short communication successful development and
TRANSCRIPT
358
Abstract: Introducing new technology in the dental school curriculum may face some uphill challenges navigating through university-level bureaucracy, financial ramifications, and influencing the mindset of certain faculty. A dental school that relies heavily on teaching traditional restor- ative procedures may particularly face many challenges to embrace new technology. The restorative department at a US dental school created a division of computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry to introduce the concept of digital dentistry to dental students and faculty. This article describes methods that were adopted to improve acceptance and increase the productivity of chairside CAD/CAM restorations for both students and faculty at the dental school in US.
Keywords; CAD/CAM, curriculum, digital dentistry, US dental school
Introduction
Although the fundamental motives behind restorative dentistry have not changed, the production, materials, and delivery methods for restorations have significantly improved due to the introduction of digital dentistry [1]. The Commission on Dental Accreditation (CODA) standards require all dental schools to provide faculty development programs to help educa- tors keep up to date with new technologies [2]. Recognizing the value of digital dentistry for dental education, Oregon Health & Science University (OHSU) School of Dentistry (Portland, OR, USA) decided to introduce education on chairside computer-aided design and computer-aided manu- facturing (CAD/CAM) systems in the curriculum. The goals were to update the restorative curriculum and provide the students with experience and understanding of chairside CAD/CAM systems.
The purpose of this short communication is to describe successful development and implementation of a chairside CAD/CAM restorative curriculum at a US dental school. The hope is that the details of the US example can serve as guidance on how chairside CAD/CAM systems can be introduced into the curriculum of Japanese dental schools.
Each phase of CAD/CAM implementation in clinics Phase 1: Introduction of chairside CAD/CAM to the school for faculty and students revitalizing the CAD/CAM dentistry program The curriculum of the chairside CAD/CAM restorative program started as an elective program, which was conducted after regular school hours as a study club from around 2010. First and second year students received introductory training with the CEREC Red and Blue Cams (Dentsply Sirona, Charlotte, NC, USA) in their preclinical education, but no faculty or students were using it in the clinic.
The school then acquired eight intraoral scanners (CEREC Omnicam, Dentsply Sirona) and ten milling machines (CEREC inLab MC XL,
Dentsply Sirona) in summer 2017. Two intraoral scanners, designated only for restorations, and two milling machines were assigned to two operators for clinic use in December 2017. The challenge in this phase was that the initial utilization was very low, as faculty, and senior students did not fully accept the equipment. Due to the minimal utilization of the CAD/CAM system, the Restorative Dentistry Department restructured the chairside CAD/CAM program in the 1st quarter of 2018.
Methods for increasing awareness and improving acceptance The initial step was to make chairside CAD/CAM restorations more appealing by providing the patients with a financial incentive. The fee for CAD/CAM restorations was approximately 25-35% lower compared to porcelain fused metal and gold metal restorations (Table 1). In addition, a CAD/CAM study club for faculty with varying levels of experience was created. The monthly meeting offered a lecture presentation and hands-on for every attendant. The lecture presentation included basic information on using the equipment, such as making a patient profile, selecting a tooth, and selecting the CAD/CAM material for the restoration.
The program director developed a chairside CAD/CAM curriculum for the clinic, with the approval of the dean of clinical affairs, in which two dental operatories in the clinic were reserved exclusively for these types of procedures. The director also met with the clinical group leaders and encouraged the group leaders to promote chairside CAD/CAM restorations among the students and help identify teeth that can benefit from these types of restorations.
Phase 2: Introduction of CAD/CAM to preclinical education Preclinical experience with CAD/CAM systems The chairside CAD/CAM restorative education for students and faculty are summarized in Table 2. In the preclinical curriculum, 1st year students have an opportunity to experience chairside CAD/CAM systems in dental anatomy course, and learn about digitally designed tooth morphology. In the 2nd year course, students utilize these units to learn about treatment planning, and restorative procedures. After that, the 2nd year students take an intensive 8-week CAD/CAM course before matriculating into the clinic. In this CAD/CAM course, they are asked to prepare typodont teeth with 7 different restoration designs. They prepare each type of restoration thrice, with self-evaluations for each one, in a stipulated amount of time. Faculty that are interested in learning more about CAD/CAM procedures are encouraged to participate in this course so that they can enhance their knowledge base. The challenge in this phase was to modify the curriculum in order to include CAD/CAM courses for 1st and 2nd year dental students.
