The ROI of Technology: Boosting the Bottom Line
ROI can be measured in dollars, patient satisfaction, time savings, and more, and dentists have plenty of great choices for investments that will drive practice growth and patient satisfaction
What dental product has the greatest ROI? For Perry Jones, DDS, MAGD, IADFE, that’s an easy one. “Hands down, it’s the intraoral scanner.” Why? There are many reasons, but the first is affordability. “It’s not expensive,” Dr. Jones said. “You can get a really nice digital intraoral scanner for under $20,000 or $30,000. And if you play the game right, you’ll bundle it with an in-house zirconia mill and pay about $60,000. That’s the deal of the century.” Whether milling in-house or using a lab workflow, Dr. Jones, an educator and speaker who practices in Richmond, VA, believes that every dental practice should, at the very least, be using an intraoral scanner for digital impressions. “There are so many pluses to that technology that I would say it’s almost unconscionable that so many doctors don’t have that device in their office.” Intraoral scanners are just one of the many technologies that can help drive practice growth. State-of-the-art imaging systems, including CBCT units, also create new opportunities for better and more comprehensive dentistry. Other technologies that bring great ROI potential run the gamut from lasers to practice management software to the clinical materials that save you time and money, and keep patients happy.
“There are so many pluses to that technology that I would say it’s almost unconscionable that so many doctors don’t have that device in their office.”
- Perry Jones, DDS, MGAD, IADFE
Capturing a Great ROI
But how does one measure ROI? For Dr. Paul Bookman, who practices in Bryn Mawr, PA, there are 3 primary measuring sticks.
“The first is strictly a financial measure: Has the initial investment been recuperated and how quickly? Secondly, does it make procedures quicker, thereby allowing me to schedule additional procedures, which ultimately brings in more revenue. Thirdly, does it present a ‘wow’ factor for the patient and put them at ease, knowing we are on the cutting edge. Because if it does that, their opinion of the practice will remain high and they will continue to refer friends and family.”
In Dr. Bookman’s practice, the greatest revenue generators are the technology systems from Dentsply Sirona that enable same-day dentistry—his CEREC Primescan intraoral scanner and CEREC MC XL milling and grinding unit, which fabricates inlays, onlays, veneers, crowns, bridges, abutments, and surgical guides.
“My CEREC technology has paid the greatest dividends,” he said. “Besides saving time and money in the long run, I get new patients all the time who specifically come to me for this technology. These are patients I may never have gotten without having this technology and equipment in my office.”
For Dr. Jones, the reasons to invest in an intraoral scanner go well beyond their affordability. The advantages of such an investment include the elimination of costs for impression materials, the streamlining of the restorative workflow, patient comfort, impression accuracy, and the use of the scans for a variety of workflows, including implants and orthodontics.
“Even for the dentist who is just getting started, this technology of intraoral digital scanning is going to rock your world,” Dr. Jones said. “You are going to be able to do things that you wouldn’t ordinarily do, and you can delegate most of the work to a team member who can take those scans and record data. You save all that time that you’d be spending doing a manual method.”
Bringing Lab Work In-House
While the intraoral scanner serves as the entry point to digital dentistry, many dentists find a fully digital workflow most beneficial to both practice and patient. The Planmeca FIT Plus advanced CAD/CAM system had an immediate and profound impact on Dr. Austin Westover’s practice in Winchester, VA. The system includes the Planmeca Emerald S intraoral scanner, Planmeca PlanCAD Premium design software, and the Planmeca PlanMill 50 S, a robust milling unit capable of milling everything from a single-unit crown to a full-arch restoration.
“My lab bill is virtually nothing. A single crown used to cost me $120 from the lab and now it’s $10. A single implant case would cost $400 to $500; now my costs are $90. I can mill a night guard in a few hours for $50 and the patient can pick it up the same day,” he said. “I am able to do things faster and for a lot less money compared to using a lab.”
