By Neal Kravitz
With the incorporation of intraoral scanners and 3D printing, orthodontists now need a digital method to replace their paper laboratory prescriptions. This CTech blog reviews the benefits of digital laboratory prescriptions and the steps necessary for their implementation. The workflow challenges of submitting digital prescriptions will also be discussed.
The essential function of digital laboratory prescriptions is to allow an orthodontic practice to communicate with their in-house or commercial laboratories. These prescriptions can also have attached digital files, such as JPG, PDF, and STL. Now, the orthodontist will be able to send a digital prescription along with the patient’s digital scan and any pertinent records immediately to their laboratory technician.
Digital prescriptions offer numerous benefits. Primarily, they standardize the laboratory process, which is particularly helpful in a multi-office practice. Other notable benefits include managing all prescriptions, storing prescription data, and improving communication with the laboratory technician.
The two methods currently available for submitting digital prescriptions are: (1) to log-in to your laboratory’s website portal and submit the digital prescription directly or (2) utilize a third-party digital prescription software, such as a EasyRx.
EasyRx uses a universal digital prescription form that can be submitted to any connected laboratory. Laboratory connections are made during the initial setup, but other laboratories can be easily added later. If EasyRx is not yet connected with a desired laboratory, they can be emailed an invitation to sign up for a free account through the software.
The software creates digital prescriptions from prescription templates stored in its Universal Library. These templates include a digital illustration of the appliance, which can be customized by adding or removing parts through drag-and-drop (Figure). Comments also can be added to the digital prescription to provide additional instructions to the laboratory technician.
An office can easily add prescription templates for its preferred appliances by emailing handwritten prescriptions to a customer representative. For example, an office with a particular Herbst design can create a new prescription template with a saved digital illustration. This further facilitates standardization and delegation of the prescription submission process.
This software does more than simply create digital prescriptions, however, it also prepares the STL file for 3D printing (hollowing and basing the digital model), tracks laboratory shipments including to commercial aligner companies, and creates prescription invoices. It was developed in 2013 originally to help manage an orthodontic laboratory, but has since been reengineered for use in private practice.
EasyRx is a web-based application hosted on the Amazon Web Services cloud platform. It is compatible with both Mac and PC computers, and operates on all major Internet browsers. Most importantly, EasyRx integrates with all practice management and intraoral scanner software, including: Dolphin, CS OrthoTrac, Cloud9, topsOrtho, Oasys, iTero, TRIOS, Carestream, and EnvisionTEC.
Getting started and Challenges
To start a digital prescription, the software program is accessed through the patient’s digital file in the practice management or imaging software. An office that uses Dolphin, for example, can launch the program from the Integrations tab on the left side of the screen. Data sharing between these systems is seamless, and the patient’s information is automatically loaded into the digital prescription.
Submitting digital prescriptions, however, has some challenges. The submission is often delegated to a technician who may select an incorrect template, which may then cause the wrong appliance to be fabricated and delivered to an office. More commonly, the technician simply forgets to submit the digital prescription, as there is no plaster model to serve as a physical reminder.
To ensure the correct prescription is selected in a timely manner, an office can create a template prescription for every variation of an appliance, and then submit the digital prescription immediately after the intraoral scan. An estimated six months should be given for an office to become proficient with digital prescription submissions.
Digital prescriptions are a bridge between the intraoral scan and the appliance fabrication. Whether an office owns a 3-dimensional printer or not, digital prescriptions are a necessary progression in the new digital laboratory workflow.