Phase 3: Introduction of CAD/CAM to clinical education clinical experience with CAD/CAM systems For clinical sessions, faculty and students are encouraged to schedule patients for an entire day in order to start and finish the restoration in a single visit, as followed by regular clinical digital workflow (Fig. 1). Ideally, during the morning session, the student prepares the tooth and cap- tures an intra-oral scan. Using a part of the lunch break, they complete the laboratory procedures, including designing, milling, and crystallization. The students have the opportunity to seek the assistance of an in-house certified dental technician for the laboratory phase. When the patient
Journal of Oral Science, Vol. 63, No. 4, 358-360, 2021
Short Communication
Successful development and implementation of a digital dentistry curriculum at a US dental school Carlos A. Jurado1), Akimasa Tsujimoto2), Amit Punj3), Natsuko Aida4), Masashi Miyazaki5), and Hidehiko Watanabe6)
1) Texas Tech University Health Science Center, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA 2) Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA 3) Division of Prosthodontics, Montefiore Medical Center Department of Dentistry, Bronx, NY, USA 4) Department of Biochemistry, Tokyo Dental College, Tokyo, Japan 5) Department of Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan 6) Department of Restorative Dentistry, Oregon Health & Science University School of Dentistry, Portland, OR, USA
(Received February 12, 2021; Accepted August 10, 2021)
Correspondence to Dr. Akimasa Tsujimoto, Department of Operative Dentistry, University of Iowa College of Dentistry, 801 Newton Rd, Iowa City, IA 52242, USA Fax: +1-319-355-7267 E-mail: [email protected]
J-STAGE Advance Publication: September 9, 2021 Color figures can be viewed in the online issue at J-STAGE. doi.org/10.2334/josnusd.21-0070 DN/JST.JSTAGE/josnusd/21-0070
359
returns for the afternoon appointment, the restoration is ready for delivery. Students are also encouraged to prepare teeth and remove old restorations under rubber dam isolation. The rubber dam is removed for the scanning phase and for the delivery phase they are mandated to re-apply the rubber dam for bonding procedures. The challenge in this phase was to first select the ideal clinical faculty that were competent mentoring students on doing chair-side CAD/CAM restorations on real patients and to organize the new clinical workflow for CAD/CAM restorations.
Phase 4: Maintenance and expansion of CAD/CAM education outcomes after two years The methods of phase 1-3 were implemented to increase utilization and acceptance of chairside CAD/CAM restoration. By the end of 2018, the strategies mentioned above were coming to fruition. The dental students and faculty members with limited experience using the chairside CAD/ CAM system felt more comfortable using it and were very satisfied due to
the continual training. The assignment of dedicated clinic chairs for CAD/ CAM procedures and a more confident mindset among both the faculty and students in embracing this technology helped tremendously. The culmina- tion of these strategies increased CAD/CAM utilization almost three-fold in 2019, compared to 2018. Although all types of restorations increased in number from 2018 to 2019, the production of chairside CAD/CAM restorations increased sharply (Fig. 2). The challenge in this phase was to encourage students to maintain the high production of chair-side CAD/ CAM restorations.
Phase 5: Application of CAD/CAM systems for comprehensive treatment At present, the school is continuing educational programs to enable dental students and faculty to employ chair-side CAD/CAM restorative treat- ments as a more comprehensive treatment method. In addition, through the provision of new information in the study club as it becomes available,
Table 1 Chairside computer-aided design and computer-aided manufacturing (CAD/CAM) education for students and faculty
Student education Preclinical (1st and 2nd year students) Clinical (3rd and 4th year students) 1st year students:
• CAD/CAM clinic 10 half day sessions/week • 2 CAD/CAM chairs • 4 CAD/CAM supervising instructors • 20 or more clinical instructors trained for diagnosis and
treatment planning of CAD/CAM restorations
• Digital wax up using CAD/CAM machines (2 sessions) 2nd year students:
• Introduction of CAD/CAM in indirect restoration course (1 session) • CAD/CAM project (scan and design) in a treatment planning course (1 session) • Scan and design of implant restorations (2 sessions) • CAD/CAM course (8 sessions)
Faculty education Monthly study club meetings
• Hands-on • Live patient • Case presentations
Participation in student chairside CAD/CAM courses • Access to student lecture materials/videos
Table 2 School fee, estimated production cost, and profit of chairside computer-aided design and computer-aided manufacturing (CAD/CAM), porcelain fused to metal (PFM), and gold restorations at OHSU
Restorations School fee Estimated production cost Profit
Chairside CAD/CAM restoration $ 450.00 $ 23.00 $ 427.00
Porcelain fused to metal restoration $ 600.00 $ 258.46 $ 341.54
Gold metal restoration $ 525.00 $ 228.34 $ 296.66
Fig. 1 Typical clinical workflow of chairside CAD/CAM restoration in a single visit by senior students. A: Pre-operative condition of tooth #35; B: After removal of old restoration and caries lesion with rubber dam; C: Core build-up using resin composite followed by preparation for ceramic crown with rubber dam; D: Computer aided design using CEREC; E: Bonding of CAD/CAM crown with rubber dam; F: Post- operative condition immediately after removal of rubber dam and occlusal adjustments
360
both dental students and faculty are enabled to remain up to date with the latest technology. The school is also continuing educations that promote not only the chairside CAD/CAM system, but also restorations using an intraoral scanner and in-lab CAD/CAM systems, for a broad use of digital dentistry.