While Dr. Westover enjoys having total control over his cases and the resulting esthetics, his patients love knowing they can get everything they need in the office. They don’t have to take extra time off work or wait long periods for the lab to ship their restoration.
"Since getting this system, we are seeing about 100 new patients a month. It’s been incredible," he said. "My case acceptance has dramatically improved since implementing the Planmeca FIT Plus. I use the Smile Design module to work up a case and show patients their new smile on the screen. Then I mill a temporary so they can try it out. At that point, patients are motivated to go through with treatment, having confidence they will be happy with the final result."
INTRAORAL SCANNERS
The intraoral scanner is making its way into more and more dental practices for reasons such as accuracy, speed, and patient
comfort over the traditional method for taking impressions. It also serves as the starting point of the digital workflow for restorations, implants, orthodontics, and more. ROI is achieved through many means, including the time saved by using a scanner, the elimination or reduction of impression material, and the use of digital impressions in many workflows.
A unique wired and wireless solution, the 3Shape TRIOS 4 features smart tips with instant-heat technology, allowing users to scan 2 to 3 times as many patients. Accompanying software, such as TRIOS Patient Monitoring, accurately tracks changes in teeth to identify dental issues sooner, while TRIOS Smile Design creates a photorealistic simulation of a patient’s new smile in minutes to stimulate treatment acceptance.
Designed to simultaneously capture 3D digital impressions and intraoral images, Align Technology’s iTero Element 5D Plus also aids
in supragingival caries detection using near-infrared imaging (NIRI) technology. The 3D models, intraoral images, and NIRI images are all accomplished in one scan to maximize productivity. The more detailed visualization and wider viewing angles are engineered for a better patient experience and more treatment plan acceptance.
Featuring a Smart Pixel Sensor and dynamic depth scan technology, Dentsply Sirona’s Primescan offers ideal sharpness, even in up to 20-mm depth. The scanner has an increased fi eld of view for visualizing larger areas with greater precision and fewer sweeps. Choose between a variety of three different sleeves, including autoclavable and disposable.
Compatible with any CAD/CAM software that accepts PLY and STL files, the QuickScan IOS intraoral scanner from Denterprise International has been tested by independent labs to exhibit accuracy and performance comparable to other leading scanners. Full-arch scanning can be done in under 3 minutes.
The Planmeca Emerald S, which is a supercharged version of its predecessor, offers fast
scanning speeds, the precision needed for predictable results in both singleand multiunit cases, and is easy to use. With its small size and sleek design, the scanner can capture an entire arch in less than a minute, enhancing efficiencies and the patient experience.
The KaVo X 700 Intraoral Scanner is a simple, yet powerful chairside solution supported by direct DTX Studio Clinic integration, which empowers advanced diagnostics and treatment planning. With two highspeed cameras for quick and efficient scanning, the system can export both STL and PLY files. Single-button control allows scans to be started and stopped with a single click.
MILLING SYSTEMS
In-house milling allows dentists and their teams to provide singlevisit dentistry, pleasing patients while gaining a reputation as a
hightech practice that prioritizes patient convenience. Of course, milling systems vary in capability, ease of use, and speed, with some units designed for simpler dentistry while others have the versatility to provide a wider range of applications.
The CEREC Primemill grinding and milling unit from Dentsply Sirona allows for easier and significantly faster fabrication of chairside restorations. Distinguished by its convenience, versatility, speed, and quality of output, the CEREC Primemill forms a modern setup for achieving predictable restorations with precise margins and a smooth surface. A powerful touch interface clearly displays steps and functions, making it easy to use.
Designed to produce highend restorations with lab-quality esthetics, the Planmeca PlanMill 50 S addresses the industry’s need to mill a wide variety of materials, including zirconia, IPS e.max, glass ceramics, PMMA, and wax. The mill comes equipped with a high-speed spindle and an automatic tool changer for 12 tools to keep it operating at full capacity. The versatile Planmeca PlanMill 50 S has the ability to mill discs and blocks and can be used wet or dry.
