Understanding technology adoption by orthodontists: A qualitative study.

INTRODUCTION: Orthodontics is evolving with advances in 3D imaging, additive fabrication, digital scanning, and treatment planning. With digital tools, orthodontic treatment may become more predictable, efficient, and effective while reducing side-effects. These technologies are affecting patient care, but knowledge of their adoption patterns and influence is incomplete. We aimed to identify adoption decision makers, information sources, perspectives, incentives, and barriers. METHODS: Twenty-four privately practicing orthodontists were interviewed in a semistructured format following a topic guide. Interview transcripts were analyzed to identify factors in technology adoption and its perceived influence on practice. Thematic patterns were established through iterative systematic analysis, and qualitative validity was ensured with researcher triangulation. RESULTS: Qualitative interviews revealed that orthodontists make purchasing decisions independently from staff, after consulting other dentists and company representatives. Meetings, residency training, and continuing education courses are influential information sources, whereas research literature is not. Early and middle adopters are integrating digital imaging, planning, and fabrication technologies into practice and view enhanced ease of use, capabilities, performance, and procedural efficiency as primary incentives to adoption. Improving outcomes and patient comfort are not frequently cited as incentives, and all interviewees view cost as the largest barrier. Orthodontists positively perceive the influence of technology on their practices, but are concerned that further innovation and direct-to-consumer products will cause loss of market share. CONCLUSIONS: CAD/CAM appliances, 3D imaging, and digital treatment planning are viewed as future standards of care and are increasingly being incorporated into the orthodontic office. Understanding the technology adoption process can guide innovation to improve treatment and ease the transition into a digital workflow.

3D Volume Rendering and 3D Printing (Additive Manufacturing).

Three-dimensional (3D) volume-rendered images allow 3D insight into the anatomy, facilitating surgical treatment planning and teaching. 3D printing, additive manufacturing, and rapid prototyping techniques are being used with satisfactory accuracy, mostly for diagnosis and surgical planning, followed by direct manufacture of implantable devices. The major limitation is the time and money spent generating 3D objects. Printer type, material, and build thickness are known to influence the accuracy of printed models. In implant dentistry, the use of 3D-printed surgical guides is strongly recommended to facilitate planning and reduce risk of operative complications.

Optical Coherence Tomography.

Optical coherence tomography (OCT) is a noninvasive diagnostic technique providing cross-sectional images of biologic structures based on the differences in tissue optical properties. OCT has been widely used in numerous clinical applications and is becoming popular as a promising technology in dentistry. Today, dental hard (tooth) and soft (hard palate mucosa and gingiva mucosa) tissues are visualized with OCT. With new developments in technology, the applications of OCT are being investigated in various fields in dentistry, such as to detect microleakage around restoration, tooth cracks/fractures, examination of periodontal tissues/pockets, early detection of oral cancerous tissues, and in endodontics for location of pulp canal.

MRI for Dental Applications.

Imaging of hard and soft tissue of the oral cavity is important for dentistry. However, medical computed tomography, cone beam computed tomography (CBCT), nor MRI enables soft and hard tissue imaging simultaneously. Some MRI sequences were shown to provide fast soft and hard tissue imaging of hydrogen, which increased the interest in dental MRI. Recently, MRI allowed direct visualization of cancellous bone, intraoral mucosa, and dental pulp despite that cortical bone and dental roots are indirectly visualized. MRI seems to be adequate for many indications that CBCT is currently used for: implant treatment and inflammatory diseases of the tooth.

U.S. Dental School Deans' Perceptions of the Rising Cost of Dental Education and Borrowing Pressures on Dental Students: Report of Survey Results.

This report presents findings from a survey of U.S. dental school deans designed to capture their perceptions regarding the rising cost of dental education and its impact on borrowing by dental students to finance their education. The survey included questions about factors influencing the cost of dental education, concerns about dental student borrowing, and financial awareness resources for students. The survey was distributed to the deans of all 63 U.S. dental schools in January 2013; 42 deans responded, for a 67% response rate. The results indicate that, according to the responding deans, new clinical technologies, technology costs, and central university taxes are the main factors that contribute to the increasing cost of dental education. Coupled with reduced state appropriations at public dental schools and declines in private giving at all dental schools, dental school deans face a perplexing set of financial management challenges. Tuition and fees are a primary source of revenue for all dental schools; however, many deans do not have total control over the cost of attending their schools since tuition and fees are often tied to mandates and policies from the parent university and the state legislature. The findings of this study indicate that U.S. dental school deans are aware of and concerned about the impact of increases in tuition and fees on dental student debt and that they are using a variety of strategies to address the growth in dental student borrowing.

Dental technology services and industry trends in New Zealand from 2010 to 2012.

OBJECTIVE: To provide a snapshot of the New Zealand dental technology industry and influencing factors. BACKGROUND: Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry. METHODS: A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees. RESULTS: The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems. CONCLUSION: Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

Health technology assessment in oral health.

Health-care costs are rising at an alarmingly fast rate worldwide, particularly in developed countries such as the United States. This is predominantly a result of the development of new, high-cost health technologies intended for improved diagnosis and treatment. The purpose of health technology assessment is to systematically determine the true benefits of new technologies, taking into account clinical efficacy/effectiveness and cost as well as societal preference and ethical issues. In this report, the purpose of health technology assessment is explained in light of new developments in oral health technology, particularly intraoral implants. This information is intended to educate and to challenge oral health opinion leaders to consider all of the issues involved in the development and diffusion of new oral health technologies.

Implementation strategies for incorporating new technologies into the dental practice.

Staying ahead of the technology curve is an ongoing challenge for all dentists. Ignoring advancements in technology and the related improvements in diagnostics and delivery of care, as well as the impact technology may have on productivity in practice, is simply not an option for the modern clinician who aims to maintain a successful contemporary practice. This article delivers some insight into the challenges that arise when upgrades in technology and the related acquisition investment are considered.

Minimally invasive periodontal therapy: will periodontal therapy remain a technologic laggard?

Minimally invasive therapeutic approaches have become the standard of care for many medical procedures. In contrast, the use of minimally invasive techniques in non-surgical and surgical periodontal therapy has not progressed to the same extent. This commentary explores some of the technologic forces that influence the acceptance of minimally invasive therapeutic modalities. There is adequate science to support the development and clinical use of minimally invasive periodontal treatment but the technology to perform minimally invasive procedures is not currently available. Potential explanations for what seems to be a growing technologic lag are explored.

Digital dental photography. Part 1: an overview.

This paper is the first article in a new ten-part series on digital dental photography. Part 1 previews and outlines the contents of the subsequent papers and in addition, defines the aims and objectives of a digital dental image and the features that are required for an ideal intra-oral picture.