Dental Asia March/April 2019

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In Depth With A Closer Look at Primescan After learning about its advantages, what follows is an in-depth article by Dr. Hsuan Chen from CEREC Asia Training Center, on his experience and views on Dentsply Sirona’s brand-new intraoral scanner. For current CEREC users, the new features have been highly anticipated. While for dental professionals who are thinking about going digital, the Primescan presents a competitive choice against the CEREC Omnicam and other scanners available in the market. What is Primescan? The Primescan is the brand-new intraoral scanner from Dentsply Sirona and promises to be faster, easier to use, and more accurate than the CEREC Omnicam. The Interface Though it keeps the same kart design as the Omnicam, the brand-new Primescan features an improved user interface – including a touchpad replacing the old track ball for easier cursor control, and the removal of a keyboard, giving the Primescan a clean and minimalist look. The new touchscreen now affords users a much-needed increase in real estate to work with – boasting an improved 16:9 ratio compared to the previous 4:3. Also, a more powerful battery can now support the scanner without a power socket connection. Touchscreen operation is available on the new PrimeScan. Source: Dentsply-Sirona Users may navigate through the software via the touchscreen, which pivots and tilts, allowing for a more intuitive method of moving 3D models around. The change renders the old control gestures of using the trackball obsolete, and ushers Primescan into the age where users control devices with swipe gestures – as learned from the use of mobile phones and tablets. The Scanner Side view VS index finger Bottom view VS molars The Primescan scanner might be mistaken for an Omnicam at first glance due to its similar design and colour scheme, but the differences are quite apparent once you hold it in your hand. The scanner head is substantially larger in dimension than its predecessor; the scanning area of the Primescan measures 15 mm by 15 mm, while that of the Omnicam is 10 mm x 11 mm. One of the biggest problems with small scanning fields on intraoral scanners is that it places computational strain on the stitching process because the amount of image overlap is smaller. After discarding extraneous noise, sometimes there simply isn’t sufficient data left for accurate calculations. Therefore, increasing the scanner capture size helps to preserve more data and thus better full-arch accuracy. Moreover, the added bulk seemed to have no effect on its usability. (Though whether this is true for patients with statistically smaller mouths, i.e. Asian females, remains to be seen.) In addition to its larger scanning field, the Primescan also uses specific wavelengths of blue light that, according to Dentsply-Sirona, can more accurately capture the surface data. Don’t confuse this blue light with the CEREC Bluecam, however, as the new Primescan uses a completely new method of image capture. As you will see in our analysis later on in this article, all this technology does seem to make significant differences, at least when compared with the Omnicam. The Software Admittedly, one of the changes that I am most excited about is the new design of CEREC 5.0 software. The blue background and button designs used in previous CEREC 4.x definitely looked dated (it was released in 2012, to be fair). Personally, I think they did a good job cleaning up the software interface. During the event, Dentsply-Sirona placed heavy emphasis on the new A.I. (Artificial Intelligence) in the CEREC software. A recent example of A.I. in the news is the AlphaStar from Google Deepmind that defeated two of the top Starcraft II players in a game thought to be impossibly complex for artificial intelligence. It was able to achieve this amazing feat by supervised training through millions of games. 76 DENTAL ASIA MARCH / APRIL 2019
In Depth With The blue light used by Primescan has less penetration, and therefore better surface capture. But in recent years, the word A.I. has become this overused marketing buzzword that conflates different categories of the technology into one general term. To make things more confusing, “A.I.” can technically refer to any kind of software that mimics intelligence and decision making. The old CEREC 4.6 also had “A.I.”, and look how that turned out. For this reason, it is very exciting to see the new CEREC 5.0 A.I., because it is capable of self-learning. So the more time you spend working with it, the better its automatic margins and restoration designs will be. The even better news is that the learning processes is aggregated and centralised at a main server controlled by Dentsply-Sirona, then distributed to all the end-users. This means that as a new Primescan or Omnicam owner, you can immediately take advantage of the most mature and smartest version of the software, trained by dentists all around the world. Is Primescan faster? Yes. Primescan does feel noticeably faster than the Omnicam, but keep in mind that the