Inside Dental Technology
Digital Workflow Drives IDS 2013
All indicators at this year’s IDS show on dentistry’s future direction pointed to the still maturing but explosive breakthrough advances being made in integrating digital workflows into both the practice and laboratory. From new developments in intraoral impression scanning technology and small desktop mills for the practice to large high production milling units and new generation millable materials for the laboratory, the 10 massive halls of the KolnMesse exhibit center buzzed with excitement as crowds gathered to see what new innovations manufacturers were unveiling.
Scanners, Milling Machines Everywhere
If digital impression technology and new milling materials drove the excitement at the IDS this year, new model/impression scanners and milling machines weren’t far behind. Sirona’s ( www.sirona.com) new inEos X5 automated 5-axis scanning technology features a robot arm that rotates the model or impression to capture the occlusal surface of an entire jaw for example in about 10 seconds. File data also can be exported in open STL format for processing on third-party CAD/CAM systems. The company’s newly released inLab SW 4.2 CAD software allows importing a 3D image of the patient’s face for sharing a realistic virtual smile design proposal from the laboratory with the dentist and patient.
Nobel Biocare (www.nobelbiocare.com) launched the second generation of its NobelProcera scanner and announced an open-access partnership with 3Shape for NobelProcera implant abutments. The upgrade to the new 2G scanner technology should be made available sometime this fall.
Schütz Dental ( www.shuetz-dental.de) introduced the open-architecture Tizian Smart-Scan, which offers a large field of view, is up to 72% faster than the company’s previous scanner, and will support scanning large bridges up to 16 units, abutments, and supra constructions as well as waxups, wax models, and attachments.
Another company launching a product was Amann Girrbach, whose new Ceramill Motion 2 4X can process numerous materials from zirconia, chrome cobalt, and resin to wax, glass-ceramic, and lithium disilicate. Wieland ( www.wieland.com) showcased the 5-axis ZenoTec Pro, a high end, high production wet/dry milling unit with 7-disc material changer, 10-position tool changer, and heavy-duty Zubler extraction unit and cooling system in the base.
Zirkonzahn has diversified its milling strategies with three new specialized mills. The new M1 wet mill is engineered specifically for the production of titanium or glass ceramic implant abutments and bases from pre-milled abutment blanks. The new M4 dry 4-axis milling machine is a versatile unit that can mill models from intraoral scan data in about 20 minutes or using a 4-blank plate can mill four different materials in one milling session. A unique clamping device also allows for wet milling glass ceramic blocks. The new 5-axis M6 wet milling unit sports automatic milling blank and tool changers.
For the first time we were able to get a look at Zubler’s (www.zubler.de) new DC5 5-axis wet/dry milling unit and the Vario Scan scanner. The DC5 is capable of dry milling zirconia, alumina, PMMA, composite, splint resin, wax and all standard model materials as well as wet mill chrome cobalt, titanium, and glass ceramics with two separate cooling systems. The Vario Scan strip-light projection scanner incorporates Exocad CAD software and is capable of scanning models as well as impressions.
Among the many other scanners on display at the IDS were White Peaks’ (www.white-peaks-dental.com) CALIDA LightRay EVO 360 model and impression scanner with Exocad DentalCAD design software, new Optimet (www.optimet-dental.com) DS 6000 full-auto scanner, Shining 3D’s (www.shining3d.com) 2-axis model scanner, and the MB Maschinen MB Scan ( www.mbmaschinen.de), and EGS DScan with DentalCAD software ( www.egssolutions.com).
As for milling units, it was interesting to see the variety of chairside units now on the market. Roland (www.rolanddga.com) introduced their new mini DWX-4, a very small footprint milling unit that appears to be an ideal size for a practice. Carestream introduced their CS 3000. KaVo (www.kavousa.com) for the second IDS in a row showcased the Artica unit that is marketed to both laboratories and practices. It is quite a bit larger than other units designed for in-practice use however. Glidewell ( www.glidewelldental.com) had their TS 150 Chairside mill on display as did Sirona and
E4D ( www.e4d.com).
3D Printing/Laser Sintering
No discussion of the IDS would be complete without mention of new developments taking place in this arena. The players are still few but the number of unit sizes, indications, and price points as well as material options is expanding. Prior to the IDS, EnvisionTec (www.envisontec.com) introduced the Perfactory® Micro, the most economical desktop 3D printer in their product line for small, lower production operations. At the IDS EnvisonTec unveiled the 3Dent™ SCP (Selective Contour Photocuring), which is specifically engineered to produce dental models using the company’s E-Denstone.
Stratasys (www.stratasys.com) launched its new small footprint desktop Objet30 orthodontic 3D printer. Designed for smaller laboratories and practices, the printer can produce stone models, orthodontic appliances, delivery and positioning trays, clear aligners, retainers, and surgical guides.
3D Systems unveiled its newest printer, the ProJet® 3510MP along with VisiJet® Pearlstone material for producing models that have the feel and look of a traditionally poured stone model.
EOS ( www.eos.info/en) showcased the newest application for its M270 laser-sintering unit. Now laboratories can produce up to 48 chrome cobalt removable partial denture frameworks in a single 24-hour build cycle.
