Episode 621: 3D Facial Scanners, 3D Printers, AI and How to Transition Into a Digital Practice

The less that the clinician has to do, the more that the computer can do, the better it's going to
be for your practice, the quicker things can get turned around. Guests will need a little
paintbrush to be able to do a little bit of design here and there, but for us to just be able to
fine-tune is going to be the real answer to that. Welcome to the Phil Klein Dental Podcast.
Today we'll be discussing how 3D facial scanning and 3D printing can offer the clinician tremendous
advantages to aid in the diagnosis, design, and fabrication of full-arch dentistry.
We will also discuss how to best transition our practice into the world of digital dentistry.
There's no question prices have come down. And according to our guest today, a dentist can equip an
office with a full suite of digital technology for $25,000 or less. We will also discuss the
future of digital dentistry and how AI will play a part in everything we do as clinicians.
Our guest is Dr. Isaac Tawil, who has an extensive history in the dental field and is a recipient
of two coveted awards, the Pierre Fauchard Award for Outstanding Achievements in Dentistry and the
Presidential Service Award. He is the founder of Advanced Implant Education and is a new product
consultant for several dental companies. Dr. Tawil continues to lecture and run hands-on workshops
worldwide and enjoys his private practice in Brooklyn, New York. Before we get started,
I would like to mention that Dr. Tawil’s webinar titled Digital Implantology, Advancements,
and New Techniques is now available as an on-demand webinar on VivaLearning.com. It's a great
webinar, and if you're interested in learning how technology plays a role in implant treatment, I
highly recommend this webinar. Simply type in the search field on VivaLearning.com, Tawil,
T-A-W-I-L, and you'll see the webinar. Dr. Tawil, it's great to have you back on the show.
Thanks. Pleasure to be back here. So to begin, Dr. Tawil, tell us how facial scanning has been a
real game changer for you. And you're an implantologist, so obviously it's directly related to your
implant work. Until now, we've had some really nice apps, I would like to call them,
to be able to capture the face in terms of three dimensions. Prior to that, the best that we had
was just a 2D picture. So we'd take a nice 2D photo, and then we'd try to do a smile design.
But not about you, Phil. I don't live in a two-dimensional world. We live in this three
-dimensional world. Maybe Austin is in two dimensions, but in New York, we still have three
dimensions. When I get pickpocketed, I get all my pockets picked, not just the one plane.
Definitely New Yorker. So we have to watch for our patients in that same way.
The best thing that has come along has been these 3D facial scanners. Some claim that they're not
exactly one-to-one ratio, but I defy you to show me a two-dimensional camera that's even
remotely close to one-to-one ratio. So the fact that we're almost at one-to-one ratio is really
remarkable, and we can do some amazing things. Let me give you an example of that. We can take
someone who was the dentualist, make a small design for them, and be able to give them teeth. Very,
very quickly, you can do a trying, whether that be for digital dentures or whether it be for
something on implants. I'll tell you a quick little story about a recent patient of mine. Dr. Tawil
will be right back in a moment. But first, when it comes to digital workflow equipment, it's
important to partner with companies that provide premium products with unparalleled service, all at
an affordable price. That's why you should check out Shining 3D Dental. a company that offers a
complete and integrated suite of high-quality and easy-to-use digital dental equipment.
Their local offices are based in California and Florida, so you get in-time comprehensive support.
In fact, Shining 3D Dental can furnish your office with an entire suite of digital equipment for
under $27,000. This includes their AoralScan 3 wireless intraoral scanner,
Metasmile 3D facial scanner, and the Acufab 3D printer with its post-price.
We had a patient that we had treated for an upper fixed.
uh appliance a screw retained hybrid appliance zirconia his he had a lower previously before that
he had a denture on on the top and he was looking to do these teeth same day or next day which we
did we did that at rural dental laboratories out in cleveland ohio we did a live surgery in front
of a bunch of doctors the surgery went great healing went great and we made him his final teeth
about a year year and a half later he came in and he had problems with his his lower right implant
we had not placed those implants and it was clearly failing on the x-ray now this lower hybrid
design it was a good design but we had to now remake this whole thing because we had to instead of
losing one implant we put two in its place and now we had about seven implants we had to capture
and he threw in a little caveat in there he said you know since i were doing this over do you mind
redoing the upper for me as well i asked him why he had always felt that his lip was covering too
much of the teeth The dentures were so long, he didn't even think about the aesthetics of it, and
we really didn't look at it. We were just so happy to give him fixed teeth, and we didn't know what
he looked like prior. He barely showed about a millimeter or two of his upper teeth, which is
common. We brought in this picture, and we actually posted this on our Facebook group, on the
Chrome group on Facebook, and you can see his old picture, and you can see all his teeth. So what
we did was we used his old scans for the top teeth. His new scans for the lower teeth,
we used something, so a mixture of some photogrammetry on the upper, some what we call grammetry,
using an OptiSplint device on the lower so we can scan. And in one sitting, we took impressions.
