Complete dentures: the ultimate challenge in digital dentistry

The importance of digital processes in dental lab technology is growing. Comprehensive CAD/CAM solutions have become available for almost any indication. Only complete denture prosthetics remained virtually untouched by these developments for a long time. Recently, however, a few individual manufacturers have started to show an interest in offering digital solutions for this indication. Read this interview to find out first-hand about the experiences that Sonja Ganz, Master Dental Technician in Germany, has had with digital processes in manufacturing complete dentures.

Interview with Sonja Ganz, MDT (Germany) about Digital Denture from Ivoclar Vivadent

Ms Ganz, what is Digital Denture?

Sonja Ganz: Digital Denture is a completely digital and validated process for manufacturing complete dentures. It comprises CAD/CAM aspects, i.e. CAD design components and CAM manufacturing components and the matching materials. It is the first all-inclusive digital process for the manufacturing of complete dentures. This process was first introduced at IDS 2015.

How long have you been working with Digital Denture?

Sonja Ganz: Digital Denture Professional was launched three years ago at IDS 2015. The beta tests already took place in the previous year, in 2014. Since we were among the beta testers, we have been working with Digital Denture since the inception four years ago.

What kind of advantages does Digital Denture offer technicians?

Sonja Ganz: Dental technicians, for example, can ask their practitioners to make a rigid centric relation record, which they subsequently convert into a digital format for working purposes. Furthermore, they can position the teeth according to one of the different set-up methods and use the denture teeth from Ivoclar Vivadent, such as SR Phonares and SR Vivodent, which they have in their tooth cabinet. Finally, they can digitally manufacture the denture in the CAD/CAM machines from Ivoclar Vivadent.

This digital manufacturing process allows me to work precisely and reliably: the quality of my work is consistently high. Therefore, the outcomes are predictable. I encounter fewer sources of error and the results are highly reproducible.
Moreover, I would like to emphasize that young dental technicians want to work with digital methods. The Digital Denture system allows me to portray dental laboratory technology as a very interesting and attractive profession.

What kind of advantages does Digital Denture offer patients?

Sonja Ganz: The benefits of Digital Denture for patients include fewer appointments than in the past. Ideally, the procedure starting with impression taking and ending with the insertion of the final restoration requires only three visits. In addition, patients are assured of highly biocompatible and durable materials. The complete dentures show outstanding fit and they are extremely fracture resistant.

What persuaded you to work with Digital Denture?

Sonja Ganz: We are a laboratory that believes in being innovative. We have incorporated digital processes into far more than 70 per cent of our work, because there is an immense interest in using digital technology to manufacture removable dentures.
I am strongly convinced that Digital Denture is a step in the right direction in terms of the developments taking place in digital complete denture prosthetics. The system has incredible development potential.

Were you convinced of the idea right from the beginning?

Sonja Ganz: Yes, absolutely. Digital Denture immediately gave me the feeling that I would not have to give up everything that I had learned in my 26 years of working as a dental technician. Rather, it rendered all the knowledge I had acquired into a digital format. The system incorporates a digital version of the manual methods that I have been using for decades. Integral parts of the process, such as the bite record given to me by the practitioner can now be digitalized. Another example is setting up teeth: I learned to do this manually, but now I can do it on the computer. I was able to use the system without any problems or significant adjustments right from the beginning. Of course the proven materials from Ivoclar Vivadent helped me in the process.

In short: Digital Denture was the right choice for me, right from the start.

Can you tell us a little about your experiences with Digital Denture?

Sonja Ganz: First of all, I had to convince my customers to try something new. The situation was like the one which we encountered when all-ceramics were initially introduced some time ago. Our customers were used to metal-supported ceramics and we had to convince them of the new material with some very strong arguments and results. We took the same approach again. Our data base contains the details of customers who have been achieving excellent results in complete denture prosthetics for many years. I spoke to them and asked them to trust me and give digital technology a chance. This worked very well.

Do you speak to your colleagues about Digital Denture?

Sonja Ganz: Colleagues often ask us about Digital Denture. In many cases, they ask themselves – and us – if this is the right way to go? Should they try their hand at it? Is the investment worthwhile?
In this context, it is important to consider that digital technology relies on CAD software, which is in use in many laboratories already. All that needs to be purchased is the corresponding add-on module. I feel that it is definitely worthwhile to risk this investment. Digitally savvy dental technicians will soon feel very comfortable using Digital Denture and will find their way around quickly and easily.

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How long have you been working with digital methods in your laboratory?

Sonja Ganz: I have been relying on digital techniques for 18 years, in other words, right from the beginning when CAD/CAM technology entered the dental industry. 

Do you anticipate that every working step will be digitalized in future and that every type of dental restoration will be made using digital technology?

Sonja Ganz: It is our vision to completely digitalize the work done in our laboratory some time in the future. As mentioned, we would like to portray dental lab technology as an interesting profession for young people who have grown up with computers and smartphones. We have experienced the benefits and seen the potential offered by digitally processed materials. I believe that dental lab technology will some day be completely digitalized. However, this does not mean that people will become redundant. What it does mean is that the things we do manually today can be effectively supported by digital technology. In future, we would like to have the possibility of choosing between manual and digital approaches, so that we can ask ourselves the following question: What do we want to produce manually and what is better done with the help of digital technology?

How would you rate the possibilities and the potential of CAD/CAM – and what are the risks and limitations?

Sonja Ganz: At present, the available materials present very strict limitations: Not every material is suitable for processing with digital manufacturing techniques. Nevertheless, the industry is working very hard to adjust the materials to this new technology in the long run. In this context the question arises of whether certain materials will one day become redundant and replaced by new developments.

In order to reduce the risks associated with jumping right into something new, I recommend taking things one step at a time. In our laboratory we like to take advantage of the synergies offered by traditionally trained technicians working together with young digitally savvy technicians. We find that this type of combination in particular always produces the most amazing results.

A longer version of this interview has been published in the trade journal "Das Dental Labor" x/2018 (German).