Focus On: Technology Choices for a New Practice

Sabiha S. Bunek, DDS


Sabiha S. Bunek, DDS, talks about the decision-making process when purchasing new technology.

Q: You recently built a brand-new office directly across from the University of Michigan football stadium. What were some of the decisions you made in regard to technology options?

A: I chose Open Dental, an open source practice management software, for my new office because of the overwhelmingly positive reviews it received from my colleagues. However, I had pushback from my team because no one had experience using it. It is also not sold by a dental supplier, so not every technician or sales rep is familiar with how to integrate all the software to work together. Fortunately, we had a terrific dental-centric IT company that worked through all of the kinks and got us operational without any headaches. In the end, our team committed to learning the new system, and now we can’t live without it due to the flexibility, customization, and intuitiveness of the software and the support. I’ll take that as a win!

A new piece of technology I will be investing in this year is a microscope. I went to a microscope meeting this fall and was blown away with the level of care practitioners can provide for their patients using a microscope, not to mention the positive long-term effects it has on your posture and back. I have my eye on the mid-tier ZEISS microscope because it is easy to maneuver, has a small footprint, and allows the ability to quickly and easily capture images and video.

Q: Adoption rates of intraoral scanners (IOSs) are increasing, and clinicians are readily incorporating them into practice. Why do you think this is happening, and what are your preferences for selecting a scanner?

A: Dentistry has finally reached a tipping point where many of the IOSs on the market are on the same playing field and costs have come down. Scanners have evolved to become smaller, portable, faster on image capture, and easier to use. My colleagues continually ask me which IOS is superior, and the honest answer is that they all serve a purpose and have unique features. The questions clinicians need to be asking themselves are “What problem am I trying to solve?” “What features would help my workflow?” and “Which digital solution will serve as an asset to my practice and not be a disruption?” For example, if you do a lot of clear aligners, certain IOSs would be a better match for your office. Will you have an assistant that will be scanning, or will you be scanning on your own? If scanning on your own, you may want to choose an IOS that does not require powder and is more forgiving in a moist environment. The list of questions goes on, and, lucky for us, there are many customizable digital solutions. While I have success using both traditional and digital impression techniques, I will be investing in an IOS system in the upcoming months, mainly because of the increase in patient comfort and accuracy of the scans. Some features I will be taking into consideration before purchasing are portability, whether or not it’s powderless, wand size, and cost, to name a few. I am in the process of evaluating the newest iTero Element 2 (Align Technology), TRIOS (3Shape) and CS 3600 Carestream Dental scanners.

Q: In the decision you had to make between a 2-D digital panorex and a 3-D cone beam computed tomography (CBCT) scanner, what did you end up purchasing, and what influenced your decision?

A: I was in a group practice for 12 years, and we had a digital panorex. While a 2-D panorex image worked well for most cases, it did not provide adequate detail/information for endodontic and implant cases. For my new solo practice, I invested in a CBCT machine, the KaVo OP 3D Pro, which has the ability to take 3-D and 2-D images. I perform most root canals in my practice, and a 3-D CBCT scan offers increased accuracy for identifying root canals and their locations, ultimately increasing the likelihood of success. I can also provide the service to patients having an implant treatment and consult with specialists using the case planning software. The use of CBCT in dentistry will continue to grow as it is already playing a huge role in sleep medicine, implants, and endodontics. There are many CBCT machines on the market, and the decision-making process when purchasing one is difficult; however, as with other digital technologies, it is important to decide which features will make you more efficient and effective and will integrate best with your practice. My decision to go with the KaVo unit was based on a few key features: image quality, automatic dose control, an upgradeable platform, ease of use, and support. Beware, as once you dabble in the 3-D world, it’s hard to go back!

Q: What would you say are the most important considerations in deciding on technology for a new practice?

A: Patients who walk into our offices today are different than patients who walked in 10 years ago. Today’s patients are exposed to advanced technologies throughout the day, and their expectation for a tech-savvy dental practice is on the rise. My advice to clinicians starting up a new practice is to invest in technology now and build for the future. Technology will elevate the patient experience and improve the productivity and efficiency of your practice. Although technology changes quickly, you don’t have to implement everything all at once, but you do need to build the foundation that you can eventually build on.

Dr. Bunek is CEO and Editor-in-Chief of DENTAL ADVISOR, leading a team of scientists and clinicians in reporting evidence-based research. She earned her DDS degree from the University of Michigan and maintains a private practice in Ann Arbor, Mich. She can be reached at

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