In our practices, it is essential that the dentists, hygienists, assistants, management, and front-office staff, as well as the lab-side technicians, all speak the same language and understand the terms used in our profession. That default communication provides the foundation for every other facet of what we do. The same can—and should—be said of the digital technologies we use.
We constantly hear from manufacturers of digital dentistry equipment about how important an open platform is when it comes to fully realizing the ideal digitally enabled workflow. The benefits of such interconnectivity allow us to make use of these emerging technologies with minimal amount effort. The questions to ask are what does it actually mean to have an open platform, and are the platforms that claim to be open are truly open?
An open platform means that the platform can seamlessly exchange information with another, and the file formats used by the software and hardware do not require proprietary programs that have to be licensed from specific vendors. In the case of an intraoral scanner, for instance, an open platform would create a 3-D model that could be easily opened by a vast number of design programs, which would in turn be able to send to various printers or mills. This is essentially “plug and play,” as no extra steps or purchases are required to immediately make use of the technology.
Digital photography, for example, utilizes open format cameras, producing JPEG files that can be accessed easily by any other camera or photography-related program. JPEG files can be converted to other file types using one of these software programs, while its standard format remains usable by almost all technologies in the field. Were it a closed platform, one brand of camera would produce an image file that only certain programs would be able to open, limiting the use of the picture and the camera.
In dentistry, the most familiar closed platform technology we deal with on a daily basis is often our practice management system, which contains our outpatient records. Transferring a record from one system to another can be challenging. There is transferability between different practices as long as they are running the same version of a particular practice management system. Within the system, there may be radiographs, photographs, or even 3-D intraoral scans that can be attached to the patient’s record, yet the file as a whole is unrecognizable to other systems.
Radiographs can often be exported using various file formats, yet when they are imported into a different system, the quality of the image can sometimes be degraded. Ideally, when sharing radiographs, we try to make every possible attempt to use the same radiograph management program. When it comes to cone beam studies, most systems use the DICOM format, which is an open platform. There are a number of DICOM viewing programs from system to system, but in general we have found lots of interoperability when looking at the DICOM files acquired from various manufacturers of cone beam scanners.
In restorative digital dentistry there are three components: an image capture device or scanner, software to design restorations, and 3-D mills and printers that fabricate the prostheses. An open platform scanner generates a 3-D rendering of the teeth using the open STL file format. Currently, most manufacturers will use proprietary software to store and display the 3-D image. As long as we use the same system, we can store, retrieve, and design restorations. Interoperability without the STL format can be challenging, but as the technology advances, manufacturers are expected to move in the same direction as other technologies.
These many digital aspects of dentistry—as well as their unique challenges—illustrate why open platforms are pivotal to the successful integration of various technologies under one roof, as well as the ease of communication between the practices and labs that aim to use their files. If the file types being generated by one side cannot be opened by the other, it requires either third-party “middleman” software or the purchase of proprietary programs exclusively used to read those files—investments that may not fit the budget of each lab or practice. The need for open file formats goes beyond the current generation of digital dental tools; it informs the future of the field. Open platforms facilitate experimentation, innovation, and allow new technologies to emerge and become integrated almost immediately, having been designed using the same language. It is important that we focus on open platforms as the field of digital dentistry continues its rapid evolution.
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