Discussion
The current generation of students are quick learners of digital dentistry, as compared to dentists who were trained in a different era [3]. Thus, it is challenging for senior faculty to change their clinical workflows in order to adapt themselves to new technology. Different approaches to training in digital dentistry, keeping in mind how different generations learn, are essential. Once faculty feel confident that this technology yields success- ful restorations, it becomes easier for them to recommend and teach it to dental students.
In the statistics for production of restorations in the restorative depart- ment at OHSU on 2018 and 2019, production of chair-side CAD/CAM restorations increased year on year. This increase was clearly related to the chairside CAD/CAM restorative training for the faculty, and thus achieve- ment of this initial goal is shown to be important in Phases 1-3. It is true that this kind of faculty development does not lead to acceptance of the technology by every faculty member, but it does appear to be possible to carry out effective chairside CAD/CAM restorative training by continuing to work patiently to have as many faculty as possible change their behavior in line with the initial goal.
However, it is also true that there remain obstacles to the continued expansion of this CAD/CAM education. The financial cost can be a barrier to increasing the number of machines in the clinic. It is extremely difficult to ensure that large numbers of machines are available in both the simula- tion clinic and clinic at all times. Some schools may be able to resolve this problem through donations from alumni, but another approach, which may be applied in parallel, is to rely on cooperation with manufacturers. Of course, the role that industry can play in promoting chairside CAD/CAM education in dental schools has already been recognized.
Although, in Phases 4 and 5, manufacturers can also play an important role in providing up-to-date information in the study club and offering the new technologies and machines. Such a collaboration between dental school education and the manufacturers is a win-win situation for the further development of CAD/CAM education. If students become more familiar with CAD/CAM dentistry, they will move in that direction, and thus are likely to purchase such equipment when they go into private practice. Further, the spread of CAD/CAM dentistry is likely to lead to technological developments and a reduction in the cost of equipment, so that digital dentistry will become more democratic. Of course, this educa- tional development will also be very beneficial for patients.
There are many universities that have introduced chairside CAD/CAM system in response to the changing environment and government requests, but that are unsure how to build on the basic courses that they provide in order to offer a fully satisfactory grounding in digital dentistry. Faculty who are taking the lead in CAD/CAM education in the US are addressing this problem in many different ways [4]. In this report, the steps taken at OHSU, the persistence of the faculty who have carried out the whole process have been introduced, and the importance of support not only from the university have been shown, but also from manufacturers. This report will be helpful in launching or improving digital dentistry in Japan, as the technique takes the lead in the field of restorative dentistry.
Conflict of interest The authors have no conflict of interest to declare.
References
1. Blatz MB, Conejo J (2019) The current state of chairside digital dentistry and materials. Dent Clin North Am 63, 175-197.
2. Quick KK (2016) New accreditation standard for dental education programs on humanistic environment. J Am Coll Dent 83, 13-16.
3. Brownstein SA, Murad A, Hunt RJ (2015) Implementation of new technologies in U.S. dental school curricula. J Dent Educ 79, 259-264.