Omnicam is currently already one of the fastest scanners available. So how fast do you need, really? Is Primescan easier to use? Despite the changes, veteran Omnicam users will have no trouble adjusting to the Primescan on the first try. The new scanner’s large imaging area and increased depth of field (up to 20 mm) seems to keep the image capture more continuous without breaks and the addition of the touchpad and touchscreen improves user experience. Do note, however, that the Primescan is bulkier and heavier than the Omnicam. Is Primescan more accurate? Accuracy can be divided into two components: trueness and precision. Trueness is how closely the data conforms to reality (or the best approximation of reality), while precision is how closely the data conforms to each other. These two concepts are mutually exclusive, and therefore can be tested separately. According to Dentsply-Sirona’s own tests, the Primescan is able to achieve the following accuracy: Local Accuracy Global Accuracy Trueness: 14 μm Trueness: 32 μm Precision: 10 μm Precision: 30 μm A trueness value of 14 μm (microns) means that whatever you scan will be, on average, within 14 microns of the target object. While this is an excellent result, it is not unheard of. In fact, similar numbers have been achieved in other studies by CEREC Omnicam, 3Shape Trios, and a whole host of other scanners as shown below: For global accuracy, the numbers are a bit more interesting. You can think of local accuracy as how good a single restoration fits. Global accuracy, then, is how well a full-mouth appliance (i.e. clear aligners, bite plates, implant frameworks) fits. So an accuracy value as close to zero (perfect representation of reality) is desired. First, a global trueness of 32 microns is very respectable. For context, a study in 2017 compared four intraoral scanners and found that their global trueness ranged from 45.8 to 61.4 microns (see table 1). Now you can definitely find studies that shows even better results for a lot of scanners, like this, this, this, this and this study. Keep in mind, however, that there are a few ways to do global accuracy calculations (but let’s not get into it for now). For the purpose of this discussion, we can get a sense of a scanner’s performance based on relative values, and the Primescan’s results are looking pretty good. But numbers and figures can be misleading, especially those with business and financial implications. So we decided to test it for ourselves. Local accuracy values for desktop and intraoral scanners. Source: Heike, 2016.
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CONTENTS MARCH / APRIL 2019 18 24 2
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First Words The New Age of Digitali
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Dental Updates New VOCO Prophylaxis
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Dental Updates AACD Welcomes 2019 C
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Periodontal Disease Bacteria Linked
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Dental Updates Henry Schein One Acq
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Under the Spotlight 18 DENTAL ASIA
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Under the Spotlight It is easy for
Page 24 and 25:
Word of Mouth by Dr. Christoper Ho
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CELEBRATING DIGITAL TRANSFORMATION
Page 28 and 29: Dental Profile achieve very good re
Page 31 and 32: Dental Profile TAKING DIGITAL IMPRE
Page 33 and 34: Dental Profile The high-precision S
Page 35 and 36: Dental Profile MARCH / APRIL 2019 D
Page 37 and 38: Clinical Feature The importance of
Page 39 and 40: Fig. 8: X-ray after extraction show
Page 42 and 43: Clinical Feature Glass Ionomer Seal
Page 44 and 45: Clinical Feature Fig. 1.1: An erupt
Page 46 and 47: Clinical Feature 7 TH GENERATION AD
Page 48 and 49: Clinical Feature 1. Decay is noted
Page 50 and 51: User Report CENTION N: REDEFINING D
Page 53 and 54: User Report Amalgam GIC Cention N P
Page 56: User Report Fig. 15: Teeth 46 and 4
Page 59 and 60: User Report initial drilling channe
Page 61 and 62: User Report Fig. 16: Postoperative
Page 64 and 65: Behind the Scenes REPLACEMENT OF EX
Page 66 and 67: Behind the Scenes angles due to the
Page 68 and 69: Behind the Scenes and silanated for
Page 70 and 71: Behind the Scenes A JOURNEY THROUGH
Page 72 and 73: Behind the Scenes Fig. 11 Fig. 15 r
Page 74 and 75: Behind the Scenes The overall aesth
Page 77: In Depth With Fig. 1: Primescan - t
Page 81: In Depth With The first set of data
Page 85 and 86: In Depth With Extending Dental Oper
Page 87 and 88: In Depth With combines the cutting-
Page 89 and 90: Product Highlight BRAVIA ® XL Spec
Page 91 and 92: Product Highlight COLTENE Unveils t
Page 93 and 94: Product Highlight 3Shape launches T
Page 96 and 97: Show Preview 9 th -12 th June 2019
Page 98 and 99: Giving Back to Society February is
Page 102: Advertisers’ Index Advertisers Pa
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Dental Asia March/April 2019

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