The digitalrevolution is changing the world, and dentistry is no exception. Many technologieshave been introduced in the market allowing the dental team to use newmaterials and devices in the production of dental restorations, in order tomake dental profession easier and faster, as well as, improving communicationwith patients and their dental team.
There are many areas of digital dentistry where a generalpractitioner can benefit from, and many more are being researched. Among these, computer aideddesign/computer aided manufacturing (CAD/CAM) technologies,intraoral imaging, guided implant placement, includingdesign and fabrication of surgical templates, digital radiography, occlusion, temporomandibularJoint analysis, and photography are only a few examples. Today, more than 50 years later the first titanium implantpatient, guided surgery has become increasingly popular due toimproved diagnosis and planning, followed by higher transfer accuracy of thevirtual plan to the patient’s mouth. It allows for a three-dimensionalprosthetically-driven implantplanning with virtual view of the bone, soft tissue, prosthetic set up andadjacent and/or opposing anatomy. Hence it has undoubtedly been a majorachievement in the last years to provideoptimal three-dimensional implant positioning, as well as, higher patientsatisfaction.
Similarly, CAD/CAM technologies have become part ofour daily practice, allowed the dental team to create prostheticrehabilitations with an accuracy and precision that were previously difficultto obtain using well-established protocols. Original criteria for assessment of the implantsuccess included successful osseointegration and survival of the dentalimplants. Today, the new goal is to improve the quality and thesafety of oral treatments by focusing care on the real patient needs andwishes. The primary motivating factor for patients is a big desireto improve their dental esthetics and function in the least invasive way. Hence, new parametershave been introduced to assess success in the achieving of lifelikeimplant-supported restorations, including but not limited to esthetics and patient’ssatisfaction. Computer aided design/computer aided manufacturingtechnologies, are well as guided implant placement, allow for fullyintegration with other digital devices, such as, intraoral scanners, to providefor accurate and faster patient-centered solutions.
Digital impression is oneof the most exciting new area in dentistry for a wide range of procedures inprosthodontics, restorative dentistry, and orthodontics. Although there is nodoubt about the potential and accuracy of established digital solutions, suchas CAD/CAM restorations and guided surgery, there is still lack of evidencethat recent digital technologies available on the market are superior toconventional protocols. Truly, the evidence, by itself, does not make thedecision, but it can help support the patient care process.
Evidence-basedmedicine has always required integration of three key components:research-based evidence, clinical expertise (i.e., the clinician’s accumulatedexperience, knowledge, and clinical skills), and the patient’s valuesand preferences. Looked at in this way, research & development andmarketing departments need to work together. NobelBiocare has always been a leader in publishingoriginal researches and developments in the field of dentistry. Today, twelve yearssince its launch, NobelGuide guided surgery concept evolved from an ambitiousidea to become a solution many clinicians find indispensable. Take at look atthe past, the digital dentistry revolution started back inthe 1990s when Professor Matts Andersson, who had been influential in producingthe very first CAD/CAM restorations a few years earlier, was contacted byProfessor Daniel van Steenberghe, who just lead a virtual planning development project atthe Catholic University of Leuven, Belgium.
This group there haddeveloped a promising program for dental treatment planning based on digital imaging (computedtomography, CT). However, they had not found a way tolink the virtual plan to a physical model, yet. They hadcontacted the right person, professor Matt Andersson, who immediately sawa possible way to couple the two together. A special project had begun. Development ofthe concept moved quickly after until professor Matts Andersson attended asurgery on cadavers and saw it matched perfectly with the preoperative planning. The project was a success.
Fromthere, things moved fast. A group that included five pioneers (MattAndersson, Daniel van Steenberghe,Ingvar Ericsson, Andreas Petersson and Izidor Brajnovic) developed aguided surgery concept destined to be always remembered. In 2001, Izidor Brajnovic produced the first flaplesssurgical template. Shortly after, the idea of the radiographic and surgicalindex was introduced and an early version of NobelGuide was born. NobelGuide wasready to take centre stage starting from 2002 when the first patient wassuccessfully treated with the concept, by a minimallyinvasive flapless technique and considerable post-operative comfort. A year later (2003), in Las Vegas, at the NobelBiocare World Conference in Las Vegas, live surgeriesusing NobelGuide, performed by Professor Ingvar Ericsson, who was operating inStockholm, and Dr. Peter Moy, who was treating his patient in Yorba Linda, weresimultaneously watched by more than 2000 people from around theworld.
The NobelGuiderevolution didn’t stop there. In the 2005 NobelGuide digitized dentalimplantology by introducing the first comprehensive concept for 3D treatmentplanning and guided surgery, named NobelGuide, and it’s beendeveloping ever since. It was a great breakthrough for the professionand for our patients. The key benefits are the optimizeddiagnostic and implant planning, resulting in predictable, and preciseprosthetically oriented treatment, higherdegree of safety and predictability compared to “freehand” implant placement. There’s thepossibility of flapless or mini-flap surgery, meaning less invasiveness in manycases and the possibility to treat complex cases and sites that have limitedbone quantity.