Foreword

This book opens the “digital pathway” to 3D success for the orthodontic clinical practice. It is a successful demonstration on how digitization of patient information and digitalization of clinical procedures can lead to a digital orthodontic transformation for the design and manufacturing of patient-specific devices—and in turn to considerable benefits for clinicians and patients.

Many years ago, I had the opportunity to propose the use of computer-aided engineering as a potential clinical tool for preoperative planning, surgical practice, and customization of medical devices. However, the efficient integration of medical imaging with design, simulation, and rapid manufacturing was a long, challenging, and demanding task. It could take weeks or even months to coordinate just the export of images from medical scanners. Specific knowledge and equipment were also necessary to transfer image data to a computer. Extra effort was required to decode and read the “native” formats utilized by those closed systems. Overall, too much effort, too many projects, extensive scientific work, and numerous clinical cases and patient stories have been required in order to prove the value of a digital engineering approach in clinical practice.

By the turn of the millennium, the underlying engineering technologies, as well as the relevant digital 3D workflow, were fully established. Computer-guided implantology was the first concrete example of a successful digital process in dentistry. During the following years, a considerable simplification and automatization of the procedures was achieved, mainly due to considerable software developments but also hardware improvements and increasing computer power. Nevertheless, it took decades to garner widespread recognition for the apparent benefits of engineering approaches in dentistry and medicine, as well as the potential of a generalized digital transformation in health care. Today, everyone wants to “go digital,” even when it is often unclear what that even means.

Strictly, the termdigital refers to the management of digital information.Digitization is the initial step to make all information available in a digital format. Anddigitalization is the next step to develop the appropriate tools to manage the digitized information. The “digital transformation” is the integration of digital data with digital tools into all aspects of any enterprise. The fact that many technologies, such as modern design and manufacturing, utilize digital information and rely on computational procedures leads us to consider ourselves under the “digital umbrella” as well. It is very important though to mention that a successful digital transformation is not just about the technology. It fundamentally changes how an organization operates in order to deliver the potential benefits. It requires a cultural change with new and different ways of thinking. It is a constantly evolving situation that requires experimentation for the implementation of novel processes that are frequently radical and challenge analog routines. In health care, the order always used to be disease, medicine, and then patient. However, a digital health care transformation puts the patient at the center of medical care, affecting how people access or even define health care.

What does a potential “digital health care transformation” really mean? It is estimated by IBM Watson that each person can generate enough health data in their lifetime to fill 300 million books. More medical data has been created in the past 2 years than in the entirety of human history, and this is predicted to double every 73 days. Most data though are unstructured and stored in hundreds of forms such as lab results, images, and medical transcripts. It is called Big Data because it is voluminous and complex. Traditional processing software was inadequate to deal with it, but now there are the technical capabilities to monitor, collect, and process this scale of information. Big Data can be analyzed by intelligent systems that can imitate human learning and reasoning, otherwise calledartificial intelligence (AI). AI has the capability to sift through billions of pieces of unstructured information and “investigate” millions of patient cases in order to find patient-relevant information, sort its importance, make necessary connections, and summarize conclusions in a predictive way. In addition, such digital processes can employ “cognitive computing” techniques to simulate human thought by learning how to recognize and use the data. The relevant technology platforms can encompass reasoning, speech, and object recognition, language processing, and human-computer interaction. Doctors can interact directly through dialogue, discussing various proposals. Through “machine learning” (ML), digital systems can also be automatically trained and keep learning from any mistakes as well as successes to adapt and become “specialists” in a range of disciplines. As such, a potential digital health care transformation can help clinicians to make informed decisions regarding diagnosis and treatment options. It is also possible to obtain insights on outcomes of various treatment options, to be