Science Video

Digitial Dentist
3D Images From Hand-held Scanner Offer Precise Fit In Dental Work

August 1, 2007 — Prosthodontists use a new digital technology that creates a 3D image of patients' teeth, eliminating the need for messy molds. A hand-held scanner takes digital pictures of a patient's damaged and surrounding teeth. The three-dimensional images are then displayed on a screen, and then sent electronically to a lab that creates a final, more precise fitting crown.

Patients are all smiles about a new, mess-free way to make teeth impressions. Now, there's new hope for dental patients enduring the unpleasant, messy process of making teeth molds.

Brigitte Akalovsky is one of 50 million patients each year needing a crown placed over a damaged tooth. But before fixing a tooth, patients are traditionally stuck with a mouthful of messy, bad-tasting material to make a tooth mold.

"You don't like it. You have this big, gooey thing in your mouth and it's just bulky," Akalovsky said.

Now, Brigitte's tooth repair is mess-free. Prosthodontists are using a new digital technology that creates a 3D image of patients' teeth, eliminating the need for messy molds. "Because its all three-dimensional digital images, it's a much more accurate product that we get," Juan Loza, a prosthodontist, said.

A hand-held scanner takes digital pictures of a patient's damaged and surrounding teeth. The three-dimensional images are then displayed on a screen, and then sent electronically to a lab that creates a final, more precise fitting crown.

"It brings a whole new level of technology that was not available until now in my practice. Now, I have a digital system that is very accurate," Loza said.

The digital dentistry helps create near perfect impressions that almost eliminate refitting for crowns and bridge implants -- and made a perfect picture fit for Brigitte.

"Very quick, the fitting was perfect," Akalovsky said. The 3D digital technology is available in several states, including New York, New Jersey, Pennsylvania, Illinois, Washington, Idaho, Oregon, Wisconsin, Missouri, Kansas, Maryland, Colorado and Utah.

The Optical Society of America contributed to the information contained in the TV portion of this report.

BACKGROUND: A new product called iTero will render the traditional method of taking dental impressions obsolete. It is fast, painless and free of mess, creating an exact replica of the patient's teeth, resulting in a better fitted crown or bridge in 10 minutes. iTero allows dentists to generate a dental impression by quickly scanning the inside of a person's mouth with a handheld wand. Images of the patient's mouth are captured in real time, then magnified and displayed on a monitor while the patient is still in the chair. This enables dentists to make any necessary adjustments before completing the scanning process.

THE PROBLEM: Some 50 million dental patients require crown and bridge implants each year, and every one of them must have a physical impression created of the area to be restored. The process is unpleasant: the dentist inserts a soft goo into the patient's mouth which hardens over the course of several minutes into a putty that is then forcibly extracted. If the impression is imperfect, the crown or bridge may require excessive adjustment, or may need to be remade entirely. The end result is more time spent in the dentist's chair and even more discomfort for the patient.

ANATOMY OF A TOOTH: We think of teeth as being the part visible above the gum, but this is only the tip, or crown, of a tooth. There is also a neck that lies at the gum line, and a root, located below the gum. The crown of each tooth has an enamel coating to protect the underlying dentine. Enamel is even harder than bone, thanks to rows of tightly packed calcium and phosphorus crystals. The underlying dentine is slightly softer, and contains tiny tubules that connect with the central nerve of the tooth within the pulp. The pulp forms the central chamber of the tooth, and is made of soft tissue containing blood vessels that carry nutrients to the tooth. It also contains nerves so teeth can sense hot and cold, as well as lymph vessels to carry white blood cells to fight bacteria.

CROWNING ACHIEVEMENT: Dental crowns, also referred to as "dental caps" or "tooth caps," are dental restorations that cover over and encase the tooth on which they are cemented. Dentists make use of dental crowns when need to rebuild broken or decayed teeth, strengthen teeth, or improve the cosmetic appearance of a tooth. Crowns can be made out of porcelain, metal, or a combination of both. Other terms that are used to refer to dental crowns are "dental caps" and "tooth caps" A dentist might recommend placing a dental crown to restore a tooth to its original shape; to strengthen a tooth; or to improve the cosmetic appearance of a tooth. The fundamental difference between porcelain veneers and dental crowns is the amount of a tooth's surface each respective type of dental restoration covers over. Dental crowns typically encase an entire tooth whereas porcelain veneers only cover over the front side of a tooth.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.


Note: This story and accompanying video were originally produced for the American Institute of Physics series Discoveries and Breakthroughs in Science by Ivanhoe Broadcast News and are protected by copyright law. All rights reserved.
 

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