How digital dentistry can play a part in every stage of full mouth rehabilitation

06 November 2023
Left to right: Henriette Lerner and Dimitar Filtchev.
Left to right: Henriette Lerner and Dimitar Filtchev.

The fifth in the 2023 Digital Excellence Series from Align Education explored solutions for full mouth rehabilitation. Presentations from Henrietta Lerner of Germany and Dimitar Filtchev of Bulgaria detailed how dentists can use digital technology, including Artificial Intelligence (AI) to visualise better, plan and perform full mouth rehabilitation treatments.

Henrietta, who has practised dentistry for 33 years, said of the more recent advances in dentistry, “I’ve realised over the years that every revolution that happens in dentistry is refreshing my mind and making me want to stay another 33 years in this field because it’s becoming increasingly comprehensive and increasingly complex. We are no longer treating even the full arch - that is not complex enough. Dentistry is a discipline, which is treating not only the mouth, but the full body, which has to be in functional harmony.”

She added, “Digital dentistry is a good virus that came into our offices, and we have accepted and opened the door to it because we are all on the same journey of giving our patients more reproducible, predictable, minimally invasive, accurate and aesthetic functional treatment, as fast and as accurately as possible.”

In the course of presenting a series of complex case studies, Henrietta explained step-by-step how digital dentistry informs and guides treatment, her approach to workflow, plus aesthetic parameters that she said were essential to successful full arch rehabilitation. She also stressed to delegates that digital dentistry now allows her and her patients to visualise treatment results - a key factor in helping to change her treatment strategy and in-practise workflows - to give patients better health, faster treatment and a better outcome.

She also explained how pre-surgery tooth alignment using removable aligners allows for much less tooth substance to be removed in full mouth rehabilitations. Henrietta said, “75 per cent of patients could benefit from tooth alignment. And 45 per cent of prosthodontic procedures will be much less invasive.”

Henrietta reflected on the scan and plan steps as a critical foundation for her minimally invasive approach to a potential surgical and treatment workflow. She said, “When we talk about Scan, we are talking about the acquisition of all the digital data, photos, videos face scans, intraoral scans, lap scans and occlusal analysis, movement, registration of the movement virtually and dicom data acquisition.

“The next step is the planning after we have superimposed, as accurately as possible, all the digital data to generate a dental avatar or digital virtual patient. This forms the basis of our implant planning, including the bone, the soft tissue, the prosthetics and the surgical guide.

“In the third chapter, Make, we bring together all the digital data we have created via the different software to print the different guides and the provisional models. We used to mill, but printing is the new milling.

“The fourth chapter, Done, which is the surgery itself and in the past 10 years we haven’t done any surgery that is not guided – from single tooth surgery to full mouth rehabilitation.”

Digital dentistry is the key to communication

In his presentation, Dimitar, told delegates how the iTero intraoral scanner is central to patient treatment at his practice. He said, “It is a great tool to collect information; before doing surgery, during surgery and after surgery…we scan every step, and this also helps us in our communication with our patients, and between our team and the technicians.”

In explaining the patient journey, Dimitar said every patient is scanned, and this is used to understand if the teeth need to be aligned, with a simulation allowing the patient to see what the result of treatment with aligners will be. He said this also helps to motivate more patients to embark on their Invisalign treatment journey.

Dimitar also presented several complex case studies, including a full mouth rehabilitation, in which he explained how digital dentistry informed and aided treatment. “It is helping us to be much, much more communicative with the patient, and to create different solutions,” he said, adding that 100 per cent of implant cases at his practice are now completed via a digital journey, including guided surgery. He told the audience that this had made such a difference to the treatment. He advised that while some practitioners are sceptical of being able to complete full mouth rehabilitation using only scans, he and his team were now completing 20 cases per month, all of them fully digital.

The next in the Digital Excellence Series is on November 29, at 7.30 CET/6.30 pm. ‘Empower your dental practice utilising AI and digital diagnostics’ is presented by Falk Schwendicke and Ingo Baresel.


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