UC’s Innovative Dental Student Treatment Plan Advances Dental Education

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“You don’t realize how important your back teeth are until they’re there,” said Minh-Tom Van (DDS ’23), a fourth-year dental student, as he reflected on a recent case. His patient suffered from pain in the posterior molars, unable to chew or eat properly for eight months. Although not an unusual situation, Van was inspired by a faculty member to come up with an exceptional treatment idea.

Minh-Tom Van, CU School of Dental Medicine DDS Class of 2023

When learning to take impressions, design crowns and restore implants, students at the University of Colorado School of Dentistry (CU SDM) learn two processes: digital and analog. Van thought, why not learn both at once?

“This is an exciting case because it is a step forward in the advancement of dentistry,” said CU SDM Clinical Associate Professor Brian Brada, DDS. “Students can learn to take a traditional analog impression on one side and a digital impression on the other. This is the first time we’ve done something like this here at CU Dental.

Van’s class was the first cohort of students to take a new course called Advanced and Digital Prosthodontics, where they have the opportunity to learn how to use a 3D scanner to take digital impressions. After getting his toes wet with an introduction, Van was eager to put it into practice. He worked with one of his mentors, Clinical Associate Professor David Gozalo, DDS, MS, to develop a treatment plan.

“It wasn’t a traditional aesthetic case where the goal is to create a smile that looks nice,” Van said. “It was more about restoring the function of the patient’s teeth and mouth. It was difficult for him to eat well. You don’t realize how important your back teeth are until they’re there.

A lifelong learner embraces students’ innovative ideas

Patient Dennis Thomas, a Vietnam War veteran and University of Colorado alumnus, needed six implants in total: three on one side of his mouth and three on the other. He has always been an advocate for continuing education, so when Van offered him the opportunity to be part of something new and improve student learning, he was more than happy to help.

“I was in the US Army Medical Command, so I understand what it’s like to be a student. That’s part of the reason I decided to have my dental work done here at school; I am happy to be part of their education and the first steps of their career.
– Dennis Thomas, UC dental patient

Thomas traveled the world with the army for 23 years Colorado to Missouri, Hawaii, Germany and back. He even spent time in a military medicine program in radiology at the historic Fitzsimmons Army Hospital, which is now the cornerstone of the CU Anschutz medical campus.

Thomas Fitzsimmons

Dennis Thomas in front of the historic Fitzsimmons building

As a lifelong learner, Thomas likes to stay busy, to say the least. Currently, he is a pilot, flight instructor, martial arts instructor, skier and snowboarder, photographer, jazz musician and scuba diving instructor.

“Education does not stop. I am in my 70s and every day I want to learn something new.

This impressive array of interests created a unique concern for his dental care: he had to be absolutely certain that there were no air pockets in his mouth. If it were to fly too high or dive too deep with an air pocket, the buildup of atmospheric pressure changes could cause extreme discomfort, or worse, it could burst and break the tooth.

“My dental team is very responsive to my needs,” Thomas said. “Like a bartender remembering your drink, they remember I’m a dive instructor and a pilot, and they always ask how everything is going. I can tell they’re not just asking to see how my mouth feels, but also because they care about me personally. It’s gratifying to see health care providers pay so much attention.

Thomas and Van particularly bond with their upbringing in Colorado: Both were born and raised here in the centennial state and attended the University of Colorado Denver for their undergraduate studies.

Van and Thomas in the clinic

Student Minh-Tom Van and patient Dennis Thomas at the UC School of Dentistry Student Clinic

Digital versus analog, from the perspective of the student and the patient

“I anticipate that the long-term results between analog and digital implants will be very similar,” Van said. “It’s like two different paths to the same goal.”

In a traditional analog process, the student takes gooey impressions of the patient’s mouth and sends the physical impression to a lab to create the implant crowns.

In a digital process, the student creates a 3D rendering of the patient’s mouth using a TRIOS 3Shape digital scanner. The implants are then designed in a computer program and milled using an Ivoclar milling machine, which creates an identical physical replica of the digital design, ready to be delivered to the patient in minutes.

“[Thomas] enjoyed the whole digital process,” Van said. “It’s much faster for the patient. Although it is more work for me as a student and for the consulting practitioner, it is worth it in my opinion to deliver quality treatment more efficiently.

3d rendering

3D rendering of patient’s mouth (left side) with digitally designed implant crowns shown in place

print model

Analog impressions of the patient’s mouth (right side) with physical implant crowns in place

Students learn the process of digital impressions as part of their curriculum, but historically they have sent the digital files to labs to create the implants. In this case, however, Van ordered all of the implant parts, digitally designed the crown with his faculty supervisors, and milled the implant crown down to the abutment himself.

This is the first time a student has completed the complete milling process, from impressions to delivery, all in the student clinic.

The final step is to make sure the implants fit properly, feel good, and work as close to natural teeth as possible. “That’s the goal,” Van said.

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During his first follow-up appointment, Thomas told Van, “I feel great. My bite is natural, the alignment gives me a beautiful smile and all the implants look like my real teeth. I am proud of the work that [Van] did. I really appreciate him and the whole team.

When asked what he was going to eat first, now that he had full functionality of his back teeth, Thomas replied, “I’m going to smoke brisket and ribs for my family this weekend. . I can’t wait to dig.

Dennis Thomas

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