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Published in CenterView on July 15, 2013
Dr John Phillips and Dr. Edward Hill
Dr John Phillips and Dr. Edward Hill

SOD cuts learning curve on new digital impressions system

By Matt Westerfield

The world of dentistry is changing, Dr. Edward Hill says.

The professor of care planning and restorative sciences in the University of Mississippi Medical Center School of Dentistry can remember when students poured all dental impressions by hand the old-fashioned way some 30 years ago.

These days, “students still need to know how to make a conventional impression and pour it up,” he said. “But the thing about it is, the technology is moving so fast that 10 to 15 years from now, it’ll be all digital imaging.”

The School of Dentistry is way ahead on that digital frontier: Last month, it became the first dental school in the nation to design, mill and invest - or place - a patients’ restoration using the CEREC Omnicam system, the latest evolution in capturing digital impressions.

According to Sirona, the company that produced the CEREC, the school edged Harvard by a few days. What’s more, this next-generation technology not only adds to the school’s clinical toolbox, but prompts changes in the way students are taught restorative dentistry.

CEREC, which stands for Chairside Economical Restoration of Esthetic Ceramic, actually has been around since 1987, when Sirona introduced its optical imaging system. But Dr. Scott Phillips said it’s been evolving ever since.

“It’s always had one major limitation in my opinion: You had to spray a powder or a medium on the teeth in order to obtain your optical impression,” said Phillips, associate professor of care planning and restorative sciences.

The CEREC milling machine, which mills ceramic restorations (center)
The CEREC milling machine, which mills ceramic restorations (center)

Sirona introduced the CEREC Omnicam last year, he said, which was a leap forward in that it was the first chairside optical impression and chairside milling system, with photographic quality images, that didn’t require a powder or other type of reflective medium.

Dr. Gary Reeves, dean of the school, and Dr. Larry Breeding, associate dean of clinical affairs, agreed to trade in the school’s earlier-generation CEREC and upgrade to the Omnicam a few months ago, Phillips said.

“We were the first dental school in the U.S. to get an Omnicam, and we made it a goal to be the first dental school to do one of the CEREC restorations,” he said.

After receiving training on the machine, Phillips and Hill found a good patient candidate on June 20. They prepped the patient’s tooth, imaged the tooth using a special camera that shoots 60 images per second, designed a crown on the CEREC software, milled the porcelain crown and completed the procedure, all in one session.

By contrast, the traditional method involves taking a physical impression of the teeth and creating a stone model used to design the crown out of wax. Then the wax crown is invested in a stone mold where it then is melted out and a metal or ceramic crown is cast in its place. The process can take two weeks.

Third- and fourth-year students spend large amounts of time in the school’s restorative lab repeating this process, but now they are getting extra training on taking digital impressions with a new course that began in January.

“In the past, we’ve had bits and pieces of digital dentistry in other courses, but starting this spring, our second-year students, who are now going into the clinic as D3s, all took a new digital dentistry course,” said Phillips, who graduated from the School of Dentistry in 1996. “We’re trying to get the students more comfortable with that system so that they’ll go to clinic and want to use it and not be intimidated by the machine.”

And Phillips said beginning this month, the school offered an elective course for incoming D4s.
“This year, it’s a basic course for the seniors who didn’t have that second-year course,” he said. “We had to limit it to a small number, but we had more people wanting to take the elective than we had spots.”

With the technology advancing exponentially and more dentists in private practice using digital imaging, Hill said the next generation of dentistry students probably won’t be taught the conventional method of taking impressions.

“It would be a disservice to continue to teach the old way and they graduate and the labs aren’t doing it,” said Hill, who earned his D.D.S. at the University of Tennessee Health Sciences Center in Memphis in 1979. “We’re having to evolve as the profession evolves. It’s hard to keep up with the learning curve.”

Phillips agreed.

“This is what they’ll see when they graduate,” he said. “It’s the way everything is going as technology advances.

“We want to expose the students to that because that’s what the future is. It’s going to be a digital lab.”