175. Andrew Johnson, DDS, CDT - Digital Workflows in Dentistry
May 23, 2023
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Dr. Andrew Johnson, DDS and CDT specializing in digital workflows in dentistry discusses topics such as transitioning away from dentures, workflow for scanning dentures, challenges of scanning soft tissue, and affordability and clinical resources in digital workflows for dentistry.
Advancements in digital dentistry are revolutionizing the traditional denture process, offering benefits like improved accuracy, reduced chair time, and enhanced patient satisfaction.
Digitizing the entire denture process, from consultations and digital scans to final production, can improve efficiency, reproducibility, and patient outcomes while balancing quality care and profitability.
Deep dives
Advancements in Digital Dentistry for Dentures
Recent advancements in digital dentistry have brought significant changes to the traditional denture processes. Dentures, which have remained largely untouched by technology for decades, are now seeing a surge in innovation and evolution. The current denture process involves squishing plastic play-doh into molds and boiling it until it hardens. However, digital dentistry and 3D printing are revolutionizing this field. These advancements in technology offer benefits such as improved accuracy, better fit, reduced chair time, and enhanced patient satisfaction. Dr. Andrew Johnson, a surgical prosthodontics expert, emphasizes the need to digitize the entire denture process, from initial consultations and digital scans to the final production of dentures.
The Financial Challenges of Dentures
Dentures present financial challenges for dental practices due to several factors. Denture procedures require significant chair time and can be demanding and costly. The presence of a talent vacuum in the lab industry, with qualified denture technicians becoming scarce, contributes to increased expenses. Additionally, the outsourcing of acrylic processing can lead to longer lead times and detachment between the dentist and the dental lab. Insurance reimbursement rates and allowable fee schedules also limit the financial success of denture procedures. These factors make it challenging for dentists to achieve profitability and success in their prosthodontic practice.
The Need for Innovation in Denture Processes
The traditional denture-making process has remained relatively unchanged for almost a century. Despite advancements in material and teeth used for dentures, the process itself has seen little improvement. Dr. Johnson compares dentures to mousetraps, where numerous patents have been issued for variations, but the classic design remains the most effective. The focus should shift towards digitizing the entire denture process, rather than solely focusing on the end product. Digitizing the beginning and middle stages of denture creation can improve efficiency, reproducibility, and patient outcomes. By integrating digital techniques, dentists can achieve a balance between quality care, profitability, and patient satisfaction.
An Innovative Workflow for Digital Dentures
Dr. Johnson has developed a streamlined workflow for producing digital dentures. The process involves gathering digital scans of patients' existing dentures using internal scanners or CT scanners. Additionally, capturing smile photos with video or cameras provides essential information for designing dentures. Using this digital information, Dr. Johnson pre-corrects preformed wax try-ins, aligning them to patients' facial contours and landmarks. The use of radio pick markers in these try-ins enables CT scans for treatment planning, including implant options. This pre-production step allows patients to visualize the aesthetics of the denture before committing to treatment. This innovative workflow eliminates unnecessary chair time, leading to more efficient and cost-effective denture procedures.
Dr. Andrew C. Johnson completed his general dental and prosthodontic training at the University of Tennessee Health Science Center and has been practicing in Northwest Arkansas since 2013. Along with his specialist certificate, Dr. Johnson earned a master’s degree in dental science researching CAD/CAM restorative techniques and emerging digital dental materials. He maintains certifications by both the American Board of Prosthodontics and the National Board for Dental Laboratory Technology, and serves as adjunct faculty with the UTHSC Advanced Prosthodontics Program. Dr. Johnson has been published in multiple dental journals and lectures internationally on a variety of technological developments in dentistry. He consults for a wide range of dental clinicians, suppliers, manufacturers, and developers on topics ranging from three-dimensional imaging and virtual treatment planning to computer-guided and robotic surgery as well as digital prosthesis design, production and long-term complication management. However, his broader professional interests include process scaling, provider calibration, and workflow disruption.
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