The future in three dimensions

25 02 2010

Speaking with great passion for his subject matter, Lee Culp, CDT, seemed like an evangelist for the digital future of dentistry and dental lab work as he addressed the 82nd annual meeting of the American Prosthodontic Society Thursday at the Westin Chicago River North. Calling his presentation, “Beyond Imagination” Culp offered countless bold pronouncements as he mixed charming humor and an array of photos illustrating the range of restorations he has completed with digital dental and production technology.

His vision is of a dental world filled with the ones and zeros of binary code, where impression materials, physical waxups and lab technicians painstakingly layering porcelains to build the perfect crown are just memories of how things once were done. Insisting that this digital future still leaves plenty of room the artistry and craftsmanship of lab technicians, Culp said the digital path is one of speedy, efficient in production, and is already capable of producing high quality, long lasting restorations.

“The computers and machines can do incredible things today,” he said.

Of course, those computers are only as good as the people who use them, and Culp said good restorative work still must begin with a good impression. A digital impression with poor visualization of the margins is no better than a poor physical impression, but with a good impression as a starting point, the materials, computers and mills exist today to create highly esthetic full-contour restorations. Culp said he prefers glass ceramic materials such as Ivoclar Vivadent’s e.max lithium disilicate and thinks the future of lab work will involve digital design, computer milling and finally artful staining and glazing to make things anatomically realistic.

The approaching future he talks about will involve full 3D imaging of a patients entire oral anatomy, and Culp said the “3D patient” will be a reality by the end of the year. To accomplish this, diagnostically valuable DICOM data from cone beam scans will be integrated with the more detailed and machinable images from digital impressions to create restorations from start to finish in just hours with no physical model or even temporary required. In fact, Culp said he is already doing this on some cases.

Showing off the latest in imaging technologies, Culp displayed slides of the detailed images captured through optical coherence tomography. This laser-based imaging technique is not yet commercially available, but it is in the works, and when ready will allow clinicians to scan digital impressions that capture data beneath the margins. In fact, the scans are so detailed they can show the thickness of a tooth’s enamel layer to guide preparations and help spot caries that are still beneath the surface and invisible to existing technologies.

“Technology is there today to do these things,” he said. “We are going into the ones and zeros and we are going there fast.”

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One response

26 02 2010
licherd

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