Digital Dentistry Workflows with Dr. Mike Skramstad

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Digital dentistry has transformed restorative workflows over the past decade—but many clinicians still struggle to understand where digital tools truly improve accuracy and where limitations remain. In this episode of Dental Digest, Dr. Melissa Seibert sits down with digital dentistry educator and CAD/CAM expert Dr. Michael Skramstad to explore how intraoral scanners, digital bite registration, and AI-assisted articulation are actually performing in modern restorative practice.

Dr. Skramstad has spent decades working at the intersection of clinical dentistry and digital innovation. As a longtime CAD/CAM educator, CEREC trainer, and product consultant for major dental manufacturers, he has stress-tested many of the technologies shaping today's digital workflows. In this conversation, he shares practical insights into how scanners perform in real-world restorative dentistry—not just under ideal conditions.

The discussion begins with one of the most persistent challenges in digital workflows: occlusion accuracy. While intraoral scanners can capture highly detailed digital impressions, digital bite registrations can still introduce discrepancies. Dr. Skramstad explains the multiple factors that influence digital occlusal accuracy—including scanner technology, scan strategy, tooth mobility, the number of teeth captured, and even how firmly a patient bites during the scan. He notes that while single-unit restorations tend to be forgiving, larger cases such as full-arch restorations demand far greater precision.

The conversation then explores emerging tools designed to address these limitations, including AI-based articulation software such as BiteFinder, which analyzes tooth morphology and wear patterns to algorithmically re-articulate digital models and improve occlusal alignment.

Dr. Skramstad walks through how clinicians can integrate these tools into their workflows when sending cases to the lab or designing restorations with Exocad.

Dr. Seibert and Dr. Skramstad also compare leading intraoral scanners and discuss how different systems perform depending on the clinical application. Some scanners excel at capturing tooth structure, others capture soft tissue more effectively, and certain systems may provide advantages when scanning full-arch cases. The discussion highlights why scanner field of view, scan stitching algorithms, and scan path protocols all influence the final digital model accuracy.

Beyond technology itself, the episode also touches on clinical workflow and team integration. Dr. Skramstad shares how responsibilities such as scanning, designing restorations, and fabricating surgical guides can be delegated within the dental team. He discusses why some aspects of digital dentistry benefit from delegation while others require direct dentist oversight—especially when precision and aesthetics are critical.

Finally, the conversation broadens into leadership and practice management. Dr. Skramstad shares lessons from running a large dental team and explains why hiring for character and adaptability often matters more than prior experience. These insights offer a valuable perspective for clinicians building teams in modern digital practices.