For Mike Buffum, purchasing the Sirona MCXL milling unit and inEOS stand-alone scanner (www.sirona.com), was a logical step once the CEREC Connect interface was introduced. He knew he would be able to capture work from the CEREC chairside unit and convince his dentists to send him cases, especially in light of the clinical acceptance of newer, stronger all-ceramic materials that required extra steps to achieve final strength and esthetics. Mike believes his caseload will increase when Sirona introduces the ability to provide 3D printed models this February. The ability to receive a 3D printed model will expand the indications and types of restorations Buffum will be able to provide his CEREC Connect clients.

Buffum keeps his dedicated CEREC Connect computer at benchside so he can instantly react to any case forwarded by his clients. “When a case comes in, the e-mail subject line tells me which dentist sent the case,” said Buffum. “I open the e-mail and double click on the provided link to the CEREC Connect Web portal. When I log into the Web portal, I retrieve the case prescription and the digital scan file for case design and milling.”

Rego, whose clientele practice throughout the United States, has complete versatility in his capacity to accept and/or digitize case information and provide clients with a broad range of restorations from all-ceramic to PFM. He made the business decision to invest in the Cadent iTero business model that provides a dedicated computer for receiving scan files from the iTero digital impression-taking device plus training on marking margins and filling out an- order form for a variety of model options Cadent offers.

“Labs can get involved with clients using the iTero impression-taking device in two ways,” said Rego. “They can invest in the dedicated computer to receive the iTero files, mark the margins and order the model from Cadent. While awaiting the milled model, they can then import the scan files to the Dental Wings DWOS scanner, design the case, and export design files to CMC. The sectioned, milled model arrives from Cadent and the case design assembly from CMC in two to three days for case completion. The second option is for the dentist to send the scanned case to Cadent for marking the margins and milling the model. The model is returned to the dentist, and he or she sends the model to the lab along with a prescription for conventional fabrication or for scanning and outsourcing for zirconia or 3D printed substructures or conventional waxing and layering.”

Rego believes adoption of impression-taking devices will progress slowly among general dentists due to cost and the learning curve. However, Rego is a strong believer in automated machines that speed up production and positively affect the bottom line. The ability of his Dental Wings DWOS scanner to both digitize a conventional impression as well as accept files from the Cadent iTero gives him the flexibility to meet a variety of client needs. When scanning a traditional impression, all files go to CMC simultaneously where the model is 3D printed and the case assembly parts are milled or 3D printed.

3M ESPE offers flexibility with different entry points for laboratories choosing to adopt Lava technology and for non-adopters alike. Jamie Stover, Manager of Ziemek Aesthetic Dental Lab, a Lava Authorized Milling Center located in Olympia, Wash., says his laboratory has completed approximately 250 cases from data received from the Lava C.O.S. impression-taking device without a single remake due to impression issues. Currently, about 25% of all cases coming into Ziemek are digitally originated. Ziemek also accepts C.O.S. files from dentists whose laboratories do not own a Lava ST Scanner and design software, allowing these laboratories to retain clients and provide restorations with zirconia substructures or complete cases using conventional techniques.

“This new initiative allows any laboratory to now participate and take advantage of the technology,” said Stover. “Any dentist investing in a C.O.S. impression-taking device and certified by 3M provides 3M/Brontes with information on the lab he or she prefers to use. If the chosen laboratory is not an investor in Lava technology, Brontes then provides the dentist/lab team with a list of Lava partner labs that can receive C.O.S. files. The lab/dentist team chooses a partner lab, and any digital impression files from that dentist are routed to the partner lab for marking the margins and then to 3M/Brontes for 3D SLA printing of a model. If a zirconia substructure is needed, the partner lab also can design and mill the framework while awaiting arrival of the model. The model with mounted framework is then sent to the dentist’s laboratory for completion. If no zirconia core is prescribed, then Brontes sends the sectioned model as well as working model directly to the laboratory.”

“I think the greatest benefit these new technologies are bringing to the field of dentistry is they are opening the door for dentists and laboratories to communicate,” said Buffum. “It’s giving us the ability to share information through technology integration and bring two vital sets of dental knowledge together on a case, which undoubtedly raises the level of patient care.”