T-Scan® Novus™, a new generation digital occlusal analysis system from US-based Tekscan, Inc, specialists in the development of tactile sensors for pressure mapping and force measurement, is now available in Australia through Australian Imaging.
Launched in the US in September 2015, the T-Scan Novus is an evolution of the original T-Scan and features an ergonomically redesigned handpiece, sensors and sensor supports together with a full software update.
"T-Scan is one of those products you never knew existed, but once you find out and start to use it, you can't practice without it," said Dr Stephen Cross from Hawkesbury Dentistry in the outer Sydney suburb of North Richmond. "I first came across T-Scan at a trade show and have been using the original version for around 15 months now.
"Both the original and the new Novus utilise a handpiece that is fitted with interchangeable single-patient-use electronic bite pad sensors. The patient bites on the pad and the T-Scan software graphically and numerically records and displays an array of metrics on the dynamics of the patient's bite. It effectively measures the timing and force of the teeth coming together in the mouth and is like articulating paper on steroids.
Articulating papers are largely qualitative whereas T-Scan offers a quantitative method of bite and occlusion analysis.
"We insert the T-Scan into the patient's mouth and they bite down on the sensor. Rather than interpreting the remnants of the articulating paper left on the teeth visually as we're taught to do in dental school however, T-Scan gives you far more.
"Articulating paper is like a single photo of the point at which our jaws collide whereas we're living in the age of full motion video. With T-Scan, you can visualise the motion of the jaws coming together in a way that gives you definitive data. This can then be utilised to immediately correct issues relating to pain in and related to the mouth or ensure the occlusal load on the restorative or implant work you're completing is correctly balanced.
"We used T-Scan on a patient the other day complaining of pain and in minutes, we had isolated the problem to a single tooth that required a slight adjustment with a high speed to correct. It is the tool every dentist will want once they know it exists.
"It's also the perfect tool for the digital age. Every aspect of dental diagnosis today is benefitting from digital technology and occlusion is no different. If you're into cone beam CT, intraoral scanning, CAD/CAM and digital dentistry, then the T-Scan is a perfect fit. And if you're not, you will love it anyway."
Crown and bridgework
Fitting crowns and bridges requires skill and precision to ensure a balanced, functional and aesthetically pleasing bite. T-Scan provides dentists with digital bite force data, helping to analyse the occlusion of a patient undergoing restoration procedures. Computerised occlusal analysis aids in identifying regions of excessive or non-uniform force, giving the dentist knowledgeable control over the adjustment process. T-Scan ensures prostheses are loaded in harmony with the rest of the natural occlusal surfaces to minimise fractured porcelain; broken prostheses; bruxing; interferences; and uncomfortable high spots.
Proper implant loading
T-Scan allows dentists to use timing and relative force measurement data to determine when and how pressure is being distributed per-tooth. Implant loading alerts in the new software warns users if the implant is sustaining a large percentage of occlusal force or hitting early in the bite sequence. This means you can protect implants from damaging occlusal forces before it becomes a problem. Using T-Scan in a mixed implant-natural tooth dentition prevents ceramic fracture; screw loosening; cementation compromise; destruction of soft tissue; and loss of alveolar bone.
The new T-Scan Novus handpiece has been upgraded to improve efficiency in a clinical setting, such as an easier-to-hold handle, chairside sensitivity adjustment buttons, handle latch redesign, wall attachment and user-replaceable cord. The accompanying software release comes with user-inspired improvements, such as sensitivity adjustment wizard, the ability to disregard artefacts from overjet/overbite from Class II occlusions, auto-typing (categorisation) of multi-bite scans, more accurate ABCD closure timing lines and improved implant loading alerts.
Intraoral scanner integration
T-Scan software now allows digital impressions from intraoral scanners to be imported, allowing analysis of bite forces on both arches with upper and lower arch displays in 2D and 3D. The software also allows identification and removal of potentially damaging forces on implants with automated implant loading alerts; Visualization of contact points overlaid onto digital impression models from your intraoral scanner with the new Digital Impression Overlay feature; Quick installation on any Windows 8 supported device including tablets!; Exporting of scans to MP4 files and sharing of movies including in dynamic reports created for patients to take home while they consider your treatment plan.
Dr Cross said that the training he received with the T-Scan and his own experience has led him to support the belief that excessive and unbalanced occlusal loading causes sensitivity.
"Upper erosion, abfraction and sensitivity from the canines back can be attributed in many cases to the torsional twisting force on your teeth caused by problems with the bite," he said. "We heard that in the training and in practice, I have seen how a small adjustment in a problem area identified with the T-Scan in some cases immediately addresses sensitivity issues. If you adjust the bite properly, people use desensitising toothpaste far less.
"The research shows we only get the occlusion right 12% of the time with articulating papers. There is a lot of guessing and intrepretation with paper; T-Scan, on the other hand, shows loading of the teeth in real time with great accuracy.
"We used the T-Scan on a patient in pain the other day and it showed that 46% of his bite force was delivered to the upper right six. We adjusted that over two sessions over two weeks and it was fixed. You can make a tiny adjustment in the exact spot with a high speed and/or a polishing rubber and the problem is gone.
"Another example is when you're short on contact in the anteriors. T-Scan instantly identifies the problem areas and we can then do simple resin build ups on the palatal surfaces."
Dr Cross said T-Scan plays two valuable roles in his practice.
"It's a great diagnostic tool to use on patients who present with symptoms of pain on the one hand and on the other, it ensures the bite is right when we complete complex restorative work.
"T-Scan is one of those tools that flies under the radar and no one knows about it. It's not a miracle cure, but it gives you incredible diagnostic information in real time. It takes the guess work out of occlusion. It's a live view of what happens when someone bites. It shows tooth loading, quadrant loading and the final bite force. It shows when you achieve centric occlusion or when protrusions are present. Once you can see in real time where the loadings are, where they come and go and where they stay, it makes life a lot easier."