set-up can help a practice make the move to a chartless or completely paperless environment and more fully integrate digital technologies on the clinical side of the practice. Dr. Emmott said that eventually will lead to greater use of the Internet for clinical purposes along with the front office uses, such as billing and patient communications, that are already being successfully integrated into the workflows of numerous practices. The key to everything will be solid computer network software systems that can communicate with each other.

“If you don’t have a good foundation of technology, adding on the advanced stuff very rarely works well. If you have good basics, adding on the next level is relatively easy and relatively efficient,” he said. “It’s not just having the technology, but it’s using it effectively.”

Once again, this message seems to be gaining widespread acceptance in the industry with 63% of survey respondents saying integration with existing  systems is very important and an additional 19% designating it somewhat important.

“We are, whether we want it or not, in the process of digitizing the world,” Dr. Schleyer said. “It’s a trend that you can’t put your head in the sand and say you’re not going to do this, because it means you’ll go the way of the buggy whip 100 years ago. The way we handle information affects the core work of clinicians, and we will not be able to do things down the road without these digital technologies, and that’s why we need to make sure we stay on top of them.”

This is why research in dental informatics, a discipline in which Dr. Schleyer is an international leader, is needed to inform how best new technologies can help support clinicians and patients.

“Without it, it is like trying to build a house without an architect,” he added.

But staying on top of the technologies does not mean rushing in if you’re falling behind the state of the art. Dr. Jablow said change is coming, but more like a glacier than a wave so there is always time to plot a path to integration and return on the technology investment.

Even as prices for some technologies begin to fall, it is important to research and spend time evaluating any technology investment. Proper training should be part of that planning. Staff involvement also is key.

“It would be a daunting task to integrate all of these things at once, and in fact in most cases that would end up in a failure,” Dr. Jablow said. “What you want to do with any of these technologies is set up a plan. Give yourself enough time to integrate it in, and in most cases you’ll never go backwards.”

Waiting for prices to drop before adopting is not always a wise move. Dr. Emmott said that while prices on consumer electronics almost always drop significantly after a time, dental technology prices do not always drop to the same degree because of the relatively small size of the industry.

Still, while adoption of technologies such as cone beam remains slow, the pace is likely to increase as a younger generation of dentists raised on computers and the Internet continues to enter the industry. Both Drs. Schleyer and Kachalia said their students are being trained on technologies such as CAD/CAM, cone beam and lasers.

Dr. Schleyer said the current generation of students are used to being in a paperless environment and are likely to question working in a practice that continues to keep paper records. He said the next generation of dentists could be change agents for the profession and industry as they believe strongly in using technology to provide the best possible patient care.

“I do see it as our job to expose students to the best technologies for which there is evidence that they actually do help improve care,” Dr. Schleyer said. “Technology-and the rate of change of technology, more importantly-is something that’s completely normal for them. The newer generation of students and practitioners, I think they’re much more likely to adopt new paradigms.”

Dr. Kachalia said he thinks the current generation in dental school has an easier time with technology because they’ve grown up in a world with iPods and e-mail. Instant access to information is almost a given to them, so while they are certainly being taught the same fundamental principles of dentistry, they have an easier time fitting technologies into their model of providing care.

“All the fundamentals are there, but they’re able to see things in a 3D graphic world better,” he said. “That’s what they can adapt to, that’s what they like better. To some degree they’re pushing education to really look at these new realms that are out there.”

But learning about new technologies is not just something for new students, and Dr. Kachalia said there is no reason dentists should be practicing the exact same dentistry at the end of their careers as they did when they first began seeing patients. Instead, he said the industry needs to do a better job of providing lifelong education that keeps the entire industry up to date on the best available technologies and techniques for providing patient care.

Dr. Shuman said this upcoming generation of dentists who are so comfortable with technology provide one more reason for practices to keep up to date. Young dentists are going to be looking for practices to take over, and they’re going to be far more attracted to a practice with technology than a practice that is barely wired. But regardless of the way technology can impact a practice’s value, Dr. Shuman said technology should be a serious consideration because of how it can impact patients.

“We feel very strongly that even at the end of your career you should be passionate about looking at new technologies,” he said. “At the end of the day, no matter if you’re at the beginning of your career, the middle or the end, our passion as practitioners, and our goal as practitioners, is to provide the very best care we can.”

The August 2010 Technology Census was sent via e-mail to general practitioners and hygienists in the United States. The link was promoted on the MH and DPR Facebook pages, where we currently have 5,246 and 5,417 fans, respectively. The survey was completed by 144 people.

The divide between dentistry's technology enthusiasts and the general dental population is usually quite wide, but that gap appears to be shrinking as digital dental technologies are picking up momentum and gaining wider adoption and acceptance. Evidence of this trend is clearly visible in both the results of the 2010 Dental Products Report Tech Census, and the products and categories honored as recipients of the second annual Pride Institute Best of Class Technology Awards.

Tech experts chart a digital path

 is designed to be a low-cost, easy-to-use option that can handle the tasks previously performed by scalpels and electro-surge. Designed for soft-tissue surgeries such as troughing, gingivectomies, frenectomies, exposing implants, treating aphthous ulcers, and herpetic lesions, it cuts and coagulates tissue with reduced trauma, bleeding or necrosis of tissue.

Priced to move: With a list price of $2,495, it brings lasers to a new level of affordability.

Newcomers welcome: Featuring 2.5W of power, three customizable presets and the ability to use disposable tips or strippable fiber, the lightweight laser is designed for dentists and hygienists just beginning to add laser services to the operatory.

Everything needed: The laser comes with accessories, a universal power adapter and a two-year warranty, as well as a set-up DVD and online laser certification.

 is available in standard white or a limited-edition pink to raise breast cancer awareness.

The Picasso Lite soft-tissue dental laser is designed to be a low-cost, easy-to-use option that can handle the tasks previously performed by scalpels and electro-surge. Designed for soft-tissue surgeries such as troughing, gingivectomies, frenectomies, exposing implants, treating aphthous ulcers, and herpetic lesions, it cuts and coagulates tissue with reduced trauma, bleeding or necrosis of tissue.