of dedicated software. The range of services provided can encompass orthodontics, implant surgery, smile design, oral surgery, prosthetic design, and so on. Software licenses can be expensive and require initial investment and often subscription updates charged yearly. Additionally, professionals are highly trained in software and can discuss the design with the dentist before delivery. The outcome of a digital treatment plan can be a physical item such as a surgical template or even digital files or pictures.
Scan services: for those who do not possess an intraoral scanner but would like to use one, scan services bring the scanner to the customer's practice in order to register the digital impression. This novel business model can occur as a standalone company or be offered by digital dental laboratories.
Milling centers: a digital milling center is a specialized dental laboratory focused on the production of milled structures or restorations. Specific materials such as cobalt‐chromium structures are commonly used in prosthodontics but as highly dense materials, they are extremely hard to mill, requiring specialist and expensive tools and machinery. Therefore, many small laboratories tend to outsource their metal milling to milling centers. Depending on the focus and services offered by milling centers, other materials can be used such as zirconia, ceramics, PEEK or PMMA.
1.3.6 Financial Aspects of Digital Dental Clinics
The digital clinic can be more complex than a regular individual private practice, which generally presents lower complexity, operational costs, and levels of document digitalization and a smaller professional administration team. Therefore, the operation of a digital dental clinic is similar to a business company, something that dentists may not be used to. Potentially higher financial investments are necessary to equip a digital dental clinic, which makes it difficult for any clinic to enter the market. It is noteworthy that these issues are less likely to be experienced by larger dental clinics and hospitals.
A digital dental clinic can be potentially bigger than a regular practice, but not necessarily a more profitable business. As a practice grows and enlarges its operation, facilities, and employees, there is an increase in profits and liabilities in the same proportion. Therefore, in the real world, studies of economic viability of dental clinics, or related to some specific equipment incorporation, can determine if a company will perish or thrive. More than ever, a successful dental practice needs a combination of highly skilled dentists and entrepreneurial skills.
1.3.7 How to Calculate the Return on Investment (ROI)
The return on investment is a ratio between net income and the funds spent on the investment, over a period of time. Applied to a dental clinic, the ROI calculation may predict how long it will take to return the money to the entrepreneur.
The estimation of ROI is based on complex calculations comparing initial costs, earnings, and projected estimate of cost/benefit after making an investment. To achieve the same production end, more than one digital solution is available and can be compared [9].
Return on investment calculations have three aspects.
Earnings: how much revenue will the investment bring? Will there be an increase?
Costs: how much will the investment save (time, clinical steps, personnel costs, consumables)?
With this information mapped, it will be possible to create a break‐even estimation, which is the prediction of when in time the investment will return. Reaching anything more than the break‐even is considered profitable.
Estimations of ROI must take into consideration that after the equipment is acquired, it may require regular maintenance and consumables. Additionally, the obsolescence of the equipment must be included as technology evolves over time and may need to be replaced with new financial investment. Finally, to represent a good inversion, the digitalization of dental care workflows should provide quantifiable advantages in terms of quality, time consumption, and personnel cost reduction. As ROI calculation can be complex, professional advice on these economic aspects should be taken.
1.3.8 Advantages of Digital Dentistry for Clinics
Before digital dentistry, it was common for the client to visit the dentist for multiple consultations to diagnose and plan dental treatments, while procedures could last long periods of time. However, dental practices are now able to diagnose, plan, and treat their patients much faster and with fewer clinical steps and less chair time using digital technology.
Besides the potential financial benefits, the implementation of digital solutions can offer indirect benefits. The patient experience tends to be better and more comfortable when using digital treatments, with a sense of quality and a high level of technological innovation. Aspects of treatments such as planning can be easier for the patient to understand. 3D digital simulations and impressions can improve patient engagement and approval, especially when esthetics are involved.
With the adoption of digitalized procedures, laboratory and clinical procedures tend to cooperate better with administrative records, treatment planning, and fabrication through standardized workflows.
1.3.9 Workflow in a Digitalized Dental Clinic
The term workflow refers to a sequence of predefined tasks executed by various people within the work environment. The establishment of workflows creates mindsets throughout the organization that ensure a standardized exchange of data along the dental workflow from planning to therapy [10]. Each dental clinic may determine its own internal workflows, and how they would interact when some outsourced help is needed. Some procedures can eventually be planned to be exclusively digital, and there can be a mix of analogue and digital components (Figure 1.3).
Furthermore, dental clinics commonly have several professionals who can conduct treatments with different levels of expertise. In this context, treatment workflows lead to standardization of outcomes and skill levels among the dental team. This enables a more consistent and controllable production outcome.
Figure 1.3 Digital workflow involving imaging and planning centers. All treatment plans are ultimately to be approved by the dental clinician responsible for the case.
1.4 Current Knowledge and Perspectives in Artificial Intelligence in Dentistry
Artificial intelligence (AI) is a term commonly used to represent the concept of artificially created human‐like intelligence [11]. AI has revolutionized several fields of scientific research and development, with improvements ranging from facial recognition on our smartphones to genome analysis. AI has been developed in different sectors of society to solve various tasks by utilizing data more optimally, including health areas like medicine and dentistry. Data science is an umbrella term that refers to the interdisciplinary area dedicated to the analysis of structured and unstructured data, which aims at the application of statistical methods for data analytics. The work of data scientists includes using advanced techniques such as machine learning. Machine learning is a subfield of AI, in which algorithms are applied to learn patterns intrinsic to data structures, which allow data predictions (supervised machine learning) and data reduction and data handling (unsupervised machine learning) [12]. One of the factors associated with the adoption of this methodology would be that AI is especially suitable for
