3Shape TRIOS Digital Impression Solution

Review: 3Shape TRIOS Digital Impression Solution
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Friday, March 29, 2013

The incorporation of digital technologies into dentistry has brought about many exciting changes in recent years, but most of these technologies require commitment from both the practitioner and manufacturer in order to make the digital workflow efficient and effective. Some of the most groundbreaking digital integration for dentistry has come in the form of digital impression technology, such as the 3Shape TRIOS.

Integrating new technology and new models into any dental practice requires an adjustment from both dentists and patients, which can cause some initial trepidation. That, and the fact that the distributor, CadBlu, told me I was the first to have the unit installed in the United States, led me to closely monitor this new impression technology in order to determine its efficacy.

As a serial early adopter, I find it interesting to explore new dental technologies, and was excited to break in the 3Shape TRIOS technology for clinicians worldwide. When I think about new technology, I think about what is in the patients’ best interest, and I think about profitability. After extensive exploration, with respect to 3Shape TRIOS, that is just what I see.

ImageEven though traditional impression taking techniques have proven to be accurate throughout generations, retakes are time consuming and can be expensive and frustrating for patients. The immediacy of digital impression technology allows for immediate confirmation of impression accuracy, preparation and precision, and greatly enhances the speed of communication between the dentist and the lab.

The 3Shape TRIOS experience

The 3Shape TRIOS offers dentists next-generation digital impressions. Fast, highly accurate, and best of all easy-to-use, TRIOS technology has many unique features as well as many benefits for both doctors and patients which I will highlight here.

ImageThe Scanner: The 3Shape scanner is hand-held in a gun-like manner. A trigger is used to power the scanner to create a 3D image as it is passed over the teeth. The scanner provides great flexibility for both dentists and patients because it doesn’t need to be held at a specific distance or angle for focus—it can even rest on the teeth for support during the scan. During the scanning process, the upper and lower jaw and the bite are each scanned separately. I have found that TRIOS’ optical sectioning technology is quite fast—an entire quadrant can be scanned in about 180 seconds.

The System: The integrated computer combined with TRIOS’ touch screen interface makes the digital impression process quick, simple and straightforward. The basic operational system flows well and is easy to manage. ImagePatient information is added to the digital prescription at the start, a feature that allows for easy and effective communication with the lab. From the tooth shade to the due date and everything between, patient and case-specific information can be precisely recorded and stored in a location that is easily accessible.

Once the data is entered, information is sent directly to the lab from the onboard computer. The TRIOS sends the patient information to a server where it is automatically pushed to seamlessly integrated lab software on the other end, which depending on the dentist’s preferred relationships, determines which lab the information is sent to. This technology is both fast and effective. Nothing gets lost in the digital space. Doctor preferred labs are automatically notified upon delivery, and dentists receive a notification when the lab has received the patient information. The TRIOS even informs you if any information sent hasn’t been accepted by the lab. Dentists will always know exactly where their patient information is.

ImageI have found this integration very useful for interacting with the lab because notes and instructions are all stored for easy access, allowing for instant virtual communication. Labs can access the information and send screen captured pictures in order to confirm instructions or ask questions, making communication fast and easy. I also find the open source production system of the TRIOS machine is key in making this treatment successful for patients. It no longer requires a dental practice to work with a specific company or restoration material. You now have full control over the fabrication process, the materials used, and best of all, there’s no more price fixing.

Benefits of the 3Shape TRIOS

Through my exploration I have found that the 3Shape TRIOS provides tremendous benefits for dentists, the lab, and patients alike:

Dentist/Lab

  • The easy, intuitive user interface makes for an outstanding user experience
  • Fast impression taking, improved accuracy, improved clinical results
  • No need for impression materials means no mess or expense
  • Streamlined lab communication
  • No pay per use fee
  • Reduction in cost related to shipping and materials
  • Immediate confirmation of appropriate prep
  • Excellent service and support

Patient

  • Quick and comfortable patient experience – no ‘goop’, no vinyl or alginate impressions
    • This is helpful for patients with gag reflex issues
  • Digital accuracy and precision leads to a better fit for restorations
  • Overall chair time is greatly reduced

My patients truly seem to like it. I was recently looking at an upper molar scan, and noticed there was a piece missing in the scan. It wasn’t a critical area for fabrication of the restoration, but I voiced the missing piece to my assistant anyway. Hearing this, the patient said if further scanning was needed, it was okay to do more—that the treatment wasn’t bad at all.

