Current digital splint technology requires workarounds to make it a feasible option for clinically exceptional dentistry. In Part 1 of this series, I described the challenges and opportunities of digital dental technology and explained some details of my preferred protocol. Here, I continue this explanation:
An Effective Digital Splints Protocol
In my practice, I mount digitally printed models using a centric relation record and a protrusive record for condylar inclination adjustments. This is just like we have done in the past with stone models.
The lab technician can transfer this into the computer exactly as we have it in our hands. They do this with the use of a tabletop scanner. It’s important to note that the technician can now register original files for the impressions into position for the best accuracy. The greatest benefit today is the accuracy of these original scans (20-30 microns).
The design portion comes next in this process. Communication with the technician can be done in real time online. My technician and I have been working with different settings in the software that give me the best chance of skipping the reline procedure patients don’t enjoy.
I can also evaluate and do final adjustments on the mounted digital models and analog articulator. We have been successful about 80% of the time getting a splint that is rock solid and has an intimate fit on the occlusal surfaces. This is critical for fine-tuning adjustments and fracture resistance.
If it ends up as an ill-fitting or loose-fitting splint, we can still reline just like we always have because it is a milled PMMA material (as dense as a denture tooth).
Areas of Improvement for Digital Splints
My opinion at this time on digital splints is mixed:
Pro: We can produce a very high quality PMMA splint that lasts longer and generally gives the patient a better experience.
Con: We still need digital counterparts to essential analog skills that provide for all situations.
Pro: I believe we will have printed materials that outperform current milled materials in the near future (this will lower the cost to produce splints).
Con: It is frustrating that we are not getting better support from companies selling us expensive equipment.
I am proud to be part of the Pankey family because our community encourages the use of technology to enhance good dentistry.