6 exhibitors 2019 ASM — May 9, 2019 New scanner could move digital fence-sitters By Dr. Hsuan Chen Here in Toronto You can experience the ease of use and accuracy of the recently released Primescan intraoral scanning system in the Dentsply Sirona booth (No. 1103). A more detailed version of this article, “New Kid on the Block: Primescan and What It Means for Current and Potential Users,” can be accessed at www.cerecdigest.net. n The Primescan is the new intraoral scanner from Dentsply Sirona. For the dental professionals who are on the fence about join- ing digital dentistry, the Primescan presents an interesting choice. For the current CEREC users, on the other hand, social media might have just imploded with a collective, “It’s about time!” But how much of it is hype, and how much is grounded in practical truth? Our very own Dr. Michael Tsao spent some time with this new machine and noted both its apparent strengths and weaknesses. In this article, I will attempt to distil our internal discus- sions and offer some insights and analy- sis on this fascinating device. What is Primescan? You can read all about its technical achievements and specifications at www.dentsplysirona.com/primescan. In short, Primescan promises to be faster, easier to use and more accur- ate. At face value, these claims might not seem bold or even interesting, since every other major brand of intra- oral scanners have said similar things about their scanners. This time, how- ever, it seems like these promises are more than just marketing platitudes, as our analysis will show. But first, let’s talk about some physical comparisons between the Primescan and the Omni- cam. The interface The Primescan kept the same cart design as the Omnicam, albeit with some distinct differences in how you control the user interface. The mouse cursor is now controlled with a touch pad, with two smaller regions under- neath corresponding to the left and right mouse buttons. For CEREC users accustomed to the old scroll-wheel, it will take some getting used to. Not only is the track ball gone, the keyboard is removed as well for a clean and minimalist look. The battery is also apparently larger and actually able to support the use of Primescan without a power socket connection. The new touch screen is also 16:9 instead of 4:3, giving the user plenty more real estate to work with. Personally, I’ve had no complaints with the original design on the Omnicam, but these are definitely nice quality-of-life changes. If you want, you can also control the software via the touchscreen itself. The screen is able to move and tilt like the Surface Studio from Microsoft, offering an intuitive method of moving the 3-D models around. One the most common 5 The Primescan scanner. 5 The software can be controlled via a touchscreen that moves and tilts the perspective, providing a highly intuitive method of manipulating the 3-D images. (Photos/Provided by Dentsply Sirona). issues we see from new CEREC users at our training centre is their struggle with the track ball. It’s nice to see an update that shows some love for users who are probably already masters of the touch screen on their phones and tablets. In addition to its larger scanning field, the Primescan also uses specific wave- lengths 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 patented technology of image capture. As you will see in our analysis later on in this article, all this technology does seem to make signifi- cant differences. 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. in the CEREC software. And that’s why it’s exciting to see the new CEREC 5.0 A.I., because it is capable of self- learning. The more time you work with it, the better its automatic margins and restoration designs will be. The even better news is that the learning processes are aggregated and central- ized 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. Hands-on verdicts So, about those three claims made by Dentsply Sirona, let’s take a look at each one by one. 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? Yes. As a veteran Omnicam user, Tsao had 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 with- out breaks. Note that the scanner is also bulkier and heavier, so if you’re not into heavy scanners this might be a small issue. Is Primescan more accurate? Accur- acy can be divided into two compon- ents: trueness and precision. Trueness is how closely the data conform to reality (or the best approxi- mation of reality), while precision is how closely the data conform to each other. These two concepts are mutually exclusive, and therefore can be tested separately. According to tests completed at the University of Zurich, Primescan can achieve a local accuracy trueness of 14 µm and precision of 10 µm; and a global accuracy trueness of 32 µm and preci- sion of 30 µm. (Results of other scanners can be found in the Journal of Applied Oral Science article “Local accuracy values for desktop and intraoral scan- ners,” Heike, 2016 at www.ncbi.nlm.nih. gov/pmc/articles/PMC4775014). Final thoughts The release of Primescan at this time, along with its complementary soft- ware, is intriguing because it signals Dentsply Sirona’s push to capture a bigger share of the digital impression (DI) market. While in this article I focus almost entirely on the scanner, it is actually just the gateway into a whole slew of systems. For dental professionals looking to purchase their first intraoral scanner, the ease of use and accuracy offers immediate short-term benefits. At the same time, the A.I., the optional mod- ular software and great support com- munities such as CERECDoctors.com are valuable assets for the longer term. For current CEREC users, Primescan offers a fork in the road that we’re already traveling on. Assuming that the Omnicam will indeed get all the latest software updates, I feel that cur- rent users will be just as happy with either the Omnicam or the Primescan. If you are planning a gradual con- version to the new digital workflow in restoratives, implantology or orthodon- tics, then the DI-focused Primescan is a great first step into the ecosystem. About the author Formerly from Van- couver, Dr. Hsuan Chen now practices full-time in Taiwan. Chen is a lecturer at the CEREC Asia Training Facility and has a background in engineering. As chief editor of CEREC digest (www. cerecdigest.net), he writes primar- ily about the technological aspects of digital dentistry. 5 Dr. Hsuan Chen