Focus On: In-Office Technologies

Sabiha S. Bunek, DDS


Sabiha S. Bunek, DDS, discusses new in-office dental technologies available to dentists that are impacting everyday practice as well as in the future.

Q: Why do you think more dentists are purchasing stand-alone digital impression scanners?

A: While there are still a good many dentists milling in-office restorations, digital impression systems have gained momentum in recent years. Scanners have evolved to become smaller, portable, and easier to use, while price points have dropped. Manufacturers are starting to understand that to increase adoption rates, the technology cannot be disruptive and must fit into the flow of the clinical practice. A great example of this is the 3M True Definition Scanner, the world’s first mobile intraoral scanner that operates solely on a tablet. The design of the devise makes moving the scanner between treatment rooms much more easier, without cords or carts. I predict this trend of portability and familiarity with next-generation scanners will continue. A few scanners that also utilize a laptop over a big cart system are CS 3500/3600 (Carestream Dental), TRIOS (3Shape), and PlanScan (Planmeca USA).

Q: What advice would you give dentists who value the benefits of digital data but are not ready to invest?

A: For those not yet willing to switch to an intraoral digital impression scanner, the desktop impression scanners have become a viable option. With a small footprint, they require only a monitor to view the software; computers are integrated into the scanner. Dentists do not need to change their technique; they simply take a traditional vinyl polysiloxane impression and place it in the scanner, then the digitized scan file is sent to their laboratory of choice. What dentists may not realize is that their lab team may already use this type of scanner to digitize traditional impressions that are received. This practice enhances their digital workflow, eliminates model fees, and decreases costs and time required to complete a case. A few designed for the dental office are cara Scan 4.0i (Kulzer), iSeries (Dental Wings), and DSi 6000 (Optimet). Also on the rise is 3-D printing because it can provide a precise and accurate alternate method for producing study models and diagnostic wax-ups. The dental office needs to provide either a digital scan of a physical impression or an intraoral scan from a digital impression device. From this information, a 3-D model can be printed, if desired, or virtual storage can be created.

Q: What other technologies have you found to be particularly useful in your practice, and why?

A: While many come to mind, I want to highlight an arena of products that receive little attention: light-curing units. They are essential pieces of equipment for both direct and indirect procedures. Without sufficient polymerization, restorations can be subject to premature failure and exhibit poor clinical performance. Many clinicians are unaware of the need to regularly monitor the output of their light-curing unit for loss of intensity. Historically, in-office radio­meters have been less accurate versions of high-level lab equipment used to measure light output. Ivoclar Vivadent’s Bluephase Meter II, however, is a lightweight radio­meter that can be used in-office for quick, easy verification of the light intensity of all types of curing lights. With it, we get accurate and consistent readings when testing light-curing units in THE DENTAL ADVISOR Biomaterials Laboratory. It gives me peace of mind. My dental assistants would recommend the EyeSpecial C-II (Shofu Dental Corp). Designed for the dental practice, this lightweight camera produces high-quality images and only requires one person to operate. Another recommendation is the RVG 6200 (Carestream Dental) digital x-ray sensor. It integrates effortlessly with our practice management software, captures images immediately, and provides some of the crispest images we’ve seen. And integrated directly into the sensor is a proprietary caries detection software called Logicon (available on Carestream sensors) that analyzes tooth density and demineralization patterns to assist clinicians in identifying interproximal caries. In our practice, it is also a great tool for patient education.

Q: Are there any procedures you are doing now due to technological advancements that you would have referred to a specialist 5 to 10 years ago?

A: Though I have always enjoyed endodontics, a decade ago I was hesitant to start a molar root canal. The procedure was stressful, time-consuming, and unpredictable. Manufacturers have recently streamlined the endodontic process for general practitioners by utilizing various technologies to simplify it. The equipment requires less counter space and is becoming lighter in weight. Two standout products just reviewed at THE DENTAL ADVISOR have had a positive impact on the way I view taking on an endodontic case. The first is a new apex locator from Kerr Endodontics called Apex ID. This small piece of equipment is not only highly accurate but is also lightweight and portable. The other is the elements free Obturation System (Kerr Endodontics), which offers both downpack and back-fill capabilities in a cordless design. Both devices are easy to use, with quick heat-up, and they are housed in a small docking station that recharges the batteries. The 360° one-touch activation/deactivation ring featured on the downpack device is a personal favorite.

Q: What do you foresee in the near future in terms of technological advances and their impact on new professionals?

A: You may have noticed a trend in my responses: intuitive, small, and portable technologies. While we’ve had great technological advances in equipment in the last decade, most come with a big footprint and a long learning curve. Unfortunately, whether you’ve built your space or bought an existing office, operatory size has not changed much in the last 40 years. My theory is that most of us appreciate technology as long as it is user-friendly, has foreseeable benefits, and can seamlessly fit into the customary operatory dimensions. In the next few years and beyond, I see equipment getting smaller, more mobile, and designed with the patient experience in mind. I see future treatment rooms having open technology that will allow for easy integration of all equipment needed during any procedure—a place where one can easily bring up a patient’s radiographs, digital scans, and chart notes with a click of a button or maybe even with voice commands!

Dr. Bunek is editor-in-chief and CEO of THE DENTAL ADVISOR, leading a scientific team in reporting evidence-based research. With a DDS from the University of Michigan, she practices privately in Ann Arbor, Mich. She can be reached at

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