4. Davidowitz G, Kotick PG (2011) The use of CAD/CAM in dentistry. Dent Clin North Am 55, 559-570.
Abstract: Introducing new technology in the dental school curriculum may face some uphill challenges navigating through university-level bureaucracy, financial ramifications, and influencing the mindset of certain faculty. A dental school that relies heavily on teaching traditional restor- ative procedures may particularly face many challenges to embrace new technology. The restorative department at a US dental school created a division of computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry to introduce the concept of digital dentistry to dental students and faculty. This article describes methods that were adopted to improve acceptance and increase the productivity of chairside CAD/CAM restorations for both students and faculty at the dental school in US.
Keywords; CAD/CAM, curriculum, digital dentistry, US dental school
Introduction
Although the fundamental motives behind restorative dentistry have not changed, the production, materials, and delivery methods for restorations have significantly improved due to the introduction of digital dentistry [1]. The Commission on Dental Accreditation (CODA) standards require all dental schools to provide faculty development programs to help educa- tors keep up to date with new technologies [2]. Recognizing the value of digital dentistry for dental education, Oregon Health & Science University (OHSU) School of Dentistry (Portland, OR, USA) decided to introduce education on chairside computer-aided design and computer-aided manu- facturing (CAD/CAM) systems in the curriculum. The goals were to update the restorative curriculum and provide the students with experience and understanding of chairside CAD/CAM systems.
The purpose of this short communication is to describe successful development and implementation of a chairside CAD/CAM restorative curriculum at a US dental school. The hope is that the details of the US example can serve as guidance on how chairside CAD/CAM systems can be introduced into the curriculum of Japanese dental schools.
Each phase of CAD/CAM implementation in clinics Phase 1: Introduction of chairside CAD/CAM to the school for faculty and students revitalizing the CAD/CAM dentistry program The curriculum of the chairside CAD/CAM restorative program started as an elective program, which was conducted after regular school hours as a study club from around 2010. First and second year students received introductory training with the CEREC Red and Blue Cams (Dentsply Sirona, Charlotte, NC, USA) in their preclinical education, but no faculty or students were using it in the clinic.
The school then acquired eight intraoral scanners (CEREC Omnicam, Dentsply Sirona) and ten milling machines (CEREC inLab MC XL,
Dentsply Sirona) in summer 2017. Two intraoral scanners, designated only for restorations, and two milling machines were assigned to two operators for clinic use in December 2017. The challenge in this phase was that the initial utilization was very low, as faculty, and senior students did not fully accept the equipment. Due to the minimal utilization of the CAD/CAM system, the Restorative Dentistry Department restructured the chairside CAD/CAM program in the 1st quarter of 2018.
Methods for increasing awareness and improving acceptance The initial step was to make chairside CAD/CAM restorations more appealing by providing the patients with a financial incentive. The fee for CAD/CAM restorations was approximately 25-35% lower compared to porcelain fused metal and gold metal restorations (Table 1). In addition, a CAD/CAM study club for faculty with varying levels of experience was created. The monthly meeting offered a lecture presentation and hands-on for every attendant. The lecture presentation included basic information on using the equipment, such as making a patient profile, selecting a tooth, and selecting the CAD/CAM material for the restoration.
The program director developed a chairside CAD/CAM curriculum for the clinic, with the approval of the dean of clinical affairs, in which two dental operatories in the clinic were reserved exclusively for these types of procedures. The director also met with the clinical group leaders and encouraged the group leaders to promote chairside CAD/CAM restorations among the students and help identify teeth that can benefit from these types of restorations.
Phase 2: Introduction of CAD/CAM to preclinical education Preclinical experience with CAD/CAM systems The chairside CAD/CAM restorative education for students and faculty are summarized in Table 2. In the preclinical curriculum, 1st year students have an opportunity to experience chairside CAD/CAM systems in dental anatomy course, and learn about digitally designed tooth morphology. In the 2nd year course, students utilize these units to learn about treatment planning, and restorative procedures. After that, the 2nd year students take an intensive 8-week CAD/CAM course before matriculating into the clinic. In this CAD/CAM course, they are asked to prepare typodont teeth with 7 different restoration designs. They prepare each type of restoration thrice, with self-evaluations for each one, in a stipulated amount of time. Faculty that are interested in learning more about CAD/CAM procedures are encouraged to participate in this course so that they can enhance their knowledge base. The challenge in this phase was to modify the curriculum in order to include CAD/CAM courses for 1st and 2nd year dental students.
