Digital synergy: a 21st-century concept in digital dentistry
A Dental Workflow in the Digital Era

Sebastjan Perko1, Tjaša Žnidarši?2, Bojan Vindiš1, Marko Berkopec1, Jelena Boži?1, Simon Bele3, Andraž Kocjan4 and Zhijian Shen5,

All dentists and dental technicians are very aware that the greatest challenge in the rehabilitation of fixed oral prosthetics is the transfer of information from the mouth to the dental laboratory, and its return in the form of the prosthetic for the patient with as few corrections as possible. Manual protocols and techniques have been researched and developed to the maximum and there is a concluding moment in the development of technologies where what is old can be replaced by the new: in this case the complete digitalization of fixed dental prosthetics. The approach is readily applicable in any clinical situation and especially useful where longer-term provisionalisation is required, e.g., after an endodontic treatment or increasing the vertical dimension of an occlusion. The direct provisional phase is always challenging, taking a great deal of in-office time, and rarely ensuring a perfect gingival fit and/or stability over the longer term, leading to inflamed periodontal tissues in the final cementation visit and poor adaption of the masticatory system, respectively. Professor Shen has developed the so-called “digital synergy concept”, which has been tested and is still in use at the clinic for comprehensive dentistry, i.e., Medical Dentistry. The concept is attractive because it reduces the need for proximity of the dentist and dental technician, it creates an accurately milled PMMA-based provisional restoration in a matter of just a few hours, and it enables the dentist to check the gingival fit and make occlusal adjustments, if they are required. After an intraoral scan of the provisionally fitted PMMA, the dental technician can prepare a perfectly gingivally and occlusally fitted, fixed ceramic prosthetic restoration. The concept was tested using the self-glazed zirconia concept, developed by Shen et al., but can be applied to the regular CAD-CAM machining of monolithic zirconia restorations as well. There are two digital synergy strategies: the first one for clinics that have an in-house dental technician and the second, the more important one (and Shen?s legacy), that enables full digitalization for every dentist. Both were tested and offer a completely viable concept. A clinical case of a total fixed prosthetic rehabilitation with increasing vertical dimension of occlusion will be presented using the digital synergy approach.

Keywords: zirconia, self-glaze, CAD-CAM, digital dentistry, dental materials

1 Medical Dentistry, clinic for comprehensive dentistry, Ljubljana, www.medical-dentistry.com, sebastjan@ustna-medicina.com
2 DSLab, Digital Synergy Lab, www.dsynergy-lab.com, info@dsynergy-lab.com
3 Medical Dentistry, dental office for comprehensive dentistry, Novo mesto, dr.bele@ustna-medicina.com
4 Department for Nanostructured materials, Jožef Stefan Institute, Jamova 39, 1000 Ljubljana, a.kocjan@ijs.si
5 Department of Materials and Environmental Chemistry, Stockholm University