Dr. John Zalesky
DMD, MBS, FICOI, FAGD
•Dr. Zalesky treats patients at his private practice, Aurora Hills Dental Family & Cosmetic Dentistry in Colorado and teaches at the University of Colorado School of Dental Medicine.
•He is part of the Catapult Education Speaker’s Bureau and serves as Executive Director and Treasurer for Region 14 of the Academy of General Dentistry.
•Listed among Colorado’s Top Dentists by 5280 Magazine, he was recently included in the Top 40 under 40 by Incisal Edge Magazine.
•He earned his Master of Biomedical Science from the University of Medicine and Dentistry of New Jersey and his DMD from Nova Southeastern University. After his residency at Denver Medical Health Center, he completed advanced training as Chief Resident at the University of Colorado School of Dental Medicine.
case report
case report
Dr. John Zalesky and his team at Aurora Hills Dental prioritize providing an exceptional patient experience. To support better patient outcomes and satisfaction, his practice embraces a complete digital workflow that enables his team to deliver a full spectrum of high-level care under one roof. His investment in digital tools has also driven improvements in efficiency and accuracy, as well as patient comfort and convenience.
“Patients don’t like going to multiple doctors for a procedure,” says Dr. Zalesky. “When we’re able to see a whole case through from start to finish, patient-doctor communication and trust improves; patients feel more comfortable and more likely to accept care—which, in turn, leads to better outcomes.”
The digital workflow Dr. Zalesky’s practice uses typically begins with capturing intraoral scans using his preferred solution, the DEXIS™ IS 3800W wireless intraoral scanner (Fig. 1).
“I only take traditional impressions when I absolutely have to,” Dr. Zalesky explains. “With traditional impressions, the patient sits with goop in their mouth for up to 5 minutes, and you sometimes wind up with avoid that requires a whole new impression the patient has to sit through.”
“A digital scan enables us to digitally manipulate the models and see everything you need to have a good final outcome—the margins, occlusion, and tissue architecture,” he says. “When we send the scans to the lab, they have all the information they need to eliminate any guesswork. And if you do see an issue, the digital software allows you to zoom in to pinpoint, cut out, and rescan just that area without having to start over with a completely new scan.”
He adds, “It’s been a game-changer for me. Now we can provide impressions digitally instead of using traditional polyvinyl siloxane (PVS) impression material, which is great, particularly for patients who have a gag reflex and can’t tolerate having an impression stuck in their mouth for 5 minutes.”
The advantages of digital scanning using the DEXIS™ IS 3800W were evident in a recent case for Dr. Zalesky involving a patient who sought to feel more comfortable and confident in her smile, which required a complete reworking of her existing crowns.
“A digital scan enables us to digitally manipulate the models and see everything you need to have a good final outcome.”
THE CHALLENGE
THE CHALLENGE
Dr. Zalesky’s practice inherited a patient who expressed dissatisfaction with the existing crowns a previous doctor had completed on her upper teeth, spanning canine to canine. In addition to being unhappy with the shade and contours, the patient felt that the shape of the veneers looked and felt too large for her face (Fig. 2).
Dr. Zalesky’s practice inherited a patient who expressed dissatisfaction with the existing crowns a previous doctor had completed on her upper teeth, spanning canine to canine. In addition to being unhappy with the shade and contours, the patient felt that the shape of the veneers looked and felt too large for her face (Fig. 2).
“My first concern was making sure this patient was going to be pleased with the new restoration, including the shade and shape of the replacements,” Dr. Zalesky recalled. “We didn’t want her to go through this process, then still be dissatisfied with the way her smile looked and felt.”
To help ensure the patient’s satisfaction with the results, Dr. Zalesky created a digitally designed wax-up, which allowed him to pre-plan the procedure and visually show the patient the final desired outcome. From that wax-up, the laboratory fabricates a prep reduction guide as well as a matrix, which is used for chairside fabrication of provisionals for the patient during the preparation appointment before the final restorations are fabricated (Fig. 3).
“That way, she could go home with the temporaries to test drive daily function (eating and speech), look in the mirror, ask her family and friends for their feedback, and make sure she’s happy with them or let me know if she’d like any changes,” he explains. “I find that spending time with the patient upfront, showing them scans and visuals, and letting them live for a while with the temps play a key role in improving the patient experience and satisfaction.”
THE SOLUTION
THE SOLUTION
To ensure a more natural, blended, and cosmetically pleasing shade match for the new restoration, Dr. Zalesky decided to extend the case to include complete coverage from teeth numbers 6 through 11 and 21 through 28. Dr. Zalesky and his team removed the existing dentistry, cleaned the prep area, and took careful steps to ensure the preparations provided optimal restorative aesthetics and material thickness. The DEXISTM IS 3800W played a pivotal role in achieving this.
