2020, Number 1
Digital workflow in orthodontics: future or present?
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When we discuss digital workflow in orthodontics, many questions arise: when will it be appropriate to enter into digital workflow? Will it be convenient to start using it? will the clinical experience be enough to replace it? Will it be necessary to review and update the postgraduate orthodontic program? How do we work as a team with other specialists, dental imaging centers, and dental companies could a hybrid model be established with clinical experience using both analog and digital technology? How can we move from analog to digital dentistry? To find the answers to these questions, it is necessary to analyze the advances in digital technology in the last 30 years and their impact on orthodontics.
The transition from analog to digital cameras has been a significant digital workflow improvement in recent years. Today, there is a diversity of high-resolution digital cameras and specialized software and applications used to edit videos and images. The images obtained with digital cameras can be stored and backed up in physical storage media or digital clouds for inclusion in the patient's record.
In addition, smartphones facilitate communication with other professionals and patients, simplifying the exchange of information of clinical photographs, digital radiography, Cone Beam computed tomography, and text and voice messages for optimization in the dental office and the improvement of the patient's experience in clinical practice.
Beyond being just a means to get in touch, the current form of communication through the Internet and its technologies allows initiating the "digital flow of clinical work". Digital workflow is a process that allows the digitalization of dental records, using computer-assisted imaging techniques and virtual treatment planning or simulations with specialized software to systematize clinical procedures in orthodontics. In addition to this equipment, digital workflow requires lighting systems to obtain good quality intra and extraoral images and high-speed internet connections.
Together, digital workflow, information, and communication technologies converge in the performance of a digital work environment called the "digital ecosystem", which helps to carry out designs, plan three-dimensional diagnoses in orthodontics, reduce work time in clinical practice, and optimize results. The digital workflow is in a state of continuous improvement through artificial intelligence.
Using digital technology offers several advantages in orthodontics. On the one hand, it contributes to the diagnosis through the analysis of intraoral and extraoral photographs, the cephalometric evaluation with specialized software, and the three-dimensional analysis of study models. On the other, it allows the design and planning of the treatment with the help of the visual treatment objective system, digital impression of study models, virtual dental extractions, smile design, and virtual set up for orthodontic treatments with aligners or braces. In addition, it allows analysis of complex cases that require orthognathic surgery.
Orthodontists can also benefit from digital treatment simulation systems for evidence-based clinical decision making on diagnosis and treatment plans, combining clinical experience and scientific knowledge to use the digital workflow and form a digital ecosystem of their work.
The orthodontist must consider that the correct diagnosis and orthodontic treatment planning are necessary to establish better results in the digital workflow. Orthodontists must also know how to use the specialized software for handling the images generated by intraoral scanners in Standard Triangle Language format for dental 3D printers. Finally, it is necessary to consider the high cost of the digital workflow, which ranges from $10,000 to $150,000 dollars or more.
AFFILIATIONS
1 Profesor de la Facultad de Odontología de la UNAM. México.
2 Coordinador de la Especialidad de Ortodoncia de la Universidad Latinoamericana. México.
CORRESPONDENCE
César Esquivel Chirino. E-mail: investigaciondental@gmail.com