Embracing the digital evolution in orthodontics

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The Leppävaara dental clinic in Espoo, Finland, is one of two public dental clinics offering orthodontic services in the city. About a year ago, the clinic began the journey towards digital dentistry with the acquisition of the Planmeca Emerald™ intraoral scanner and Planmeca Creo® C5 3D printer. In this article, Head Nurse Sanni Peteri describes in her own words why the clinic chose to go digital and how it has transformed the daily work in Espoo.

Dental tech has long since made the leap to digital, and it is time for public dental care to follow suit. At the same time, public health services are frequently subject to cost reductions. Digital technology and workflows not only streamline the daily clinical work, but can in fact generate significant cost savings that benefit both public and private dental care. My own specialty, orthodontics, is no exception.

In orthodontic care, the treatment of misaligned teeth and malocclusion continues to rely on alginate dental impressions and lab-fabricated gypsum models. Today, however, modern CAD/CAM technology allows doing all this digitally – up to the point of enabling remote consultation between colleagues and specialists. For the patient, this also means a more simplified care process and more comfortable procedures, which can especially benefit patients with dental anxiety or sensitive mouths.

Research has shown that patients frequently prefer intraoral scanning to traditional alginate impressioning. Digital impressions show the relative positions of the dental arches and can reveal crucial information about e.g. curved or misaligned teeth, crowding and asymmetries.

Benefits of the digital leap

The many benefits of digital technology haven’t gone unnoticed here in Espoo either, where the Leppävaara public orthodontic clinic recently switched over to a digital orthodontic workflow. The new equipment includes the Planmeca Emerald™ intraoral scanner and Planmeca Creo® C5 3D printer as well as a vacuum press for the in-house fabrication of retainers. 

The Planmeca Creo® C5 3D printer and other equipment in the new technical room at the Leppävaara clinic.

Though the new technology comes with an initial cost, the long-term cost savings are considerable. The new system has, among other things, significantly reduced the need for alginate impressions and the outsourced laboratory process that goes with it. We no longer have to spend time or resources on casting, cleaning and disinfecting physical impressions nor packaging and sending the casts over to a lab. Instead, we can 3D print the necessary dental models ourselves and use them to manufacture our own retainers.

At the same time, digital imaging and analysis allows storing dental impressions digitally on a server. This makes patient images and impressions immediately accessible and enables all-digital treatment planning. The repeatability of the models saves time and simplifies the work as new scans can be obtained and analysed within one and the same day. Additionally, unlike physical models, digital impressions do not have to be stored physically nor do they run the risk of breaking. 

In making the leap to digital in Espoo, it was important that the transition was planned carefully from the beginning. We had to take many different interest parties into consideration, work out data protection and security-related issues and familiarise ourselves with dental 3D printing. However, with a positive mindset and the hard work of the entire staff, we were able to move forward with the project and transition to digital.

The Leppävaara clinic now fabricates all their retainers in-house with the help of the Planmeca Emerald intraoral scanner, the Planmeca Creo C5 3D printer and a vacuum press.

Example care path

The orthodontic care path starts with an initial consultation and check-up by an orthodontist or a specialist GP. Then the patient is forwarded to a dental hygienist or dental nurse for an intraoral scan, after which the treatment is planned and scheduled. Once the treatment is complete, the dental hygienist removes the fixed braces and scans the bite.

Next, the intraoral scan is processed using software, such as Romexis® Model Analyser. The scan is then used to generate a printable aligner base, which is printed for retainer fabrication. Finally, the retainers are fitted in the patient’s mouth and the patient is given instructions on how to use them. All done!

Sanni Peteri is a dental hygienist and Head Nurse at the Leppävaara public dental clinic in Espoo, Finland. She completed her Master’s degree in Clinical Expertise in Digital Health Care and Social Services at the Metropolia University of Applied Sciences in 2020. She is also a board member of the Finnish Association of Dental Hygienists (FADH).

Text: Sanni Peteri, City of Espoo dental care
Translation: Aleksandra Nyholm, Planmeca
Images: Sanni Peteri, Riitta Pahkala

This is a modified version of an article originally published in Suuhygienisti-lehti, issue 2/2021. Published courtesy of Sanni Peteri, Suuhygienisti-lehti and the City of Espoo. 

Planmeca Oy and Planmeca Group
Planmeca Oy is one of the world's leading dental equipment manufacturers with a product range covering digital dental units, CAD/CAM solutions, world-class 2D and 3D imaging devices and comprehensive software solutions. Headquartered in Helsinki, Finland, Planmeca’s products are distributed in over 120 countries worldwide. With a strong commitment to pioneering innovations and design, it is the largest privately held company in its field. Planmeca Oy is part of the Finnish Planmeca Group, which operates in the field of healthcare technology. The Group's turnover in 2020 was MEUR 764, and it employs nearly 2,900 people worldwide.