Taking Good Digital Impressions

By Dr. Sarah Karls, Karls Family Dentistry 

Our practice made the leap to a digital scanner in late 2019. As someone who was a fan of packing cord and taking a traditional impression, I was hesitant. I had used a Cerec machine in the past and had mixed emotions about it. As the technology advanced, I started to believe. Here I share my experience with a digital scanner and why I believe it is a game changer.

We purchased the Itero Element 2 and it has been an incredible addition to our practice. The patients love that they no longer have to tolerate impression material in their mouths. It is also a great educational tool, and they enjoy watching the technology at work. The ability to rotate the image 365 degrees, enlarge the margin, and check occlusal clearance, makes restorations all the more predictable.

At first I was skeptical, but since we’ve incorporated it, I almost never take a traditional impression anymore. The accuracy has been spot on, and I rarely have to adjust crowns at insertion. I attribute these successes not only to a great scan, but also to D&S and their skilled technicians. I think one of the main hurdles to purchasing a scanner can be the price, but D&S provides a discount per case (and for total monthly submissions), and it really does add up. Considering these factors, I am certain I will never practice dentistry without the aid of a digital scanner again.

Factors that contribute to the success of a good clinical scan are design, isolation and a great dental assistant. Other tips:

  • When it is possible, I try to leave the crown margin supragingival for easy visibility. When it is not possible, I will utilize our SiroLaser Blue to remove excess tissue and control heme.
  • If I can see the margin but am having difficulty controlling the field, I use a hemostatic agent such as fas-TRACT 25% clear aluminum chloride gel. This works very well and does not leave behind heme remnants, allowing for a clean view.
  • I also utilize an Isodry for patients who have excessive saliva.
  • In extreme situations four-handed dentistry can be used to obtain the scan, but that is rare.

When we first received the Itero there were many platforms to obtain training. We had our own clinical trainer who guided us through the entire process. With the use of a webcam she helped our assistants take scans on each other and gain confidence. Once we started using it on patients there were inevitable learning curves. When this occurred we were able to contact the trainer by phone or email and she would help us troubleshoot the problem. Once proficient, the entire scanning process usually takes less than five minutes and can easily be delegated to a talented dental assistant.

Editor’s Note: An added benefit of digital impressions is fewer remakes. D&S Dental Laboratory has been accepting intraoral scans for more than 10 years and consistently sees lower remake rates once offices begin submitting digital impressions.