We used our old impressions for the upper. We borrowed three millimeters from the lower, added
three millimeters to the maxilla. And like that, we gave him back an extra three millimeters.
And his face that day, when I saw him, he was elated. So happy that...
took no time at all because he lives out in Cleveland, Ohio. He flew into New York, took his
impressions. Then I went back out to Cleveland to insert this for him as a favor. And it was my
pleasure, too. He's a great patient. And let me tell you that when he left, it was really
remarkable, the difference in his face and his smile. And then his confidence just went way,
way, way, way up because now he could see his teeth again. And we actually met up in Las Vegas last
weekend. We were out at the Serona World, the S-World. And he was out there for just a random trip
with his family. We met up, we had a drink, and his smile was ear to ear, which is wonderful. As a
practicing clinician, it's one of the things you really want to see. Your patients are truly
enjoying the teeth that they have. And you can do all this hard work and it could fail. And you're
really happy when things are successful and they work in the right way. Utilizing this digital
technology, we're able to utilize every little inch of that technology to give us the full scope
and provide him. with the ultimate treatment in just two visits, which is really remarkable. Yeah,
that's an amazing story and very gratifying without a doubt. And I'm glad you shared that with us.
But in reality, with your expertise and your years of doing implants, and you're an evaluator for
many manufacturers, you're exposed to all the newest gadgets, all the newest innovations in dental
technologies, in digital workflow. But for the average dentist who's out there that wants to do the
best. It's very complex for them in many ways to purchase,
integrate, train, and utilize all these different technology tools where they're not buying
something they are just going to sit on the shelf and they won't use. So what recommendation can
you give our audience for moving into these types of digital realms where they can?
utilize these incredible things like facial scanning what is the best way to enter this world where
you take kind of one step at a time and build your entire office utilizing these very very
beneficial technologies well the first thing like anything else that we do when it comes to being
an educated consumer is to do our research you want to look around see what is talking to you
what's exciting to you you'll look out and see intro scanners which is the right internal scanner
for you the second thing is to look at a total solution it's nice to be able to say does the
company that i'm about to work with i'm going to buy even one product for have a good history
number one are they a big company are they going to fold over tomorrow or are they going to be
around for a while and are they do they have all the different technologies that i can upgrade to
let's say i'm not ready to make a big purchase because back when i first started to go into
something like and i'll use serac as the example this that that world that was a hundred thousand
dollar expense that's a very big nut to crack and how much when's your roi going to actually come
back to you nowadays we can do a lot for less which is what's important the competition is out
there it's very fierce A lot of these companies with the competitiveness with each other brought
down the price so we can become an educated consumer. But a lot of times you get what you pay for.
So you look at them and you say, is it really worth it? Is that right? So you have to be able to go
out and try the devices, utilize them, take some courses. Don't be afraid to just say,
let me go and see a course that's out there utilizing this technology. Let me take advantage of
that and try to practice on it either on demos or on live patients.
something that is very easy to accomplish these days. There are training centers all over utilizing
different technologies. Once you can grasp that and have the comfort level of it and see that it is
right for you, then you're becoming an educated consumer. Now you're going to be in the right spot
and you'll start to utilize it right away. The worst thing that we can do is to spend thousands and
thousands of dollars on products and then they just become oversized paperweights for our office.
We really want to be able to embrace the technology, utilize it, and see the return on your
investments literally immediately. We don't want to wait a year or two years to see the return on
investments. We don't buy impression material in our office anymore. We have, I shouldn't say that,
very much impression material. The only time we use impression material is to do corrections. If
something came out and we didn't like the way it was, it's a good structure. We want to copy it,
send it back to the lab, and add a little bit of porcelain here or there. That's typically what we
would do. Otherwise, we really have no need for impression material as a whole. Between desktop
scanners that we have in the office, of which we have two, all the intraoral scanners, the facial
scanner, the CVCT, we can get everything that we need to be able to provide our patients with a
seamless digital workflow for 98% of the cases. That was well said.
And it seems to me, practicing in your environment with your experience and knowledge and
confidence with these digital... It must be a lot of fun to practice dentistry. It is a lot of fun.
It makes dentistry more exciting. When I first started, I didn't love dentistry. I'll be honest
with you. My father being a clinician is part of the reason that it went into dentistry. So I did
nothing more than just going to my father's business like a lot of my friends did. We'll be right
back with Dr. Tawil in a moment, and he's going to talk about how digital dentistry really got him
excited about practicing dentistry. Very interesting stuff. But first, as dental professionals, we
know that the right autoclave can enhance your patient flow and help build a more profitable dental
practice. It's all about keeping things moving. Chamber autoclaves are great for reprocessing large
loads, but sometimes you need a few hand pieces fast, and you don't want to wait to fill a chamber.
