The complete introduction to intraoral scanning

Considering adding an intraoral scanner to your practice? We’ve listed everything you might want to know.

“The curtain that doctors have been hiding behind: the one that says digital is no good or the quality isn’t there, no longer exists.”

Dr. Vincent Prestipino, Prosthodontist

What is an intraoral scanner?1

An intraoral scanner is a device that is used in dentistry to create impressions digitally. The scanner projects a light source onto the area to be scanned. Thousands of images are then captured by imaging sensors and are processed by scanning software, which then produces an accurate 3D surface model showing the teeth and gingiva’s geometry.

Digital intraoral scanners, as well as stand-alone equipment for computer-assisted design (CAD) and computer aided manufacturing (CAM), have become very powerful and efficient tools in today’s dental practices. They eliminate the need for traditional analog impressions and wax-ups, as well as the conventional hands-on fabrication processes associated with all-ceramic restorations.

Adding an intraoral scanner to your practice opens up a world of opportunities for CAD/CAM dentistry, which, according to the FDI World Dental Federation lets you design and manufacture a ”custom-made dental device, or a patient-specific dental device from an industrialized product, with the aid of a computer.”

”CAD/CAM means that you take impressions with an intraoral scanner, not with conventional materials and trays. With software you digitize, analyze and manipulate the scanned images, instead of pouring models. You design restorations with CAD software, not by hand-waxing models. After that, they are milled through a CAM process, rather than by pressing and/or layering.”

Dr. Jonathan Ferencz

What are the cost savings of intraoral scanning? 2

Intraoral scans are performed quicker than analog impressions, depending on your level of experience. The functionality, in terms of the workflow and ease of use, is no longer a discussion either.

Impression material and shipping

Depending on your practice set up, the savings on using an intraoral scanner can be huge. From PVS material to plaster for models, the digital workflow all but eliminates the need for physical impressions. Not to mention shipping and storage savings. If you are an orthodontist, you can digitize all your models. That’s five years of models now stored on a hard disc or the cloud.

Time savings

There are numerous studies that document intraoral scanners save you time. When comparing the digital workflow for creating esthetic restorations with the analog workflow, you’ll see there is no comparison. Digitally scanning a patient takes five minutes. No impression material used, no sitting around waiting for the PVS to dry, no patient-gagging, no mess. A huge change that translates into you having more time to see more patients.

Faster workflows

For some doctors, the digital workflow lets them accomplish nearly as much work as they have always done, but in half the time. The case of Dr. Ferencz, for example, illustrates how he managed to give a patient that came in with a broken crown a completely new crown in just one visit.

“I took the broken piece and slipped it back into his mouth – it fit perfectly like a jigsaw puzzle. And had my assistant do a pre-prep scan. Then I took the broken piece off. I gave the patient a little Novocain and grounded away the piece that was still cemented. I placed a cord and scanned the prep with our 3Shape TRIOS. The technician in the lab then designed and milled him a new crown. Ninety minutes later, he left with a final crown and not a temporary one.”

How will intraoral scanning affect my patients? 3

Improve patient comfort

While most of us think about intraoral scanner accuracy and function when we consider going digital, it is the benefits to your patients that just might be the number one reason for you to make the move. Digital impressions offer patients the convenience of not having to endure traditional impressions: unpleasant tasting materials, bulky, cumbersome trays and possible gagging. There are several studies that document patients prefer the digital workflow. And in the case of a University of Bern, School of Dental Medicine Study, it is not just some patients, but ALL patients (100%) prefer digital . Digital dentistry impresses your patients and gets them talking and recommending your practice.

Excite patients and improve treatment acceptance

A 3D scan on screen also allows for visualizing treatment options to communicate with the patient. As Dr. Ferencz put it “The best patient is an educated patient. But communication has to be quick and intuitive. So now, rather than taking out the camera and iPad, I reach for my scanner.”

You can work with apps for smile design – “A fantastic tool and one that is changing lives,” says Dentist and Smile Designer, Dr. Marc Onuoha. In addition, monitoring and simulation apps enable doctors to track and quantify, i.e., bruxism and teeth movement, or show patients the envisioned results of their orthodontic treatment. It will become so much easier to communicate with your patients and exciting them at every visit while driving treatment acceptance.

Or, as Dr. Ferencz put it: “we’ve come to realize that there is so much more potential with scanning technology as a communications tool, a demonstration tool… applications that have nothing to do with manufacturing.”

Get more options, offer more treatments

The great thing with digital dentistry is that it allows you to grow over time. You start with intraoral scanning, but over time, you can tweak your workflows and add indications and treatments, for example. Want to start designing crowns? Or even mill them in-house? It’s possible. Same for clear aligners. You can now start offering them with our open clear aligner workflow. The basic idea: you only do what you feel comfortable with and for the rest, you can rely on the 3Shape ecosystem of labs, manufacturers or service providers. If you choose a 3Shape solution, of course.