“With the DEXIS™ IS 3800W scans, we were able to pre-plan every part of the treatment,” he says. Using the DEXIS™ IS 3800W intraoral scanner, Dr. Zalesky captured a pre-treatment scan of the patient’s upper and lower arches. He then sent the scans to the laboratory to have a wax-up fabricated. He also took a scan of the upper arch preparations to ensure the accuracy and fit of the final crowns (Fig. 4).
“With the digital intraoral scan, I can see the clearance right away and make any needed adjustments before sending it to the lab.”
“This allowed me to check every aspect of the scan in real-time to make sure that we’d captured all the information we needed and, most importantly, didn’t miss any margins,” he explains. “It also allowed me to see the occlusion and make sure there was enough clearance between the upper and lower arches. This was very helpful because you don’t normally see the clearance until the lab has mounted the case. With the digital intraoral scan, I can see the clearance right away and make any needed adjustments before sending it to the lab.”
This level of visibility results in better accuracy and fit, which in turn minimizes the need for prep reduction copings or restoration remakes. “The patient gets the right fit the first time around, and I don’t have to bring the patient back again,” says Dr. Zalesky.
THE OUTCOME
THE OUTCOME
After the upper crowns were completed and the patient was fitted with the temporaries, she was so pleased with the results that she asked Dr. Zalesky to repeat the procedure on her bottom teeth (Fig. 5).
“I ended up prepping all the work at once, saving the patient from having to return for multiple visits,” Dr. Zalesky recalls.
By being able to pre-plan every step of the case, check the scan for accuracy and fit before sending it to the lab, and enabling the patient to leave with temps she could try out, Dr. Zalesky was able to maximize the efficiency and productivity of his team and focus more on the patient.
The fit of the new crowns was also a success.
“I’m extremely picky when it comes to margins and the fit of crowns, veneers, and implants,” explains Dr. Zalesky. “Performing long-lasting dentistry comes down to mere microns, and if you’re relying on cement to fill, you won’t have the same accuracy. Which is where using the IS 3800W makes a real difference.”
“With the DEXIS IS 3800W scans, we were able to pre-plan every part of the treatment.”
The patient was thrilled with the final outcomes of her new restorations, as well as with the entire process and experience (Fig. 6).
“Not only was she able to achieve the results she was hoping for, with a beautiful smile that truly reflected who she is, but we earned her confidence and trust in our practice,” says Dr. Zalesky. “That’s the true benefit of adopting a digital workflow and of having an efficient, reliable, easy-to-use, and high-quality solution like the IS 3800W wireless intraoral scanner as part of our digital practice.”
For Dr. Zalesky, the DEXIS™ IS 3800W is the obvious choice for intraoral scanning, serving as the first step in his practice’s digital workflow.
“I use the IS 3800W for everything: implants, orthodontic aligners, nightguards, crowns and bridges, veneers,” he says. “It’s my go-to scanner for taking impressions and for removable cases where I need to intraorally scan digital edentulous ridges and overlay PVS impressions to stitch them together to get dentures that offer an amazing fit with no irritated spots. This leads to fewer patient post-op appointments and increased satisfaction.”
He and his team particularly appreciate the range of innovative DEXIS™ IS 3800W features not found with other intraoral scanners.
Wireless portability
“There aren’t a lot of scanners on the market that are completely wireless,” Dr. Zalesky explains. Weighing just 240 grams, the DEXIS™ IS 3800W is also one of the lightest and most compact intraoral scanners available, with a comfortable grip in a portable solution that easily moves between operatories.
Interchangeable tips
The DEXISTM IS 3800W comes with 2 tip sizes and styles (plus an optional posterior tip) that comfortably accommodate a range of patients and their oral anatomies. “A lot of scanners have just 1 tip size, which can make it difficult to get a good scan for patients who can’t open as wide or when you have to get into a tight area, particularly in the posterior.”
Image quality
With a field of view of 16 × 14 mm and a depth of field ranging from −2 to +16, the DEXIS™ IS 3800W captures a high level of detail even in interproximal areas and subgingival margins. “The images are very clear, and I can view them in true color or change to the stone model, which I know a lot of doctors are familiar with,” explains Dr. Zalesky.
Patient education
The high-quality scans captured by the DEXIS™ IS 3800W provide a powerful educational and learning tool for patients. “I can show the patient their scan chairside, so they can see in real-time a view of their dental structure that they can’t otherwise see themselves,” says Dr. Zalesky. “It’s like we’re standing on the tooth. I can show the patient where they have wear or other issues so the patient can understand what’s going on. This leads to increased treatment acceptance, which also increases my productivity.”
REFERENCE
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