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3 tips for moving to a digital ortho-restorative workflow

Nov. 28, 2021
Digital workflows provide tangible advantages in both orthodontic and restorative cases. Shaun Keating, president and CEO of Keating Dental Lab, offers three helpful tips as you consider a digital transformation.

Like many laboratories around the country, the Keating Dental Lab team has long prioritized agility and innovation. Both are crucial elements to delivering exceptional products and services, thus improving the customer experience. Being agile and innovative allows our laboratory to ideate, plan, and implement with relative ease, positioning us to adapt systems and processes that deliver return on investment quickly and efficiently.

For restorative and orthodontic case projects, we have found that the implementation of fully digital project workflows—primarily built around intraoral scanning—has significantly improved our key metrics. Many of our dentist partners have adopted Align Technology’s iTero intraoral scanner, which has provided our lab and customers with tangible advantages in the areas of scan quality, project collaboration, and support and service.

Ultimately, moving to digital workflows has reduced our time to production and improved consistency. Consequently, we have been able to take on more customers and cases, thereby increasing revenue.

As you consider your digital transformation, we are sharing our top three lessons learned that might help you through your digital journey. 

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Prioritize communication

Digital project workflows create a seamless handoff of patient information from dentist to laboratory. It’s remarkably easy. So easy, in fact, that it creates pathways to become more efficient and effective, so you can spend more time on strategic aspects of your business. Maintaining clear lines of communication between lab and dentist is essential.

When my laboratory receives an intraoral scan, if something is not clear, we can immediately reach out to the practice to clarify details, and more importantly, avoid problems. We prefer to handle this strategic business component by discussing the doctor’s requirements and letting the system take care of the logistics, such as logging patient records and collating all relevant case details in one easily accessible place.

From a clinical and patient impact perspective, the potential upside here is significant. Since digital is now our primary fabrication method, we have had several cases where an office sends over case files and recommends a complicated treatment plan. From one file, we can sequence and produce implant-based restorations, crown and bridge, and veneers. In the analog world, this was mostly accomplished through multiple impressions and try-in appointments. We have also observed iTero scanner users’ ability to produce restorative cases more predictably, due to first moving teeth and roots into proper position and being more conservative in tooth preparation. This sequencing improves patients’ acceptance of treatment plans.1

Optimize through synergy

In the “age of optimization,” the number of available operational synergies is almost staggering when moving to digital workflows. For ortho-restorative work specifically, it’s worthwhile (where possible) to work with practitioners well versed in one consistent, integrated technology platform. 

For example, we have found our postorthodontic restorative work has been significantly streamlined when our customers use both Invisalign clear aligners and the iTero intraoral scanner to submit cosmetic cases. Because the diagnostic and workflow components are part of the Align digital workflow, our job is much easier when it arrives at our laboratory. When these cases come in, we can produce outstanding restorations in less time, as the foundation was already laid through robust preoperative planning and orthodontic treatment.

Validate diagnostic data

Digital project management makes data curation and organization inherently easy, but it is still up to the users to ensure they are focusing on the right variables. First, you need to ensure that the scan received is accurate. Although technology has come a long way in bridging the gap, the potential for operator error is still a possibility. Fortunately, modern systems (including the iTero family of intraoral scanners) allow rapid validation features, helping identify potential errors before they become true problems.

Additionally, you should have a robust set of intraoral photographs to supplement the clinical data. There is no need to reinvent the wheel here; the American Academy of Cosmetic Dentistry (AACD)-recommended clinical photography sequence is perfectly suitable. Specific photographs that we find helpful for a range of cases include (1) preoperative dentition, (2) stump color, and (3) patient-approved provisionals.

The takeaway

The most significant advantages of making a move to a digital workflow are simplicity and predictability. Evolve your dental office to best practices for the digital age with the ultimate goals of ensuring your tools, processes, and technologies are working to provide the most value for your patients. With a strategic approach, significantly improving day-to-day efficiency through digital workflows is not just a concept; it can become your reality.  

Editor's note: This article appeared in the November 2021 print edition of Dental Economics.


1. 100% of surveyed users agree that iTero Element 5D imaging system enables better patient education and understanding of their oral health, leading to an increase in patient acceptance of treatment plans. Data on file at Align Technology. November 15, 2019.

Shaun Keating is the president and CEO of Keating Dental Lab (formerly Keating Dental Arts), based in Irvine, California. He can be reached at [email protected].

About the Author

Shaun Keating

Shaun Keating is the president and CEO of Keating Dental Lab (formerly Keating Dental Arts), based in Irvine, California. He can be reached at [email protected].

Updated October 4, 2021

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