HJAR May/Jun 2023

56 MAY / JUN 2023 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH The days of waiting on a restoration, such as a crown, for one to two weeks are over. Many restorations and appliances can be made in a single visit, the same day of the appointment, or in a few days. CAD-CAM (computer-aided design and computer-aided manufacturing) has been around for several years and has been perfected with many up- dated models. Instead of having a conven- tional impression taken, which hardens intra- orally, an intraoral scanner is placed over the tooth preparation and a digital impression is obtained. The material of choice is selected, then placed in the milling machine, where the data that captured the correct dimensions for creating the restoration is transferred, and the restoration is made. This advancement proves to be highly accurate, reduces ap- pointment time for the patient and dentist, and is more cost-effective in the long run. 4 There are other ways of achieving an im- pression and creating a restoration or pros- thesis. 3D scanners and 3D printers also col- lect the physical data in order to create the appliance. While the intraoral scanner is used directly in the patient’s mouth, the 3D scanner is a stationary machine that scans dental im- pressions, models, restorations, orthodontic molds, and implant cases. The image is gener- ated fromdata gathered from the object being DIALOGUE COLUMN ORAL HEALTH THE FIRST doctor to recognize that the combination of bacteria and acid left on teeth leads to formation of carious lesions was Pierre Fauchard, who lived from 1678- 1761 and is regarded as the father of mod- ern dentistry.” 1 He coined the phrase “caries” for decay and is credited to be the first to emphasize the importance of having sound education of preclinical science in deliver- ing dental care with knowledge and skill. 2 Even the basic principles of his description of crown preparations are relevant today, as he was forward-thinking and ahead of the times. As we reflect on all the advancements and improvements in dentistry over the past few centuries, it is amazing how far the field of dentistry has come and will keep going. Even in the past few years, procedures, materi- als, techniques, equipment, and methods of providing care have been augmented and perfected to be better, faster, more efficient, more comfortable, and more accessible. Dentistry 4.0 is in sync with Industry 4.0 and refers to the fourth revolution of modern dental technologies to better treat patients. 3 These advancements allow a patient-cen- tric care model, providing improved service that can be faster, and many times immedi- ate, which is immensely different from the traditional healthcare model. captured. This technology uses a camera to capture the deformation of light in order for the shape of the model to be made. 5 3D Printing, also referred to as additive manufacturing, creates the crowns, bridges, models, custom dentures, surgical guides for implant placement, and even some types of implants. This particular technology has been around since the 1970s but has continuously advanced in accuracy and turnaround time. 6 Once the dentist scans the information in the form of a CAD file, this file is then used to create the needed prosthesis through 3D printing. Many offices have invested in their own 3D printing versus sending the file to an off-site laboratory. By incorporating 3D printing ma- chines into their own offices, clinicians gain the ability to increase control over workflow and decrease turnaround time, thus increasing efficiency in time for both patient and office. 7 Artificial intelligence (AI) in dentistry can assist in and improve diagnosis, assist in treatment planning, support the clinician’s treatment, and is not meant to replace hu- mans. It is used to predict patterns and iden- tify disease based on the data the human has placed in the computer. AI can be used for early diagnosis of oral lesions even before they are visible clinically. 8 DENTISTRY 4.0: The Fourth Revolution in Modern Dentistry NEW ADVANCES AND TECHNOLOGIES IN DENTISTRY