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The team of Professor Dr Metodi Abadzhiev, DMD, PhD, DSc unleashes the power of cutting-edge technology to help patients smile again

Professor Dr Metodi Abadzhiev, DMD, PhD, DSc, founded Abadzhievi Dental Center 16 years ago. Ever since, he and his team never ceased to improve, perfect and keep up with the latest developments in their field, offering top-quality treatment that combines conventional and modern methods. Digital dental medicine is one of the hot trends in medicine, with significant advantages for the patients. Professor Abadzhiev shares with us more on this innovation and how the specialists in the dental centre apply it.

What is digital dental medicine?

Development of technologies brought up many opportunities for digitalisation of a number of dental manipulations. Specialised software and hardware can be used at every single stage, from the examination and the planning of the clinical cases to the final manufacture of the constructions. Of course, conventional manipulations should not be ignored, they are the basis of our work. But hi-tech equipment allows us to build up on them. Nowadays, use of modern technologies in prosthetics has become a must. Moreover, there is the aim to "close" the digital cycle to the end of the treatment.

How do you apply it in your practice in Abadzhievi Dental Center? What are the advantages for the patients?

Partial digitalisation started about 15 years ago. The manufacture of ceramic and zirconium constructions was the first step. Then we gradually started implementing new technologies until we fully digitalised the work process. During the first examination the patient is photographed following an established protocol. If needed, 3D X-rays is done, too. These photos are processed by a special software. DSD, or Digital Smile Design, is the most popular software for this, but a far better Bulgarian development is already on the international market. With VisagiSmile we can design the teeth's shape, location and size not only in accordance with the major parameters but also the patient's temperament, which is analysed in advance. Stepping on this analysis we can make in advance project prototypes of the future constructions before the treatment has even started. The patient can see the result both on a computer screen and in their mouth. This is very important especially in cases of complete dentition rehabilitation, which is a major specialty of our clinic.

What technologies do you use in Abadzhievi Dental Center?

The technologies used by dental technology generally arrive from other fields of science. The software for the most popular intraoral scanner, for example, was created by two students for use in otolaryngology. The popular name CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) comes from industry. Other developments were first used in military or space industry. We are basically the end consumers of such technologies, benefiting from the fact that their flaws were already fixed. These machines' precision is incredible, the error is in the order of a couple of microns.

The increasingly popular 3D printers also find mass application in dental medicine. We use them to prepare work models, temporary constructions, prototypes, implantological guides in 3D planning. In Bulgaria, there are already 3D metal printers for fast and precise manufacture of metal skeletons for all types of prosthetic constructions. The technologies used in this are Laser Melting and Laser Sintering.

There is a huge progress in image diagnostics as well. Modern computer tomography helps us to virtually exercise the planned intervention in advance and to make implant guides. The guide is very valuable in large implantology cases as it helps for the best positioning of the implant. The depth, the direction and the place of the osteotomy are preliminary set. Consequently, the risk of errors is minimised.

Abadzhievi Dental Center

What stages undergoes digital dental treatment in Abadzhievi Dental Center? How is the process organised and what specialists does it include?

The patient is first examined and the main parameters of his desires are determined. It is important that they match what is achievable from a biological standpoint.

Then are made intra end extraoral pictures and X-ray diagnostics, the oral cavity is scanned, printed models are made and analysed. These are followed by virtual modelling with the specialised software for smile design. If there is a need or if it is desired, the prototypes are printed. This stage of the treatment is incredibly important.

Then follows the preparation of a treatment plan and its realisation. Specialised equipment is used in the preparation of the dental tissues and the implants setting. It is one of the few manipulations known from the distant past but in reality now, with the use of digital planning, it is performed with minimal invasiveness and tissue loss.

An imprint is needed for the manufacture of prosthetic constructions, which has to recreate the prosthetic field in a laboratory environment. Before, this was done with various types of silicone that were placed in the patient's mouth and were hardly pleasant. Today, we make a digital impression with the intraoral scanner. The information is sent via the Internet to the laboratory, where constructions are modelled with specialised software after the preliminary plan. Depending on the selected material (ceramics, zirconium dioxide, metal ceramics, composite, PEEK, kevlar) the constructions are either cut on a CAD/CAM digitally programmed mill or are printed. The process of metal cast is practically left in the past. The colour individualisation and the final aesthetic shaping of the construction is in the hands of the team of highly specialised dental technicians.

The whole team of dentists, dental technicians and assistants takes part in the process. The patient is part of it, too, and can significantly help the treatment process.

What trainings have the specialists in Abadzhievi Dental Center undergone?

Digital dental medicine is a relatively new field. Despite this we, the professors at Varna Medical University, were the first to author several manuals on the different stages of digital treatment. There is still no separate discipline, but it will eventually happen. Otherwise, just like in other fields, the improvement of our qualification is in our own hands.

Participation in congresses, seminars, trainings in Bulgaria and abroad are a requirement for all members of our team. The evidence for our efficiency are the results of our clinical cases: grateful, smiling patients.

Varna, 63 G Rakovski St, floor 1

phone: 052/ 61 37 38

fax: 052/ 61 07 72

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