Tips

ImageMy experiences with the 3Shape TRIOS have given me insight into how the machine works, and what dentists can do to improve the experience overall.

  • The ‘auto-align’ occlusion feature is incredibly accurate—the results are that even a model-less crown or onlay can be created with almost no adjustment needed
    • Makes the resulted occlusion on the created unit very accurate
    • Interproximal contacts are accurate
    • Makes seating and adjustments a snap
  • In the past, onlays have been very difficult to seat because of minute adjustments. Digital impression technology such as the TRIOS is ideal for onlays. With easy access to advanced materials and adhesives, onlays are easier to prepare. My hope is to see more onlays via digital impression technology because they are easier for the doctor and better for the patient. This is one way I’ve found the TRIOS makes it easy to do what’s right for the patient.
  • Image capture is better when patient isn’t breathing in and out of the mouth or when my assistant uses high evacuation suction. Pulling moisture away from the mouth allows for a faster scan. If the teeth are bone dry it is helpful, even if the machine says saliva is okay. I also found it useful to retract the tongue. Moving objects can allow the scanner to get confused.
  • Prep design is important. Make sure prep is supra-gingival. A soft tissue laser could be used for gingival troughing if a sub-gingival prep is necessary. Smooth, flat contours are great and easy for the dentist to create. Chamfer finish lines are unnecessary with bonded ceramics. A 2 mm clearance keeps material thickness appropriate for providing strong restorations. I opt for thick margins of 1.5 mm depth or more. Porcelain materials are reproduced better by avoiding feather edges.
  • Pick the right distributor and take advantage of customer support. Because 3Shape does not sell the TRIOS directly to dentists, your distributor is your first line of communication when you have questions or issues. My customer service for the 3Shape TRIOS is provided by CadBlu. I’ve never had an experience with a distributor like I have with CadBlu. I have found they have surprising sophistication a unit as new as the TRIOS. As distributors of several digital systems, their support technicians have extensive experience with digital impression systems—their knowledge of digital impressioning in general is very apparent. CadBlu’s support reps are very diligent about getting back to me in a timely manner. My assistants have also been complimentary of their service.
  • Utilize your staff. Not only am I proficient in the digital scanning process, but my staff is as well. Whether it’s before I get in the room, or after I deliver anesthesia to the patient, my assistant will typically capture both arches. After performing proper tissue management, train your staff to do everything else. It is important that you know how to operate the scanning technology, but your staff should be the experts. Not only will it be rewarding for the staff and make them feel like they are a valuable member of your team, it will allow you to see other patients while the scanning process is being completed.
    It takes awhile to figure out how to make this machine productive. There could be a productivity issue if you aren’t cautious. Combat this by teaching your staff how to use the technology—make them better than you. In my practice currently, the only thing that I do is confirm the scans of the prep and proximal teeth. The only way to make the TRIOS profitable for your practice is by stepping away from the impressions.

Software Updates

It seems like every time you turn around, companies such as Microsoft are introducing the next software evolution. But what exactly are they updating and how effective is it really? In dentistry, no digital imaging software is perfect, but I’ve found the 3Shape TRIOS gets closer every day. I’ve learned that 3Shape currently has more than 140 full-time developers working to ensure continuous innovation based on feedback from customers about their everyday use of the system.

Improving software is critical yet expensive, which is why it often lags in the dental field. Since my unit has been installed, there have been several software updates, and since the TRIOS’ inception, the software has been updated a total of nine times. Week after week, these updates show 3Shape’s commitment to continually improving the device. I am truly excited that 3Shape is so diligent about updating the TRIOS software.

The 3Shape TRIOS advantage

The advantages of integrating the 3Shape TRIOS into your practice are endless. With this technology, dentists can offer patients more solutions than ever before. Dental implants, digital implant scanning abutments, mini dental implants—these can become mainstays of your dental practice. The materials needed to offer comprehensive restorative dental procedures to your patients are right at your fingertips. Incorporating digital scanning technology into your practice is not only in your patients’ best interest, but financially speaking, it is in your best interest as well. Be an early adapter. With the 3Shape Trios, the future has arrived.

Review Synopsis

Product

3Shape TRIOS Digital Impression Solution

The Good

Digital impressions with 3Shape's TRIOS provide a simplified clinical workflow, improved lab communications, better fitting restorations and an enhanced patient experience.

The Bad

With any new technology, integrating the new workflow into the practice takes time, planning and staff involvement.

The Bottom Line

TRIOS digital impressions are accurate, easy to capture, allow practices more restorative options, and provide a more comfortable experience for patients.

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