Of all the amazing things one could imagine being 3D printed – I doubt that many would pick teeth. In truth, 3D scanning and milling in the dental industry is a well established trend in the field and is one of several digital innovations that is advancing the field of health care. While digitization in clinical dentistry has created efficiencies in the production of anatomical models, dental prostheses, and surgical guides, continued advancement of these technologies has been seen as a potential threat to commercial dental laboratories, a key partner in the clinical supply chain.
Amongst the array of dental services provided by clinicians, a significant portion of dental work involves advanced production outsourced to dental laboratories. These include crowns and bridges to replace broken down or missing teeth, full/partial dentures, appliances for treating sleep apnea or jaw growth abnormalities, or surgical templates for implant placement. Traditionally, clinicians will take an impression, or mold of teeth and surrounding structures and send this to a commercial lab. There, a technician will create stone models from this impression, and off of this impression he/she will create a mockup of the appliance sculpted from wax (this is commonly called a waxup). The technician then uses various laboratory technologies to convert the wax models into prostheses, appliances, and templates comprised of the final materials (porcelain, gold, acrylic, among others).
Over time, CAD/CAM technology has reduced lead-times and variable costs for commercial labs. Currently, most dental labs are equipped with 3D scanners similar to the Sirona CEREC system. Labs are able to scan their models and design products digitally, which drastically reduces the time for waxups. Subsequently, milling and 3D printing technologies allowed labs to fabricate products autonomously, with little human input.
At the outset, it has appeared that advanced scanning and fabrication capabilities have been a boon to commercial dental labs. However, lower costs and improved quality is threatening to turn CAD/CAM from ally to foe for laboratories. Sirona Dental’s recent campaign, titled “CAD/CAM for Everyone,” has aimed to deliver scanning and fabrication capability to every office, thereby reducing doctors’ reliance on commercial labs.
Digital impression systems and chairside milling technology are now affordable for many dental offices. Value to patients and providers is clear:
- Digital impressions are quicker and markedly more comfortable than conventional techniques.
- Since prostheses are fabricated in-house, patients no longer have to wait for final delivery wearing temporary crowns.
- Increased patient satisfaction and reduced health risk, since patients often break or dislodge temporary crowns/bridges.
- Digital scanning provides analytics/measurements to improve accuracy and quality through feedback
- Units can be delivered in fewer appointments using less chair time
- Reducing costs (time cost for assistants, conventional impression materials, temporary crown materials, lab fees, remakes, shipping)
- Increasing revenue through higher patient turnover
- Premiums can also be placed on milled units since they use more advanced materials.
While it may seem that commercial dental labs will become extinct, there are several opportunities for this industry to adapt to dental digitization. Commercial dental labs can adapt by:
- Leveraging the existing technology to reduce delivery times and provide on-demand services such as same-day delivery
- Creating systems to provide real-time consult to reduce errors and improve fabrication quality
- Achieving economies of scale ->move towards 100% utilization to reduce cost charged to dentists
- Vertically integrating to reduce cost and offer innovative materials technologies
Clearly, digital dentistry has offered vast improvements in the dental care delivery system and is here to stay. I hope that commercial dental labs adapt to these changes sooner rather than later to provide additional value to our patients.