machine which, when combined, would allow dentists to produce chairside ceramic inlays and onlays in single appointments.
Since then, the technology has greatly improved and dentists and dental technicians experience a time when CAD‐CAM can produce results that resemble pure magic, which is what happens when technology is advanced enough. The next two chapters of this book will cover CAD‐CAM technology and available procedures in depth.
The advent of 3D printing is revolutionizing several dentistry fields, improving the quality and precision of surgical techniques, and gaining a massive preponderance in restorative dentistry. The term 3D printing defines a manufacturing process in which additive techniques are used to build objects one layer at a time, in contrast to milling techniques that require a material block to be ground to the final desired shape.
Engineer Charles Hull introduced the first 3D printing technology in 1986 with his patented stereolithography (SLA) system and 4 years later, Scott Crump patented the fused deposition modeling (FDM) technique. Widely used in a multitude of manufacturing fields for the last 30 years, 3D printing with newly developed materials is on the verge of radically changing general medicine and dentistry. From the production of surgical guides, study casts, mock‐ups, temporary indirect restorations, occlusal splints, and orthodontic aligners to the more recent production of long‐term resin restorations, complete dentures and even titanium dental implants, this additive technology is thought to be the future of CAM, with some much anticipated innovations in materials and techniques that will soon allow ceramic restorations to be printed with higher customization possibilities and lower raw material waste.
With the advent of diagnosis, patient and case documentation, treatment planning, novel treatment techniques and more recently throughout the workflow in oral rehabilitation, digital dentistry is a reality with a promising future. However, much more is yet to come and other fields such as artificial intelligence (AI) will play a major and currently unimaginable role in overcoming all known boundaries. Already considered a rising field, AI technology in dentistry has been the focus of serious research. Software with deep learning capabilities is already helping to improve orthodontic treatment outcomes, caries diagnosis, diagnosis and prediction of periodontal diseases, risk assessment of oral cancer, treatment plan suggestions, patient data analysis, and smile design, among others.
Companies like Pearl, Smilecloud, and LM Instruments, among many others, lead the development of new tools and software capable of autonomously predicting pathology, suggesting treatment plans or providing solutions to improve clinical management and maximize cost‐effective approaches, as well as patient safety.
Within its many limitations and shortcomings, digital dentistry is an unavoidable new reality. However, it should not be considered as a means of solving all problems and dentist/dental technician errors, but rather as a tool to maximize and improve processes already performed adequately.
Since the dawn of time, technology has brought forth what lies inside each of us in a sense that both mediocrity or greatness may emerge. Indubitably, a careful and knowledgeable dentist will see his/her work potentiated and productivity increased, but mediocre work will be emphasized by the technology. Hence, dentists and dental technicians should not look for refuge in technology or take it as a means of solving preexisting problems, but rather focus on acquiring knowledge and performing high‐quality dentistry that respects all the basic principles and then potentiate it through a digital approach.
1.3 In‐House and Outsourced Digital Workflow
1.3.1 The Digital Dental Clinic
For many years dental professionals have been delivering dental treatments based on analogue workflows and well‐established principles of dental procedures. With the introduction of digital dentistry, many of the conventional steps in dental procedures are being changed for digital procedures, by means of computerized software, apps, hardware, equipment, materials and techniques.
Current and recent research projects have been addressing the actual benefits of the new digital methodologies arising in the field of dentistry. The need for such projects is also being investigated, considering that there would be no point in changing established workflows and implementing new technological methods without clear benefits for patients and professionals. Among the research findings that are further discussed in this book is the fact that digital workflows can increase quality and predictability, deliver faster results, standardize processes, and enhance communication among the dental team and the patient [8]. These findings mean that the adoption of digital workflows is becoming more popular in several countries. Nevertheless, only a small number of dental clinics and practices are actually adopting in‐house CAD‐CAM systems in their daily clinical routine.
1.3.2 Impact of Digital Technologies in Dental Clinics
The digital era is completely transforming the ways in which people interact, work, and live. In many areas, the number and types of jobs available are changing. At the same time, entire professions, markets, products, and services rise or disappear. The dental profession is also being impacted by the digital transformation. In a digital dental clinic, treatment workflows use computerized technology that can affect dental teamwork at all levels: administration, support personnel, receptionists, dentists, hygienists, and dental technicians.
Administration personnel and secretaries can quickly store and analyze large amounts of patient data, using dedicated management software, improving efficiency and diminishing the quantity of paper used. The dental hygienist will need to be able to understand and use high technology equipment such as dental scanners and digital x‐rays, while support personnel should also be able to maintain biosafety measures in highly sensitive machinery. This means that, for instance, the hygienist could perform intraoral scans and be able to analyze and correct mistakes during the procedure if necessary, using specialized software under dentist supervision. Currently, dental hygienists and even dental technicians in most countries do not have digital dentistry training in school, making the selection of specialized personnel in the market more difficult. Therefore, with the adoption of digital trends, members of the dental team will need special education for the use of workflows, equipment, materials, and methodologies.
Another important aspect is that digital dentistry adds tools to aid in treatments that still follow the same principles of dentistry. The adoption of digital dentistry allows for enhancement of treatments and abilities obtained using conventional analogue techniques. For instance, oral surgeries can be more accurate and faster by using surgical guides to orientate drilling procedures (see Chapters 6 and 7). Digital imaging and new software tools are useful to enhance oral diagnosis. New materials such as zirconia and new ceramics improve esthetic outcomes. Machinery can work continuously with accuracy and speed that no human is able to achieve.
1.3.3 The Education of the Digital Dentist
The need for education in digital dentistry is also very clear for dentists, who might have a key position in the dental team. The role of the digital dentist is to plan, execute, and coordinate the dental staff while delivering digital treatments. Ideally, the digital dentist needs to make decisions, and thus has to fully understand both analogue and digital dental procedures. A growing number of studies are increasingly supporting satisfactory clinical outcomes with digital technologies. As a result, the reliability of CAD‐CAM restorations is creating a growing demand from practitioners and students to learn about digitalization.
To support this trend, dental schools are increasingly improving their schedules with new information on digital technology for dentistry students. The student can be presented with concepts of digital dentistry applied in several areas of dentistry,
