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What happens when AI joins the exam room? This is what a checkup with Dx Plus looks like.
Dr. Kaveh Golestani uses TRIOS 6 with Dx Plus for routine checkups. He invites us in for a bi-annual checkup of a male patient. With clear images and a step-by-step explanation, he will walk us through the way he distributes responsibilities, what scan strategy he uses, and the protocols he follows.
At the end, he shows us how he uses the visuals in conjunction with a phone app, to motivate his patient to take better care of their oral health.
Case information
Patient, male, visiting for bi-annual checkup.
The patient has a long-term history of bruxism, clenching, and mechanical abrasion, with increased recession on teeth #27, 22, and 23 (FDI notation).
This condition, which we have been monitoring, has worsened. A more comprehensive treatment plan will be needed to address this issue. Previous concerns regarding tooth wear have improved due to the patient’s use of a nightguard. The intended final outcome of this checkup is to clearly inform the patient of his dental condition and motivate him to and take better care of his oral health issues
Let’s walk through the dental checkup protocol using 3Shape TRIOS 6 scan and Dx Plus software.
Step 1: the checkup scan
Prior to conducting our conventional standard checkup, my assistant performs a full arch TRIOS “Checkup Scan” on the patient. As is standard, we begin by scanning the mandible, then the maxilla. 3Shape’s suggested scan strategy is recommended, but we have found that with TRIOS 6, the scan strategy is not strictly necessary.
The conventional checkup protocol
After the TRIOS scan, our usual conventional checkup protocol is followed. This includes extraoral and intraoral assessment, soft and hard tissue evaluation, palpation of the temporomandibular joints (TMJ), and checking for clinical findings such as caries, periodontal pockets, wear, recession, among other conditions.
The conventional assessment serves as our clinical baseline with which we can compare our digital findings attained with the TRIOS 6 scan and Dx Plus software.
Reviewing the visualizations together
Surface caries: when reviewing the surface caries visualizations, we can see some yellow spots indicated on the patient’s molars. However, we find these unconcerning. We do recommend the patient to focus a little more attention on brushing #31.
Recession: Dx Plus software color codes recession based on depth. By comparing two scans taken over time and using the Dx Plus measuring tool, we quantify that the patient’s recession depth on #22 & 23 have progressed from 1.6 to 3.6 mm and 3.8 to 4.6 mm respectively. As a result, I will recommend a more comprehensive treatment plan for his receding gum line.
Tooth wear: when reviewing the patient’s tooth wear, we had an interesting finding. The patient previously had pain in his lower left quadrant. When treating it, it took us approximately 20 minutes to locate the source of pain, which was an uncomfortable experience for the patient. Now with the Dx Plus visualization it took me approximately one minute to identify the tooth wear.
Plaque: Dx Plus software also visualizes plaque in a purple color much like a disclosing agent. When comparing a previous scan to the patient’s present one, we could see a big improvement compared to the previous appointment. The visualization and comparison clearly showed a good reduction in plaque.
See more visuals of the Dx Plus checkup in the full case study.
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Follow up after the checkup
Our receptionist introduces the patient to 3Shape’s DentalHealth mobile app. The patient can now see his scans and Dx Plus results on his mobile along with receiving tips for better dental health.
This is a radical change in how we engage with our patients and can inspire them to take better care of their teeth.
What this case tells us
The case demonstrates the impact that visualizing a patient’s conditions on a screen can have on them and how, when used in conjunction with the 3Shape “DentalHealth” app, we can motivate our patients to possibly take better care of their oral health as well as use the data to confirm our own conventional diagnostic exam results with a second opinion provided by AI-assistive technology.
Benefits for me as a clinician
While Dx Plus technology is still very new to us, I can see it benefiting our practice in the following five ways.
- It improves our patient communications and engagement
- It improves the workflow and delegation of tasks to hygienists or assistants
- It automates summary reports of the potential findings and exports to the PMS
- It monitors changes so we can track changes such as tooth wear or recession
- It gives us a modern image which is something patients appreciate
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