Dental Students Train on Full Digital Restoration Workflow From Day One

Students in every year of the Doctor of Dental Surgery program at the UT San Antonio School of Dentistry are now working within a single, complete digital workflow for dental restorations, whether they are practicing in the simulation laboratory or treating patients in the clinic. The system, supplied by Austria-based digital prosthetics manufacturer Amann Girrbach, runs end to end from three-dimensional oral scanning at the chairside to the design, milling and fitting of crowns and bridges. According to the university, the school is the only dental school in the United States running this particular end-to-end workflow from that manufacturer. The technology is supported by a commitment of more than $5 million over five years from the university and its Department of Predoctoral Dental Education.

The change is significant because of how most dental schools sequence their teaching. Institutions that do provide complete digital workflows typically do not introduce them until the third or fourth year of training, once students have already spent years on conventional techniques. Until this year, students at UT San Antonio followed the same pattern, encountering digital tools only later in the program while their early years relied on analog methods such as taking putty-tray impressions and using a facebow to record patient jaw relationships. Now both digital and analog methods remain in the curriculum, but students master the two approaches side by side from the very start of their studies.

To support the initiative, this year’s 100 incoming dental students each received dental articulators, devices that reproduce the way an individual patient’s jaw opens, closes and slides, along with software that links the articulators to the same workflow the students will use on patients two years later at the school’s clinic. The school also upgraded and expanded its fleet of intraoral scanners, the handheld devices that capture precise three-dimensional images of the teeth and soft tissues, adding 16 units to the clinic floor. All of the new equipment ties into the same Amann Girrbach system, so there is no gap between the technology students learn on and the technology they eventually use clinically.

Raul Jose Bonilla, a clinical assistant professor and director of dental anatomy with the Department of Predoctoral Dental Education, is spearheading the effort. “What it really shows is that we’re on the cutting edge,” he said, adding that the school has always aimed to progress not only itself but the profession. Diane J. Sullivan, professor and chair of the department, framed the adoption in educational terms: “As the academic home where future dentists begin their journey, we cultivate an environment centered on evidence-based science, excellence in dental education and compassionate patient care.” She described the adoption of advanced technologies such as the complete digitized workflow as one more way the school grows skilled clinicians and leaders in oral health.

The workflow itself follows a defined technical sequence. It begins when a student scans the patient’s teeth and soft tissues with an intraoral scanner, and the scanning software converts those images in real time into an interactive surface model displayed on a chairside monitor. A high-precision jaw motion sensor, worn on a lightweight head frame, then tracks and records the patient’s individualized jaw movements. That motion data works in tandem with the patient’s scans inside prosthetic design software, where the restoration is designed against the patient’s own anatomy and bite rather than a generic template.

Once the design is complete, it is sent to one of the school’s in-house milling machines, which produces the finished crown or bridge. A 3D printer can also produce provisional restorations as well as resin models of the patient’s mouth. Those printed models snap onto the dental articulator, where they serve a dual purpose: they act as a teaching tool for students and as a method of verifying restorative work before the final prosthetic is tried at the chairside. The result is a closed loop in which the digital design, the physical model and the eventual restoration all derive from the same source data.

Bonilla emphasizes that this integration matters most for establishing clinically relevant, hands-on exercises. Because every student works from an identical digital file, longstanding sources of variability disappear, including articulator mounting discrepancies, facebow transfer inconsistency and differences between individual operators. A single digitally designed exercise can be printed in multiples and used identically across operative, fixed and removable prosthodontics courses, giving every student in a cohort the same reference point from the first year onward. That standardization is difficult or impossible to achieve with purely analog techniques, where each impression and mounting introduces its own error.

The pedagogical payoff, according to the school, is that students master the complete workflow well before they treat patients. They enter the clinic already fluent in how scan quality, articulator settings, design parameters and milling or printing interact and integrate. A student can assess an intraoral scan, recognize potential problems, make modifications and communicate precise adjustments to the milling center. The practical results described by the school are fewer remakes, shorter chair times and restorations that more accurately preserve and replicate each patient’s existing anatomy.

The installation is the product of a relationship built over several years. Richard Zimmermann, a clinical associate professor with the Department of Predoctoral Dental Education, is credited with originating the relationship with Amann Girrbach. Through his initiative and focus on research and development, the school became a secondary, or beta, tester of the company’s latest milling machine at the time, and it has since purchased two additional milling machines from the manufacturer. All three machines are used as part of the full workflow. A recent presentation on the system by company representatives drew faculty from across the school, from adjuncts teaching first-year dental anatomy to prosthodontists who specialize in complex oral reconstruction and cosmetic dentistry. “For each one of our clinical teams and restorative courses, the team leads were there, and the assistant leads were there,” Bonilla said, describing faculty members learning the system and asking how they could begin using it.

Faculty reactions capture how quickly the technology has moved. Tom Watkins, a long-serving clinical professor and local practitioner who graduated from the school in 1980 and now teaches part time, said students now leave prepared to work digitally as well as the old-fashioned way. “It’s come a long way,” he said. “It’s just phenomenal what we can do, and it really makes dentistry so much more fun.” Carlos David Escobar Palma, director of digital dentistry and clinical assistant professor at the school, added that access to state-of-the-art hardware and software is transforming how students are taught and prepared, creating opportunities for faculty professional development and, in his words, allowing the school to provide patients with an even higher level of care. The School of Dentistry, ranked the number one dental school in Texas by the Blue Ridge Institute for Medical Research, offers 18 degrees and programs in dentistry and dental hygiene, and its clinical practice, UT Dentistry, operates in the Center for Oral Health Care and Research serving the general population.

Subject of Research: Integration of a complete digital dental restoration workflow into all four years of a dental school curriculum

Article Title: UT San Antonio School of Dentistry now prepping students from Day 1 with a complete digital workflow for teaching, performing dental restorations

Article References: UT San Antonio School of Dentistry now prepping students from Day 1 with a complete digital workflow for teaching, performing dental restorations. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: digital dentistry, dental education, intraoral scanning, CAD/CAM milling, dental restorations, Amann Girrbach, UT San Antonio, prosthodontics, 3D printing, dental articulators, DDS program, Antonio