Professional Courtesy: Make Plans To Upgrade by Dr. Thomas Giacobbi

Professional Courtesy: Make Plans To Upgrade

by Thomas Giacobbi, DDS, FAGD, editorial director

Do you have any friends who still use a belt-driven handpiece? I doubt it, but some of you will remember what they look like: medieval, fitting for the “scare chair” in a darkened dental operatory.

What about friends still using film X-rays exclusively? There may be a small number of these Luddite dentists but most of us have moved to digital X-rays, a great example of revolutionary technology I’ve watched the industry adopt—slowly—until it eventually became standard.

The introduction of new technology in any arena follows a predictable path: Early adopters accept the challenges of working with the latest gadget in exchange for the bragging rights that they did it first. Rapid adoption comes when the watchers on the sidelines decide enough obstacles have been removed, the technology is more mature and it’s time to jump in or get left behind.

This month, I thought it would be a good idea to look at the status of the most-talked-about technologies in dentistry to see if they are ready for your practice.

If you are performing oral surgery, endodontics, orthodontics or implants, you need access to a CBCT. You may have a friendly colleague who will take scans for you, a local imaging center, or you might bite the bullet and offer this service in-house. Having access to the third dimension is critical in certain situations and a blessing in more routine cases. When it comes to planning implants, it should be the standard of care.

Intraoral scanners
There’s a plethora of options to take digital impressions and send those images down a variety of digital pathways. There is a solution for everyone, but not every solution will work for every practice. Start with an examination of your procedure mix. Are you doing basic C&B and restoring implants? Do you want a solution for clear aligners as well? Do you plan to provide same-day restorations or send most scans to your favorite labs? The answers to these questions will help you find the right path to the best options. Many argue they can do just fine with good old impression materials. They are right, but the workflows and patient expectations tell us they should be looking for an intraoral scanner if retirement is more than five years away.

3D printing
This is cutting-edge technology that does not yet have wide adoption. Material innovations will drive the adoption of this technology, and new materials are coming at a rapid rate. Printing long-term restorations will be the breakthrough innovation, and I don’t think it’s as far-fetched as it sounds.

Clear aligners
If you like to make crooked teeth straight, there are many options available to you in 2022. This procedure is best performed with an intraoral scanner for a streamlined workflow and superior accuracy.

In-office milling
This technology has been around for years but is not yet widely adopted because the path to implementation is more complex than trading impression material for a scanner. When you design and fabricate restorations in the office, there is a lab element most dentists haven’t seen since dental school. The patient flow through the appointment is different from our typical “prep and temp for delivery at a second appointment” approach.

Patients absolutely love the added convenience of having their treatment completed at the same visit, but dentists should consider the true cost of this convenience by evaluating chair time, material costs, machine maintenance, and inventory and design challenges. This technology may find wide adoption in the future as the remote design allows the dental practice to pull the finished piece from their milling unit with the confidence that it will fit and have the same amazing contours as their current lab-fabricated restorations.

As we finish 2022 and look ahead to 2023, perhaps you will plan to add some of these items to your practice or there may be something else on your mind. Please share your plans and comments below. Reach me by email at

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