Phase 3: Introduction of CAD/CAM to clinical education clinical experience with CAD/CAM systems For clinical sessions, faculty and students are encouraged to schedule patients for an entire day in order to start and finish the restoration in a single visit, as followed by regular clinical digital workflow (Fig. 1). Ideally, during the morning session, the student prepares the tooth and cap- tures an intra-oral scan. Using a part of the lunch break, they complete the laboratory procedures, including designing, milling, and crystallization. The students have the opportunity to seek the assistance of an in-house certified dental technician for the laboratory phase. When the patient
Journal of Oral Science, Vol. 63, No. 4, 358-360, 2021
Short Communication
Successful development and implementation of a digital dentistry curriculum at a US dental school Carlos A. Jurado1), Akimasa Tsujimoto2), Amit Punj3), Natsuko Aida4), Masashi Miyazaki5), and Hidehiko Watanabe6)
1) Texas Tech University Health Science Center, Woody L. Hunt School of Dental Medicine, El Paso, TX, USA 2) Department of Operative Dentistry, University of Iowa College of Dentistry, Iowa City, IA, USA 3) Division of Prosthodontics, Montefiore Medical Center Department of Dentistry, Bronx, NY, USA 4) Department of Biochemistry, Tokyo Dental College, Tokyo, Japan 5) Department of Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan 6) Department of Restorative Dentistry, Oregon Health & Science University School of Dentistry, Portland, OR, USA
(Received February 12, 2021; Accepted August 10, 2021)
Correspondence to Dr. Akimasa Tsujimoto, Department of Operative Dentistry, University of Iowa College of Dentistry, 801 Newton Rd, Iowa City, IA 52242, USA Fax: +1-319-355-7267 E-mail: [email protected]
J-STAGE Advance Publication: September 9, 2021 Color figures can be viewed in the online issue at J-STAGE. doi.org/10.2334/josnusd.21-0070 DN/JST.JSTAGE/josnusd/21-0070
359
returns for the afternoon appointment, the restoration is ready for delivery. Students are also encouraged to prepare teeth and remove old restorations under rubber dam isolation. The rubber dam is removed for the scanning phase and for the delivery phase they are mandated to re-apply the rubber dam for bonding procedures. The challenge in this phase was to first select the ideal clinical faculty that were competent mentoring students on doing chair-side CAD/CAM restorations on real patients and to organize the new clinical workflow for CAD/CAM restorations.
Phase 4: Maintenance and expansion of CAD/CAM education outcomes after two years The methods of phase 1-3 were implemented to increase utilization and acceptance of chairside CAD/CAM restoration. By the end of 2018, the strategies mentioned above were coming to fruition. The dental students and faculty members with limited experience using the chairside CAD/ CAM system felt more comfortable using it and were very satisfied due to
the continual training. The assignment of dedicated clinic chairs for CAD/ CAM procedures and a more confident mindset among both the faculty and students in embracing this technology helped tremendously. The culmina- tion of these strategies increased CAD/CAM utilization almost three-fold in 2019, compared to 2018. Although all types of restorations increased in number from 2018 to 2019, the production of chairside CAD/CAM restorations increased sharply (Fig. 2). The challenge in this phase was to encourage students to maintain the high production of chair-side CAD/ CAM restorations.
