By Leif Svensson
Recording 2,500 scanning cases for me is a great milestone with a lot of clinical highlights. Amid the 2,500 cases, I was able to build a specialised training programme for the largest TRIOS scanner roll-out in Asia-Pacific, spanning 100 locations with over 500 practitioners. I have had the opportunity to work with many practitioners along the journey and have learned so much, especially in the world of digital implant planning and scanning.
Here are my top 10 learnings after scanning 2,500 dental cases.
- Good hardware: Research and acquire the best scanner you find most affordable.
- Be fearless: It is normal to expect nervousness in the first 10-20 scans. But after conducting 100 scans, more experience and knowledge is attained so get to the 100th milestone as soon as possible after the first training session.
- In-surgery set-up: Set the scanner on the most versatile rolling stand or a TRIOS MOVE+. I have found several good scanner accessories from Anatomic4d, but there are many alternatives available in the market.
- Adopt a good scanning posture: This is critical—decide if a stand-up, front approaching posture, or sit-down, rear approach scanner. Master positioning the body according to the arch and indication. I even think about posture as it relates to the quadrant I am working on. Position the body where the scanner head is parallel to the area you are capturing. It is good to learn and memorise these positions in surgery.
- Always support the scanner tip: At all times, try to achieve a bipodised support position for the scanner tip with another finger or part of the hand. The support finger should thus be supported by a patient landmark, such as a tooth, sulcus or other. Do take note that a swap of the support finger might be required when scanning around the patient’s mouth. Use the support finger to steer the scanner. It is a handy pivot and scanner head rotation point, especially when crossing the patient’s midline. I also use scanner bipodisation positions to retract soft tissue while still capturing and supporting the scan head. This is a great asset. OptraGate is good when capturing tooth surfaces. When capturing soft tissue, however, this form of retraction can get in the way. Finger retraction is the best—the retraction finger becomes the support bridge between the hand and scanner head support, and just rolls along clearing a path for capture.
- Be critical of your scans: Do not be afraid to ditch and go again.
- Trim: Trim the scans according to the application indication. Look for foreign detached and attached anomalies in the scans, especially when conducting non-artificial intelligence (AI) scanning.
- Find a good lab: Find a laboratory that communicates well. Some laboratories have direct technology links these days. Good support is key when starting.
- Be patient with edentulous scans: Edentulous areas are the most challenging to scan, whether full or partial. Build up to it. Start small and increase as more confidence is gained.
- Be inventive: It is not necessary to follow the exact predefined manufacturer scan strategy, especially in cases with large edentulous areas. My general rule when there are missing teeth is to always start where the hardest structures are. In this case, start where the most teeth are, then build the scan path from there.
Published in Dental Asia May/June 2022 issue.
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