Glidewell’s fastmill.io In-Office Mill is a 4-axis computer-controlled mill that encapsulates technologies originally developed for the laboratory production floor in a form that fits comfortably in the dental practice. The fastmill.io makes it possible to prescribe and deliver same-appointment BruxZir Solid Zirconia restorations, with no sintering oven or dental laboratory required. The unit features a quick, electric-powered spindle and quiet operation.
A highly automated milling and grinding machine with a 10-fold blank changer, the R5 from vhf can shift effortlessly between wet and dry milling and processes milling blanks up to 40-mm thick. DirectDisc Technology ensures blanks can be clamped quickly without tools. The high-precision spindle features 800 watts of power and 80,000 rpm, milling and grinding the toughest materials on the market.
Constructed using the technology found in full-frame CNC industrial machines, the Versamill 5X450 is designed to perform reliably with high precision for the long term. This purpose-built, open-source
5-axis mill provides owners with maximum flexibility and versatility. The Versamill 5X450 can accept input from popular dental design
programs and process virtually any dental milling material, including wax, zirconia, acrylic, composites, glass ceramics, and others. The system’s strength and rigidity, coupled with the undercut machining capability of full 5-axis control, provides superior surface finishes, faster cycle times, and greater tool life.
CBCT
To provide the best possible care, Dr. Jones believes a 3D scan should be taken on every patient. "I had a study of 100 random CBCT scans that I took in my office, and 36 of those scans had pathology that could not be seen except with a three dimensional picture. That's one-third where you're missing pathology. You can't diagnose what you can't see."
The Planmeca Viso G7 is designed to surpass the demands of industry leaders, specialists, and institutions. It has a 25×30-
cm sensor with 4 built-in cameras and can capture a 30×30-cm volume and image from the skullcap to the cervical spine. The unit is ready to handle Planmeca ProFace and Planmeca 4D Jaw Motion technology, while the occipital head support allows an unimpeded view of facial tissue. It includes Planmeca CALM and Planmeca Ultra Low Dose technology.
The Excelsior PRO 3D from PreXion includes 4 fields of view, 48 preset scan modes, a dedicated 2D pan mode, and an optional cephalometric feature. With a 0.3-mm focal spot, a voxel size of 0.08–0.2 mm, and 360° gantry rotation, the unit
offers exceptional image clarity and minimal scatter for optimal treatment planning and diagnostics. Users can compare pre- and postop scans slice by slice and view inside structures while rotating the 3D image to isolate pertinent areas.
With its versatile imaging programs and intuitive user interface, the KaVo OP 3D is a low-dose, customizable imaging solution for any practice. Panoramic, cephalometric, and 3D imaging options are all available in one innovative unit. With KaVo OP 3D, users can benefi t from DTX Studio suite, a single digital platform that connects technologies and workflows from image acquisition to diagnostics, planning, implant surgery, and restoration.
With the largest field of view of any Dentsply Sirona 3D/2D system, Axeos uses intelligent low-dose exposure to capture high-quality
images. Easy-to-use features such as smart height adjustment and quick scan times lead to exceptional patient experiences. Four volume sizes are available, and an autofocus function ensures you’ll automatically receive an image with the best possible sharpness in focus. The ProVecta 3D Prime from Air Techniques is a versatile 3D imaging system that generates a unique 130mm x 85mm jawshaped, anatomically adapted volume that encompasses all treatment areas without imaging nonrelevant anatomy. The highest resolution CsI flat panel sensor creates brilliant, highquality 3D and 2D images from one sensor, with no swapping or complications.
LASERS
Laser dentistry is a patient pleaser, with users reporting high case acceptance rates for treatment. The reasons are many—less bleeding due to their coagulative ability, less need for antibiotics, less need for pain medication, and less need for analgesia are just some of the many benefits of laser dentistry. From literally growing new bone and soft tissue in periodontitis and peri-implantitis patients, to analgesia-free operative dentistry, to releasing tongue ties on 3-day-old babies who cannot nurse, lasers can do it all.
