Dental Tribune International

Interview: Digital technology through the eyes of a young Italian dentist

By Alessandro Genitori
February 26, 2019

In an interview with Dental Tribune Italy, Dr Ioana Datcu, a contract dentist in the province of Ravenna, Italy, enthusiastically talks about her work during this exciting period in dental history. “Dentistry is a passion of mine that requires constant effort to keep up with the times and implement new technologies on a daily basis in order to understand the pros and cons that these innovations can bring to my everyday clinical routine,” she said.

We talk a lot about the “digital revolution”—do you think this is the correct term?
It is definitely a revolution, or at least, in my personal experience it is. I have the opportunity to introduce new technologies and treatments, such as intra-oral scanners and the application of guided surgery to my daily practice, which can be documented to understand the evolution of my field of work, while I offer my patients improved and cutting-edge services. From the patient’s point of view, these technologies allow professionals to offer services that are more ergonomic and functional in terms of comfort and treatment times. One of the examples is the importance of dental impressions. More and more patients come to my dental practice already well-informed and ask me about alternatives that they expect me to provide.

Unfortunately, patients often doubt our professionalism, because they have been traumatised by previous experiences, so we must be able to prove how the use of these new technologies could meet their needs by providing intelligent solutions. These technologies are not only beneficial for the patient, but also for the professional, as new software and tools are constantly evolving, allowing us to spot the inaccuracies in our work and help us improve our service in real time. Obviously, these technologies amplify our capabilities, but cannot completely replace us. When combined with our knowledge and dexterity, these tools have the potential to be astonishing. However, we have to acknowledge their limitations in order to use them in an intelligent way. For example, in implant surgery, these tools have allowed for improved predictability, decreased invasiveness of the soft tissue and greater ease of use. All these factors contribute to a better execution of these procedures, but we must remember that the principles of surgery should not be taken for granted. We must start from the basics and remember that this process requires a steep learning curve.

In this context, how can we identify the right course of development?
Starting to use these tools is already a big step! Once you have implemented them in your practice, you must go through a learning curve, during which you have to keep using these tools until you master the available technologies and understand their function and potential. For example, real-time monitoring gives me the opportunity to immediately see whether my preparation has been done correctly, so that I have the chance to make changes on the spot without having to redo the dental impressions, bother the patient and waste time and material. I therefore obtain a file that allows me to interact with the laboratory in real time and to see if the lab has the necessary tools to cast a model in a precise and fast way, while facilitating the collaboration with dental technicians who are outside my dental centre. Furthermore, the files are not subject to breakage or deformation during transportation and allow for the easy management of medical records.

Today, tools, such as CBCT and intra-oral scanners, allow for our growth as surgeons, while providing a 360-degree view of the patient’s dental anatomy and creating the opportunity to evaluate various solutions and scenarios for implant placement.

Does scientific research support the advent of this revolution?
Digital instruments in dentistry are the re-adaptation of tools that have contributed to the technological evolution of other fields, such as architecture, engineering and design. It gives an idea of the possible applications of these tools and the precision we could achieve. Unfortunately, these tools are not yet sufficiently supported by medical and dental literature because of the continuing re-adaptation and development. Therefore, various companies offer their products without being able to validate them in a satisfactory manner. However, I think that producers thoroughly understand this process. Unlike in other disciplines, the cost of these solutions for young dentists are still quite prohibitive and the constant changes make the machines obsolete after a short time—as with smartphones. In addition, it also requires continuous software updates to adapt to new interfaces and methods of use. Basically, you have to keep up with the latest advancements—from both an instrumental and practical point of view—to avoid being outdated.

But in this context, how can you choose where and how to invest?
You have to know the subject very well, which is important to be able to make an informed choice—although all choices carry risks. The first questions you have to ask yourself are: “Am I buying the best on the market?”, “Is it a wise investment and will it pay off in time?”, “Can I get a better tool at a lower price?” and “How long will it take for my tool to become obsolete?” Although I am still unsure of what to buy, I am lucky because I have been able to test different machines and see which of them, if any, suit my needs the best. You have to get out there and learn how to judge technology as an active user and not a passive spectator. We also need to look at the benefits we can offer our patients. Not to mention that the patients themselves use the things they have seen or heard on social media or from their friends as yardsticks to evaluate us. In the end, it all lies in our ability to explain how these tools they suggest are not always the most suitable solution, since there are many variables that could render them unusable.

Do these digital technologies also require trained teams?
Of course, it is like using a tandem bike. I can steer, but my team must also be able to help me keep my balance and we must have the same goal. In my opinion, companies that provide training are the best choice and give you confidence in their tools. Obviously, they must be able to provide guidelines and complete support is essential in new or unknown situations. At the same time, it is important to create adequate protocols for staff members. This does not come out of nowhere. To do so, it is important to work with technicians who are able to use these tools and have enough experience to manage their workflow.

In your opinion, what is the main advantage of digital technology?
The speed in obtaining precise results in only a few sessions and in a predictable and reproducible manner. For dentists, the key point is that we can save time, despite it being difficult to pay off the purchase costs and having to update the technology continuously. However, I believe that once all the protocols have been acquired, the advantages will be enormous. With the help of technicians, we will be able to send files directly to the laboratory and discuss, compare and see the final results shortly after. All thanks to the new materials, because it is obvious that all these new technologies must be supported by, and associated with, new and suitable materials.

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