Merging of the minds leads to 3D Virtual Print Lab

Located in the School of Dentistry’s Division of Radiology and Imaging Science (RIS) is a new 3D Virtual Print Lab capable of designing and manufacturing accurate life-size resin models of jaw bones, parts of faces and even entire skulls. These models help doctors plan surgeries and design surgical guides.

The lab is a joint initiative between RIS and the Department of Oral Health and Rehabilitation (OHR), in collaboration with UofL’s Additive Manufacturing Competency Center (AMCC) and the J.B. Speed School of Engineering. Researchers in these areas, along with biomedical engineers, are engaged in the evaluation of new printers and resins, as well as assessment of software applications for customized patient care.

“We have three Formlab2 printers in our lab, and access to a variety of 3D printers at UofL’s Rapid Prototyping Center, with an average turnaround time of just a few hours – depending on the complexity of the model or guide,” said Gerald T. Grant, DMD, MS, professor and interim chair of OHR. “These models and guides allow for better predictability of surgical procedures from facial reconstruction to dental implant placement.”

Grant says combining the expertise of engineers, prosthodontists and radiologists is “a recipe for innovation in the area of medical modeling and design.”

Under the leadership of Ed Tackett, director of UofL’s Additive Manufacturing ����ֱ�� and manager of the AMCC; Tim Gornet, manager of UofL’s Rapid Prototyping Center operations; and Grant, who also serves as president of the , UofL is establishing a digital health care innovation center.

According to Grant, the innovation center will make UofL experts available to develop research and consultation for start-up and existing commercial companies; train dentists and physicians for use of in-house printers and medical models; and explore biocompatible resins using materials like hemp oils, soybean and synthetic bone.

Facial 3D photographic suite

In addition to the new 3D Virtual Print Lab, the School of Dentistry has added a facial imaging system – 3dMD Temporal Face, thanks, in part, to funding from .

Using multiple cameras in the 3D photographic suite, the technology captures 10 frames per second for several minutes at high resolution, and automatically generates a continuous moving 3D image. Grant says this unique system captures a patient’s facial movement – much like video except with still images, and can be measured and registered to other software.

“It will be the only system of its kind in Kentucky, and is applicable to use with
oral-maxillofacial surgery and reconstruction, ENT and neurosurgical analysis for pre- and post-surgical intervention and full mouth dental reconstructions,” Grant said.

Training the dentists of tomorrow through the digital dentistry clinic��

A digital clinic for DMD students is scheduled to open in the spring 2018, complete with intra-oral scanners, computer-aided design and computer-aided manufacturing (CAD/CAM) and a milling station.

The digital dentistry clinic will give students greater access to practice and develop skills they already are learning through UofL’s digital dentistry curriculum. The intra-oral scanners have replaced traditional dental impressions needed for everything from crowns to orthodontic treatment. The CAD/CAM software will allow students to virtually design, form and shape a dental restoration. Students will then learn to use the milling station to create everything from crowns to veneers and fixed bridges.

Additionally, through work with prosthodontic faculty, students will have the opportunity to virtually plan and place dental implants. Students also will have access to SIMPLANT, an implant planning software needed for accurate and predictable implant treatment.

The new software allows the school to expand the implant curriculum for DMD students, and leverages imaging from cone beam computed tomography (CBCT), intra-oral scanners and laboratory scanners to guide implant planning from drilling to implant placement.

Sharing digital dental information enhances treatment

File sharing is critical to utilizing 3D imagery throughout a health care facility, and is the reason the School of Dentistry recently purchased INFINITT, a web-based 3D digital data system.

“INFINITT is the gold-standard for sharing 3D radiographic data between clinicians and between locations,” said William C. Scarfe, BDS, MS, professor and director, RIS, Department of Surgical and Hospital Dentistry. “The ability of this system to store 3D information, and interact with images at the chair-side will give our clinicians unsurpassed access, and provide our students an unsurpassed educational experience.”

Dental school radiologists worked with INFINITT engineers to build a system specific to the needs of the School of Dentistry, including a training template for students and residents on CBCT interpretation.

“While any dentist can buy a scanner and take an image, our graduates will be among the few who are trained to read the images for specific cases which will translate to improved diagnosis and efficient clinical outcome” said Bruno Azevedo, DDS, MS, assistant professor in RIS and lead clinician for the INFINITT project.

School-wide implementation of the file sharing software is underway, and endodontic residents are the first to pilot the school’s new educational imaging template.

During National Prosthodontics Awareness Week, April 2-8, the is educating the public about tooth replacement options and oral health issues.

“Until recently, false teeth looked and felt false. Prosthodontists are using digital technology to change the way dentistry is practiced and producing results not possible until now. We are using new techniques to replace and restore teeth to a higher level of precision and beauty than ever before,” said , professor and interim chair of the Department of Oral Health and Rehabilitation, UofL School of Dentistry.

How digital dentistry is changing practice��

There are a number of ways digital dentistry is changing the entire practice, including:

• Computers and scanning technology take tooth restoration to a new level. Teeth can be viewed in 3-D and restorations can be customized for each patient. This allows more control by the prosthodontist and better outcomes.

• Prosthodontists digitally capture information from the patient’s mouth, minimizing patient discomfort and reducing the number of appointments. Specialized training equips prosthodontists to translate the information into a patient-specific crown design, implant or other solution for improved esthetics and comfort.

• Prosthodontists using digital techniques and ceramic material can custom-design, fabricate and place a crown in a much shorter amount of time than in previous decades, in many cases the same day.

• Traditionally, removable dentures and conventional bridges were the sole means to replace missing teeth. Now dental implants, which are virtually permanent, offer improved function and comfort. Dental implants are mechanically and biologically superior to previous restorative options and do not overload or damage surrounding teeth.

“When you lose even a single tooth, it will result in bone loss, change the bite and result in adjacent teeth moving toward the missing space. The longer a person waits to get it replaced, the more challenging the clinical situation,” Grant said.

The UofL School of Dentistry covers the full scope of prosthodontic and restorative dental care, utilizing the latest technologies in radiographic imaging, diagnostic methods, advanced surgical and restorative techniques, and dental laboratory support.

Working closely with colleagues from various dental disciplines at UofL, comprehensive treatment is available for patients with challenging dental conditions and problems. Treatment is performed by licensed dentists in UofL’s highly-competitive prosthodontic residency program. For an appointment or more information, call 502-852-3482.