Using dual-wavelength technology, Ultradent’s Gemini diode laser combines the melanin absorption of an 810-nm laser with the
water absorption of a 980-nm laser. It features 20 W of peak superpulsed power for faster, smoother cutting with less tissue tagging. The system boasts a simple user interface with 20 preset procedures in 980 and 21 in 810, including Pain Relief. The Bluetooth foot pedal and autoclavable handpiece enhance ease of use.
Operating at a unique wavelength of 9.3 µm, Convergent Dental’s Solea enables high-speed and precise cutting on both hard and soft tissue. The CO2 laser is free of vibration, virtually noiseless, and anesthesia-free for most procedures. Solea allows the user to select a spot size specific to the job at hand, so there is no focusing and defocusing, affecting power and speed.
Millennium Dental Technologies’ PerioLase MVP-7 is a 6-W, free-running pulsed Nd:YAG laser with 7 pulse durations. It can be used to perform the LANAP protocol, an FDA-cleared method for treating gum disease that decreases pocket depth without removing healthy gum tissue.
Summus Medical Laser recently announced the launch of the Horizon Dental Laser System, a Class IV therapy laser system
designed specifically for the medical industry. This diode laser is designed with 28 W of power and introduces a unique capability combining 4 different wavelengths that can be controlled independently. Its dynamic combination of power, wavelength, and pulsing delivers an optimal therapeutic laser dose in less time with condition specific protocols.
DEKA’s Smart US-20D CO2 Laser enables soft tissue therapies and treatments in all areas of general dentistry, periodontics, and oral and maxillofacial surgery. DEKA’s proprietary UltraSpeed pulse, with high peak powers, provides the capability to incise tissue with the speed of a scalpel while sealing blood vessels for a bloodless surgical field. The speed of the pulse allows the surrounding tissue time to cool so there is virtually no trauma to the surrounding tissue. This means faster, more precise incisions, with improved healing properties.
Game-Changing Technologies
The term “digital dentistry” is used so often that it may sound trite, but the fact is that both the present and future of dentistry are firmly based in digital workflows. Deciding on practice goals and the various technologies that will help to meet them will help the practice not only survive, but also thrive in the climate of constant and rapid change. Here are a couple examples of unique
technologies to consider.
A system that’s been shown to be 11x more accurate than freehand dental implant surgery, the X-Guide Dynamic 3D Navigation system is gaining attention worldwide as an essential part of digital dentistry. By delivering interactive, turn-byturn guidance via a live, 360° single view of drill position and anatomy during any type of implant surgery, the X-Guide improves precision and accuracy. Compatible with cone-beam systems, the X-Guide features robust implant-planning software to plan all factors of the ideal implant location.
When it comes to occlusal adjustments, Bausch’s OccluSense system can make a world of difference. Using an electronic handheld device, pressure sensors, and an iPad application, OccluSense makes occlusion visible by combining traditional and digital registration of pressure distribution on occlusal surfaces. Thin, flexible electronic pressure sensors record static and dynamic occlusion, and color-coated sensors mark the occlusal contacts on the teeth. The system even shows local premature contacts on occlusal tooth surfaces and, with the OccluSense app, provides a graphic representation of occlusal pressure conditions on the user’s iPad.
When it comes to restoring teeth, there’s always been a great need for a mechanism to accurately assess tooth shade that best matches the patient’s adjacent teeth. Denterprise has answered the call with Rayplicker QuickShade, a digital tooth analyzer that uses spectrophotometry to scan, analyze, and flawlessly match the shade of any tooth in minutes. The multishade guide chart includes VITA Classical and more.
Investing in technology takes research, time, and money. So, no matter what ignites your passion for digital dentistry, make sure it gives you something back— whether that’s new patient referrals, increased production, or time to treat more cases.
