There is no question that a digital scan or impression, when used for fabrication of an oral appliance designed to move teeth and change occlusion, represents a "final impression" which by VA law must be taken under direct supervision of a dentist by qualified personnel.  The problem here is that the dental practice act in Virginia has not been updated to include use of new technology in this manner.  Furthermore, the model suggested for tooth movement does not establish the proper doctor-patient relationship to provide safe care to the public.