cases, nor to receive more in‐depth information.
Some academic discussions suggest that digital dentistry will advance to be a major field of study. One of the reasons for this is that the dentist needs to master new knowledge, skills, and training to conduct dental treatments [9]. This suggests that digital dentistry should be considered a separate specialty degree in the field of dentistry. On the other hand, others believe that digital concepts are merely a new way to resolve traditional problems, and therefore digital dentistry is to be considered a subfield derived from the main specialties (i.e., digital prosthodontics using the principles of conventional dental prosthodontics). Either way, digital dentistry represents a large field of study for young dental professionals and more experienced practitioners.
Most practices that decide to purchase their first digital equipment are generally given technical training that could last some days. However, this initial education is likely to be an introduction to the theoretical concepts, technical features, and capabilities of the equipment and/or software. At this initial point, further education on courses, books, and scientific publications helps to fill the gaps in training while the equipment is used in a dental clinical routine.
Typically, the initial production of digital dental work will focus on basic procedures but over time, as the digital dentist becomes more and more experienced, a mind change is likely to occur and a digital way of thinking emerges, providing new insights into planning and executing current dental procedures in novel ways. The dental clinic may thus be organized by digital dentists with expertise in digital technologies to organize and supervise the creation and outcomes of dental treatments.
1.3.4 Levels of Digitalization for the Dental Clinic
There is nowadays a paradox in the dental market as the most advanced treatments and materials are found in digital dentistry but only a minority of dental practices are digitalized. Factors which may be impairing a more widespread use of technology in dentistry include investment costs, technical education, and cultural resistance to change. There can be a misconception among dentists that in order to use digital technology, one must first invest large amounts of money and that the return on investment would be hard to obtain.
The reality is that virtually any dental practice can offer digital treatments, not necessarily initially producing their own work in house but outsourcing to third‐party clinics or laboratories more advanced in digitalization. Other possibilities can start with mobile phones, by using dedicated apps that allow smile planning, for example. The complete digital clinic, in which every single procedure is conducted with digital equipment, delivering automated, standardized, cheaper, and reliable results, is beginning to be suggested as a feasible idea by some research findings [9, 10].
The actual digital clinic may be situated somewhere between the two extremes of lack of adoption and large investment for hard users. In a more realistic approach, the dental clinic and dental professionals can be digitalized in different levels. For instance, one orthodontic clinic may be digitalized for intraoral scans only, outsourcing the set‐up, planning, and fabrication of aligners. Meanwhile another clinic is able to deliver same‐day restorations produced with in‐house equipment and personnel. The decision on the degree of digitalization for the practice will depend on the specialty of the dental clinic and the focus on their more specific needs.
1.3.5 Types of Dental Clinics and Business Models
The rise of digital technologies is also modifying the dental clinic business itself, bringing innovations that can enhance traditional niche clinics and create new business models. As the equipment used in digital dentistry is highly specialized, different business models may be required, depending on the specific field of study.
Some examples of equipment and set‐ups that can be created for special purpose clinics are shown in Table 1.1. However, multidisciplinary practices may eventually influence the hardware and software needed.
Digital imaging diagnostic and radiology centers: may invest in digital imaging equipment (panoramic radiographies, CT scanner). Depending on the services offered, some practices could provide intraoral scanning (or model scanners) and digital pictures for outsourced surgical planning. There is dedicated software available for imaging centers to provide better diagnostics and send back the requested information to the clinician.
Digital esthetics: there will be a large demand for ceramic restorations (veneers, crowns). Practices could invest in smile design software, 3D printers, and single‐unit ceramic milling machines.
Digital implantology: a digital implantology center would probably need in‐house imaging equipment and an intraoral scanner to correctly diagnose and create treatment plans. Additionally, guided surgery software would be needed to fabricate surgical stents, with a 3D printer. If digital restorations are to be executed, additional equipment similar to oral rehabilitation practices will be required.
Oral rehabilitation and prosthodontics: oral rehabilitation is a complex area that encompasses many of the main specialty areas of dentistry. Therefore, a digital prosthodontics clinic could require equipment and software to create at least some items in house, while outsourcing more complex work. To do so, good additions would be an intraoral scanner, chairside software to design restorations, a small ceramic milling machine to produce single‐unit same‐day restorations, and a ceramic furnace. If more complex in‐house prosthetic production is desired, a dedicated internal digital laboratory can be created.
In‐house dental laboratory: there is no limit to the work that can be created by an in‐house dental laboratory when compared to commercial counterparts, since the same equipment and software can be acquired. However, a complete laboratory set‐up would require a more robust financial investment in machinery, software, and materials. Additionally, a dedicated space is needed with special infrastructure planning to accommodate the hardware, and specialized personnel are needed to operate the machinery. The size, organization, and production rate of devices must be compatible with the desired workflow. Equipment for digital dental laboratory would include that required for a traditional lab plus a desktop scanner, a milling machine for 5‐axis capability for large blanks and ceramic blocks, a ceramic furnace, a sintering furnace, CAD software to design prosthetics, and a resin 3D printer.
Orthodontics: the digital orthodontist can enhance their practice with intraoral scanners. It is possible to acquire dedicated software and 3D printers to plan treatment outcomes, as well as in‐house fabricated aligners.
General practitioner: can invest in intraoral scanners in order to easily digitalize their orthodontic, restorative, and prosthetics patients. Digital sensors for radiographies are also widely used.
Surgery: oral and maxillofacial surgeons can acquire dedicated software to plan orthognathic surgeries and would need at least desktop scanners to digitalize models, although an intraoral scanner would be preferable.Table 1.1 Estimate of the amount of machinery, equipment, dedicated software, specialized personnel, and physical space dedicated structure to operate different types of digital dental business models.Intraoral scannerDesktop scannerDigital imaging3D printerSmall milling machineLarge milling machineCeramic furnaceSintering furnacePhysical space structureSpecialized personnelDedicated softwareOrthodonticsXxxxxGeneral practitionerXXXxxxEsthetic dentistryXXXXxxxDental implantologyXXXXXXxxxxxxOral rehabilitationXXXXXXXXxxxxxxSurgeryXXxxxDental laboratoryXXXXXXxxxxxxxxImaging centers and diagnosticsXXxxxxPlanning centerXXxxxxScan servicesXXxMilling centersXXXxxxx
Planning centers: a digital planning center is a new business model aiming to provide outsourced services to any dentist or practice,
