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Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Digital Esthetics. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.
How CAD/CAM and 3D printing are reshaping the dental industry.CAD/CAM changed the face of dental laboratory work about 15 years ago, and you’d be hard-pressed to find a lab that hasn’t heard about CAD/CAM, isn’t considering CAD/CAM or doesn’t already own a CAD/CAM system. And while the basic system is revolutionary, it has continued to grow and evolve.
CAD/CAM changed the face of dental laboratory work about 15 years ago, and you’d be hard-pressed to find a lab that hasn’t heard about CAD/CAM, isn’t considering CAD/CAM or doesn’t already own a CAD/CAM system. And while the basic system is revolutionary, it has continued to grow and evolve.
One such advancement comes in the form of 3D printing. Labs can derive a lot of use from 3D printers and their prices are coming down, so now might be a good time to consider adding the technology to one’s CAD/CAM solution.
01 | Internal workflows are improved.
At the lab, 3D printing is widely used to streamline and simplify workflows. Chiefly, it is used for model making. In the past, of course, a model would have to be handmade from stone. While this method has been used by laboratories for decades, it is not ideal. It takes time to create a model, pour it up and wait for it to set. Functionally, these types of models are not optimal because they lack some level of accuracy.
3D-printed models ameliorate all of this, because they can be taken directly from a doctor-supplied intraoral scan. Those scans provide a higher level of accuracy than conventional impression. It does take some time to print, however if multiple models are being printed at the same time on the same tray, a time savings is achieved.
02 | Surgical guides are a source of income.
At this point in time, the only product that dental labs can make a profit from is 3D printing surgical guides. These are plastic devices that are designed to go over patient’s gums and existing teeth to allow doctors to precisely and accurately place and drill holes for implants. Surgical guides also give the doctor the precise location, angle and depth for proper implant placement.
In the past, these devices were difficult and time-consuming for the lab to make. As useful as they could be for implant surgeons, their difficulty and tediousness lead to their not being used very often.
There are, of course, specific types of materials required for these devices. The polymers cannot be brittle and they must be approved by the FDA for use in patients’ mouths. Happily, however, the materials for this application are available, thus making easy 3D printing, based on an intraoral scan.
03 | Better your burnouts
Creating castables is easier and more efficient using 3D printable burnout resins. Because of the detail required for dental applications, castings must meet exacting dimensional requirements, and can be very demanding. That process is simplified through 3D printing.
With castable resins and 3D printing, labs can easily fabricate detailed metal parts (be it a framework, inlay, onlay, and so forth) through the investment casting process.
3D printable burnout resins are used to print the desired object. These resins are created for optimal burnout performance. Once the object is 3D printed, it is placed in a mold which is then put it into a furnace for burning out.
From here, the process follows the same steps to complete the object’s investment.
The advantage, obviously, is an overall simplification of the object’s creation. The object can be created as part of the CAD/CAM workflow, rather than being constructed using conventional, analog methods. The resulting object can be more detailed and precise.
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04 | The materials are getting better.
Materials are an important component of 3D printing – especially for dental applications. Initial 3D printing applications utilized very basic materials. However, there are some manufacturers that employ different materials – different densities, different opacities, different flexibilities. Some materials are FDA-approved to be used in the mouth for brief periods of time, and some – like the aforementioned resins for burnouts – are formulated for a specific purpose.
More interestingly, some 3D printer models can combine all these materials in one print cycle. These capabilities improve the model- and surgical guide-making process.
05 | The technology is getting better, too.
Hand-in-hand with materials is the technology behind 3D printing. Obviously, the more accurate the part, the more useful it is.
Traditionally, material is deposited by the 3D printer, layer upon layer, until the structure is created. But one company, Carbon, utilizes a process that is it dissimilar to any other 3D printer on the market. Their technology prints the entire unit as one homogenous mass, rather than a layer at a time.
“We are able to get parts with isotropic mechanical properties,” Elle Meyer Director of Business Development, Medical Technologies, Carbon, says. “Meaning, they perform like injection molded parts, rather than 3D printing prototypes.”
06 | Faster fabrications.
3D printers can create objects that are impossible to mill or injection mold, but they have one big obstacle – speed. Currently, milling a restoration takes about 15 minutes. 3D printing takes much longer, depending on the size and complexity of the object. An advantage that 3D printing has over milling, however, is that multiple items can be fabricated all at once.
“With printing, whether I’m printing out one unit or 11 units, it’s going to be the same 15 minutes,” Chris Kabot, Dental Applications Specialist, EnvisionTEC, says. “For those big cases, that’s really going to be a big advantage for these doctors to provide restorations right there at the point of care.”
Those restorations might even find themselves in the doctor’s office, one day.
“We’re going to start looking at speeds that will make laboratories more productive at the point of care, so doctors can provide these applications quicker than ever before,” Kabot says.
07 | There’s more money for everyone.
As 3D printing technology continues to improve, prices are expected to come down. For example, it costs less for the laboratory to make a 3D printed model using an intraoral scan and CAD/CAM processes than it does to make it conventionally, using a physical impression and pouring up a stone model. Also, technicians need to spend less time on a restoration, so that reduces the cost of manpower.
The end result will not necessarily benefit the patient with a less expensive crown or bridge, but it will certainly lower costs for the lab. Those cost savings could be passed along to the dentist, depending on the lab’s business model.
CAD/CAM is an amazing technology and it continues to evolve, making lab work easier and more efficient. Adding a 3D printer to your CAD/CAM solution takes its usefulness to an even higher level.