Phase 5: Application of CAD/CAM systems for comprehensive treatment At present, the school is continuing educational programs to enable dental students and faculty to employ chair-side CAD/CAM restorative treat- ments as a more comprehensive treatment method. In addition, through the provision of new information in the study club as it becomes available,
Table 1 Chairside computer-aided design and computer-aided manufacturing (CAD/CAM) education for students and faculty
Student education Preclinical (1st and 2nd year students) Clinical (3rd and 4th year students) 1st year students:
• CAD/CAM clinic 10 half day sessions/week • 2 CAD/CAM chairs • 4 CAD/CAM supervising instructors • 20 or more clinical instructors trained for diagnosis and
treatment planning of CAD/CAM restorations
• Digital wax up using CAD/CAM machines (2 sessions) 2nd year students:
• Introduction of CAD/CAM in indirect restoration course (1 session) • CAD/CAM project (scan and design) in a treatment planning course (1 session) • Scan and design of implant restorations (2 sessions) • CAD/CAM course (8 sessions)
Faculty education Monthly study club meetings
• Hands-on • Live patient • Case presentations
Participation in student chairside CAD/CAM courses • Access to student lecture materials/videos
Table 2 School fee, estimated production cost, and profit of chairside computer-aided design and computer-aided manufacturing (CAD/CAM), porcelain fused to metal (PFM), and gold restorations at OHSU
Restorations School fee Estimated production cost Profit
Chairside CAD/CAM restoration $ 450.00 $ 23.00 $ 427.00
Porcelain fused to metal restoration $ 600.00 $ 258.46 $ 341.54
Gold metal restoration $ 525.00 $ 228.34 $ 296.66
Fig. 1 Typical clinical workflow of chairside CAD/CAM restoration in a single visit by senior students. A: Pre-operative condition of tooth #35; B: After removal of old restoration and caries lesion with rubber dam; C: Core build-up using resin composite followed by preparation for ceramic crown with rubber dam; D: Computer aided design using CEREC; E: Bonding of CAD/CAM crown with rubber dam; F: Post- operative condition immediately after removal of rubber dam and occlusal adjustments
360
both dental students and faculty are enabled to remain up to date with the latest technology. The school is also continuing educations that promote not only the chairside CAD/CAM system, but also restorations using an intraoral scanner and in-lab CAD/CAM systems, for a broad use of digital dentistry.
Discussion
The current generation of students are quick learners of digital dentistry, as compared to dentists who were trained in a different era [3]. Thus, it is challenging for senior faculty to change their clinical workflows in order to adapt themselves to new technology. Different approaches to training in digital dentistry, keeping in mind how different generations learn, are essential. Once faculty feel confident that this technology yields success- ful restorations, it becomes easier for them to recommend and teach it to dental students.
In the statistics for production of restorations in the restorative depart- ment at OHSU on 2018 and 2019, production of chair-side CAD/CAM restorations increased year on year. This increase was clearly related to the chairside CAD/CAM restorative training for the faculty, and thus achieve- ment of this initial goal is shown to be important in Phases 1-3. It is true that this kind of faculty development does not lead to acceptance of the technology by every faculty member, but it does appear to be possible to carry out effective chairside CAD/CAM restorative training by continuing to work patiently to have as many faculty as possible change their behavior in line with the initial goal.
However, it is also true that there remain obstacles to the continued expansion of this CAD/CAM education. The financial cost can be a barrier to increasing the number of machines in the clinic. It is extremely difficult to ensure that large numbers of machines are available in both the simula- tion clinic and clinic at all times. Some schools may be able to resolve this problem through donations from alumni, but another approach, which may be applied in parallel, is to rely on cooperation with manufacturers. Of course, the role that industry can play in promoting chairside CAD/CAM education in dental schools has already been recognized.
Although, in Phases 4 and 5, manufacturers can also play an important role in providing up-to-date information in the study club and offering the new technologies and machines. Such a collaboration between dental school education and the manufacturers is a win-win situation for the further development of CAD/CAM education. If students become more familiar with CAD/CAM dentistry, they will move in that direction, and thus are likely to purchase such equipment when they go into private practice. Further, the spread of CAD/CAM dentistry is likely to lead to technological developments and a reduction in the cost of equipment, so that digital dentistry will become more democratic. Of course, this educa- tional development will also be very beneficial for patients.
There are many universities that have introduced chairside CAD/CAM system in response to the changing environment and government requests, but that are unsure how to build on the basic courses that they provide in order to offer a fully satisfactory grounding in digital dentistry. Faculty who are taking the lead in CAD/CAM education in the US are addressing this problem in many different ways [4]. In this report, the steps taken at OHSU, the persistence of the faculty who have carried out the whole process have been introduced, and the importance of support not only from the university have been shown, but also from manufacturers. This report will be helpful in launching or improving digital dentistry in Japan, as the technique takes the lead in the field of restorative dentistry.
Conflict of interest The authors have no conflict of interest to declare.
References
1. Blatz MB, Conejo J (2019) The current state of chairside digital dentistry and materials. Dent Clin North Am 63, 175-197.
2. Quick KK (2016) New accreditation standard for dental education programs on humanistic environment. J Am Coll Dent 83, 13-16.
3. Brownstein SA, Murad A, Hunt RJ (2015) Implementation of new technologies in U.S. dental school curricula. J Dent Educ 79, 259-264.
4. Davidowitz G, Kotick PG (2011) The use of CAD/CAM in dentistry. Dent Clin North Am 55, 559-570.