That's why a lot of dentists choose the Sycan Statum 5000G4. While the look has changed over the
years, inside, Statum still uses a reliable, innovative steam technology developed 30 years ago
that continues to deliver instruments in some of the fastest times in the industry. It's one of the
best-selling autoclaves in the world, and its reliability has made it the workhorse sterilizer in
dental offices across the United States. To learn more about how Stata may be right for your
practice, visit psycan.com. But once I got into dentistry, I started to see some excitement.
There was excitement in endodontics, the rotary endodontics coming out, implantology, and then
digital dentistry really hit the sweet spot for me because it took all my favorite things. The
iPhones, Macs of the world and computers of the world that I love to play with outside of my office
and now be utilized inside my office. A lot of fun toys, a lot of interesting things.
So when the first extra oral scanner that I ever used was actually on a car.
We were taking an old car apart and we needed a certain size part.
We actually used a scanner, an extra. what we would call extra oral scanner,
and we actually scanned the car. This wasn't me doing it. This was at a auto body shop, and I was
blown away. I said, why don't we have that in dentistry? We have intraoral. Why don't we have
extraoral? Before you could blink, there was three or four different models. This new one that
we're using now, the Metasmile from the Shine 3D, again, great, great, great extra oral facial
scanner and extremely affordable, which is key because you could say, well, those toys are just for
the hoity-toity upperclassmen, but no. This is now affordable for anyone who wants to go and
purchase it because for the price of one intro scanner, let's say a couple of years ago, I can get
a facial scanner, desktop scanner, 3D printer, intro scanner, the works, the whole suite.
And you can look around now, roughly around $25,000 and you have everything that you want at your
disposal besides a mill, which I'm not, I'm not certain that everyone needs to have a mill anymore.
These days we'll see what's coming in the near future. It sounds like we may not need them as much,
but for now they're still. commonplace in dentistry, and they'll be around, I know, for many more
years, but it seems like we're switching over towards printed products, and hopefully for the
better. Yeah, as those printable resins get stronger and stronger, and they get closer, they're not
going to reach zirconia level, but as you said, I wouldn't be surprised. You never know, though. We
may get there. We may actually get some improvements. It's not about how strong the substance
necessarily needs to be. Sometimes the flexibility. is just as important. A lot of fractures that
we have from zirconia because we don't have that flexibility. We don't have that flexorial
strength. It doesn't have, it has a point to break and then it cracks and propagates and, you know,
it's game over from there. At least these resins are repairable if need to be. And again, so fast
to print, we can get them done with in no time having a backup in the patient's chart or giving the
patient two or three backups and saying, here you go, if it ever breaks, you have extras. the
affordability of it. As we get older, things change. Our gingiva changes. We end up with more food
traps on these full arch cases. It's so much nicer to just say, let's just rescan and just make
another set. It can be done within a matter of a couple of hours. That's really where we need to be
at. And I'm sure the printers are going to even get faster than what we have now. It's been really
remarkable to watch the evolution of these 3D printers over the last 10 years. incredible how
quickly they've embraced the technology, how quickly the resin materials have changed, and how many
things are coming down the pipeline. So Dr. Tawil , as we wrap up this podcast, tell us what you see
in the future. Let's go five years ahead. What do you see as the major advancements in technology
that will affect the way we practice dentistry? Two letters, AI. And that's the big thing.
The less that the clinician has to do, the more that the computer can do, the better it's going to
be for your practice, the quicker things can get turned around. Yes, we'll need a little paintbrush
to be able to do a little bit of design here and there. But for us to just be able to fine tune is
going to be the real answer to that. As robotics enter dentistry, as more and more of these digital
technologies enter. It's even more important for this AI technology so that we can have all this
technology utilized appropriately because my time is best served working on patients, not working
in a laboratory where a lab technician is supposed to be involved. So as that AI gets better,
there's less stress on the lab technician and the clinician is able to utilize all of these
features in a timely manner instead of having to wait two weeks for a crown to be made. Maybe it
can be done in a half an hour or so. utilizing this AI technology. Yeah. The more you talk,
the more I think about how I got out of clinical dentistry way too early because I'm missing all
the fun. I'm doing these podcasts. It is a lot of fun. The podcasts are great. I get to look at the
technology of microphones and sound devices and audio interfaces, but I'm missing out on all this
great stuff. All right. Well, Dr. Tawil, as usual, fantastic discussion. We're looking forward to
having you on several more podcasts going forward as we discussed. Have a great evening and thank
you so much for your time. Thank you all. Appreciate it. If you've been enjoying our podcast, we'd
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