Beyond the First Impression

Dr. Jörg Schwarze Explains the Hidden Benefits of Digital Impressions


It’s no secret that digital impression systems like the new iTero® Element™ Scanner are light-years ahead of the traditional, tray-and-putty impression process. The accuracy of digital impressions is considered beyond compare, while the actual process is significantly faster and less labor intensive. While enhanced accuracy, shorter procedures and more-consistent impressions are the primary benefits of upgrading to digital, there are some clinicians who think the secondary benefits might carry more value.

“When treating a patient with Invisalign®, our decision to go digital was not only about improved outcomes or improved efficiency but also about patient communication.” says Dr. Jörg Schwarze, an orthodontist in Cologne, Germany. “You need to look at it from the patient’s side. They start out with nothing more than a piece of plastic that’s straightening their teeth. It can be really hard for them to see much value in that. But with the iTero Element Scanner, and being able to show them what I’m doing on screen, the patients suddenly see that piece of plastic in a different light.”

“Completing a scan takes us in the range of five to ten minutes. It’s so fast that sometimes we’ll scan the patient during the initial consultation, just to let the patient see what we’re seeing. When the patient can’t make up their mind, the 3D image of the teeth can be a deciding factor for a patient that’s not sure what to do. They now understand that there’s so much more going on than just a piece of plastic moving their teeth. When they can see part of what goes into making the aligners, it gives them more confidence about us and about their treatment,” Dr. Schwarze says.

Indeed, for many patients, it can be hard to understand the intrinsic value of a simple piece of plastic. This can be especially true for younger patients who have grown up in a time when technology has made so many incredible aspects of life seem ordinary. Look any further than the humble retainer, a similar plastic product that has a long and storied history of disrespect from teens. Teens tend to think retainers are more of a burden than a miracle of clinical and technological advancement.

For Dr. Schwarze, being able to show the impression on-screen, in real time, is beneficial. But that’s not the only advantage he’s got. With his iTero Element Scanner and the Invisalign connectivity, he can take things to the next level right out of the gate.

“We know it can be hard for patients to imagine what will happen with their teeth. You can tell them they’re going to have straight teeth, but it’s always better to be able to visualize the results. That’s where the Invisalign Outcome Simulator comes in handy; as we all know, a picture is always better than words.

When I activate the simulator, they can visualize everything that I want to do. I get to show them the technique behind that piece of plastic. Of course I always remind the patient that it’s just that—a simulation. It’s the computer’s guess as to what we can do, but it’s still my decision. So I don’t let them get too wrapped up in what they’re seeing. But it’s helpful.”

The iTero Element Scanner is Dr. Schwarze’s second iTero product. Neither he nor his staff have any fond memories of the PVS impression process.

“We have some assistants who are able to take fabulous PVS impressions. But conventional impressions sometimes get sent back because of some distortion or flaw…even when we’ve done everything correctly. My girls like the scanner now. If they had to go back to traditional impressions, they would be pretty unhappy about it. Yes, there was a learning curve, as there is with everything. We went from about 20 minutes per scan when we first started, down to about seven or eight minutes. I’d rather my team’s energies get used in more productive ways than PVS impressions.”

Which is not to say that Dr. Schwarze doesn’t appreciate the more ‘conventional’ benefits of the digital impression process.

“Of course we’re not buying the trays and PVS. But you really see the savings when you start looking at the cost per minute. Doing PVS impressions was much slower. Yes, you need to do a decent amount of digital impressions to get a ROI. But again, cost is just one feature. Think of it this way: you aren’t buying a Porsche or Ferrari for the MPG, you’re buying it looking for the performance and for the experience.

Plus, we know it’s generated some word of mouth. If one patient is talking to another, and they hear they didn’t need to get the traditional impression, then that’s a big deal. When patients get to see what the doctor is seeing. This makes it easier for the patient to justify the purchase in their own head.

A few years back I had a patient come in who I wasn’t able to treat because of her gag reflex. Well after hearing that we got the digital impression machine, she came back in. She still had some gagging reflex, but we were able to get an impression and start treatment.”

So what would Dr. Schwarze say if a colleague or fellow orthodontist asked him about going digital?

“If someone asked me about what it’s like to own an iTero Element Scanner, I’d tell them it’s a lot of fun for your staff. It’s easy to use. The software and touch-screen interface makes it easy to move around and navigate. You also get your ClinCheck so much faster. Most of our patients are really eager to begin treatment, and this cuts down on the time, which goes back to my original point, and that’s that it will have the biggest impact on the patient. And that’s why you should consider it.”


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