See what in-house dentistry can do for your practice

“Having this as an option has affected the business in a way that provides faster turnaround, more efficiency, a convenience for the patient and immediate results.”

Dr. Prestipino

 

How accurate are digital impressions?4

Digital scans versus analog impressions

There are plenty of studies that document the accuracy of intraoral scanning. We’ve listed and sorted of few of them for you, if you want to check it out for yourself.

By eliminating analog impressions from your workflow, you instantly remove your lab’s biggest source of error: your impression. In their latest State of the Industry, LMT magazine identified that 47% of labs rated the lack of quality in the analogue impression they receive from dentists as their biggest challenge. They also said it is much easier and more accurate to work with digital impressions.

Image: Selected representative 3D Compare Analysis of IOS and IMPR and color histogram depicting deviations with settings at nominal ±20 μm and critical ±100 μm.
* Source: Journal of Dentistry, Accuracy and precision of 3 intraoral scanners and accuracy of conventional impressions: A novel in vivo analysis method.

How much does an intraoral scanner cost?5

The price of an intraoral scanner

The price of your solution ultimately depends on your ambitions, growth plans and needs. Using a complete system has the potential to reduce costs related to impression material, provisional crowns, time in the office, and laboratory bills. Dr. Parag Kachalia estimated that dentists who switch to office CAD/CAM systems can reduce their laboratory bill by 60% to 70%.”

But at the end of the day, it’s not about what you pay, but what you get. Dr. Mark McOmie from the US did the math and his reflection is that the cost of the scanner is not just the upfront cost of the scanner. It’s much more relevant to look at its lifecycle and look at total cost of ownership. He took 3M, Cerec, PlanScan, 3Shape TRIOS and iTero and concluded that the costs varied wildly. Some charge a dongle fee (a per use charge), some have yearly fees, some charge monthly fees, warranty fees, support fees, etc. He added the upfront costs of the scanner, fees and maintenance agreements and multiplied it by six years. This gave the cost to own and operate the scanner for six years.

What he also did, was charting the savings of digital versus analog. Upon seeing the results and buying an intraoral scanner, Dr. McOmie concluded, “you want to know how to send your kids to college? Buy a 3Shape TRIOS intraoral scanner.”


Crowns per month  Cost per analog impression w/ bite registration + triple tray cost Discount from lab for digital impression Savings per month Savings per year Two-year savings Six-year savings  
40 40 USD 20 USD 2,400 USD 28,800 USD 57,600 USD 115,600 USD

Is intraoral scanning easy? 6

We are by no means unbiased. But from what we’ve heard, when you can operate a mobile phone, you can operate an intraoral scanner too. Most suppliers of intraoral scanners will offer scan guides, telling you how to best scan for certain indications such as crown and bridge , or clear aligners, or dentures. The more you practice, the quicker you will get.

"It really is a simpler process. Sure, there is a learning curve. But if you can use a smartphone, you can scan."

Dr. Jurim

Practical how-to guides

To help you get a sense of what it takes to do scan-only, we’ve compiled a few how-to guides to give you an idea of what working with our intraoral scanner (3Shape TRIOS) is like.

Outside of our extensive libraries with online training material, most suppliers will also have their own training institutes for trainings to help you get started, or you can find inspiration in one of the many online digital dentistry communities.

Comparing intraoral scanners7

With more and more intraoral scanner brands entering the market, choosing the system that is best for you can be a daunting exercise. Should you go for powder or not? What is the value of wireless scanning? How about subscriptions – do or don’t? Is an open system the clever way to go, or does a closed architecture make more sense?

The Institute of Digital Dentistry did a helpful comparison of the major brands that were present at IDS 2019, including our TRIOS. Their evaluation criteria might give you a good indicator of what to look out for when trying different brands for yourself:

  • Scanning Speed and Flow
  • Size of the Scanner
  • Ease of Use
  • Intraoral Scanner Price / Investment Cost
  • Subscription Requirements or Maintenance Packages
  • Open or Closed Scan Exporting
  • Autoclavable Scanning Tips
  • Touchscreen
  • Wireless Scanner
  • Caries Detection
  • CAD Integration

Their conclusion? There is no perfect scanner, although some come with clear advantages over others. Choosing one should depend on many factors such as your budget, what procedures you focus on in your practice, other 3rd party technology do you own (CBCT, printers, mills?), and whether you want to scan and send or carry out single-visit restorations.

Read full report

 

Want to learn more?

We've collected and summarized clinical studies comparing intraoral scanners and conventional workflows, and put together an information-packed webinar on the phases of going digital for you. We’d be happy to share those resources with you.
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*Source: 3Shape market map.

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