From the Neolithic to the Digitolithic

Abstract

The successful Australian Dental Congress in Perth has just concluded. The choice of topics was interesting and really indicates to the editor what is contemporary. This led to a chain of thoughts about the development of dentistry over the last 35 years.

We talk about the incorporation of digital technology into practice and how we are changing from analogue to digital, but the congress clearly showed we are in the digital age.

Going back a couple of decades, endodontic canal preparation was undertaken using reamers and files with single GP points packed with accessory points. This has changed to rotary instruments and flowable GP. Imaging of teeth has changed from the PA to CBCT.

Implants fast became a vital part of practice and what was regarded as specialist level care is routinely undertaken. For those of you a little bit more mature, you will remember the use of radiographic templates. Today intraoral scans and CBCT are merged in planning software, which in turn is used to 3D print accurate guides for partially or fully guided placement. AI is used to position the implants. There was a phase of immediate implants 20–30 years ago, which reduced due to less-than-ideal outcomes. Once the reasons why had been elicited, dentistry has returned to immediacy, especially with modern planning. Intraoral scanning has replaced impression trays.

Orthodontics was once firmly the realm of the specialist, primarily using metal brackets and wires. The incorporation of intraoral scanners and the development of dedicated software now allows for the planning of cases from start to finish. This then opened the world of clear aligners, commonly undertaken in practice. Localising canines was done by peri-apical or occlusal films.

Dental sleep medicine was covered by many presenters in Perth. This field has recently been the topic of an Australian dental journal supplement and has come on leaps and bounds in the last decade. Arguably, the field did not exist 20–30 years ago and relies on digital technology for planning of devices.

Lastly, in this quick overview, the use of 3D printing and milling technologies has led to in-house crown fabrication. Maxillofacial surgeons can also prepare 3D frameworks to replace parts of resected jaws or plan and place implants in the tibia, allowing accurate positioning when the tibia is anchored into the jaw.

So, the editor would argue that we are now in the digital age, not a transition. Are you in the digital age also?

However, periodontics has not changed. We still need to physically remove deposits. The Egyptians did this, and in 100 years' time, oral health professionals will still be doing the same.

Ivan Darby: conceptualization, writing – original draft, writing – review and editing.

The author declares no conflicts of interest.