Bego (www.begousa.com) announced a wide range of new products and services now available from its production center. The company now offers laser sintered noble alloy substructures. Other new services added to its production center are: milled IPS e.max®, milled zirconia products, milled Wirobond MI chrome cobalt, and Grade 4/5 titanium crown and bridge frameworks, custom implant abutments, and implant bars.
Argen Corp.’s (www.argen.com) booth at the IDS was crowded with attendees anxious to hear more about the company’s new digital Captek™ restorative services as well as its laser sintered noble and non-precious substructures available from Argen’s production center. On hand at the booth was Andrew Goodall, CEO Skillbond Direct in Britain and subsidiary of Argen Corp. He indicated the Argen digital SLM production concept would be coming to the UK later this summer.
Renishaw (www.renishaw.com) unveiled its new 3D laser sintering solution for UK dental laboratories utilizing its outsource production facility. Laboratories will now have access to low-cost, high quality chrome cobalt copings and frameworks that are nickel, beryllium, and cadmium free.
New Materials Expand Restorative Options
Certainly excitement buzzed over the number of new millable materials introduced this year. Amann Girrbach (Ceramill Sintron), Zirkonzahn ( www.zirkonzahn.com) (Sintermetall), DENTSPLY Prosthetics ( www.prosthetics.dentsply.com) (Crypton), Sirona (InCoris CC), White Peaks (CopraBond K) and others were showing off their branded versions of the new chrome-cobalt milling material that can be dry or wet milled in desktop mills in the green state and then sintered to final hardness. This new class of millable metal, however, must be sintered in an argon gas filled chamber. Some manufacturers, such as Amann Girrbach and White Peaks, have developed specialized sintering furnaces for this process whereas Sirona, DENTSPLY, and Zirkonzahn provide an adapter kit for their inFire HTC Speed, Cercon HT, and Zirkonofen 700 furnaces respectively that converts the zirconia sintering process to the argon infiltrated process.
DENTSPLY also introduced a zirconia-reinforced lithium silicate called CELTRA CAD that is specifically designed for milling in the Sirona MCXL desktop milling machine.
Nobilium, a division of CMP Industries ( www.cmpindustries.com), launched a millable disc for complete dentures called DentureDisc. Available for sale this summer, the disc comes in multiple shades formulated from the company’s Nobiltone high impact denture base resin. The company is working closely with CAD software providers to develop a unique, patent-pending approach to incorporating polymer denture teeth into the CAM process.
Schütz Dental has developed a new zirconia-reinforced composite for its Tizian milling machine. Tizian Reinforced Composite material can be veneered with composite for final restorations or used as a temporary bridge framework up to 14 units, frameworks for implant-supported restorations, crowns, veneers, and onlays/inlays.
One unique and commonsense concept seen at the IDS for the past few shows is the priti®crown (www.pritidenta.com), a preformed milling disc. The CAD software is compatible with both Exocad or 3Shape CAD software and is available as a free add-on. The catch is that the designed restoration must be sent to a Pritidenta certified manufacturing partner for final milling. Currently, there are none in the US, according to the company’s web site.
Digital Impressioning Takes Center Stage
Greatly anticipated at this year’s IDS was the introduction of new digital impression systems or enhanced versions of existing technologies, and the show didn’t disappoint. Slimmer design, faster data capture, and more budget-friendly is the obvious direction this technology is headed. At least four new impression scanner developments were on display, as well as five next-generation iterations with announcements that another six are still in the developmental stages. 3M (www.mmm.com), Align Technologies ( www.aligntech.com.), and Sirona all introduced their next generation of intraoral impression scanners before the opening bell of the Chicago Midwinter show this year.
So what new impression scanning technologies were introduced? Zirkonzahn’s Detection Eye intraoral digital impression scanner is a small, lightweight 6-gram unit that plugs into a computer USB port and delivers open interface STL format data. Optimized for integration into the Zirkonzahn workflow, the unit is reported to scan an entire arch in under two minutes. This and the IMES-icore intraScan 3D closely resemble the MHT digital impression technology introduced two years ago at the IDS.
Carestream Dental ( www.carestreamdental.com) expanded its imaging portfolio with the debut of their CS Solutions equipment line, which includes the CS 3500 intraoral scanner, CS Restore CAD software, and CS 3000 chairside milling machine. An interesting aspect to the intraoral scanning technology is a light guidance system that guides dentists through the data acquisition process so that the practitioner does not have to watch the monitor to ensure data is being captured accurately. As with other manufacturers offering chairside solutions, Carestream introduced the CS Connect web-portal to enable dentists to electronically transmit cases to the laboratory.
The A-tron3d BlueScan-I (www.a-tron3d.com) is most likely the lightest intraoral scanner on the market. Maintenance and calibration free, the scanner plugs into the practice computer’s USB port for complete mobility and outputs scan data in STL file format.
Still other digital impression technologies are under development from EGS in Italy, Laserdenta, SmartOptics, and Dental Wings. Closer to release are the Medentic iTray (www.medentic.de) with an oral insert resembling the conventional impression tray; and Seikowave eVox Micro (www.seikowave.com/index.php/products).
Medical Franchise Investment ( www.mfi-capital.com), a Belgian group working in conjunction with Dr. Francois Duret, unveiled the Condor intraoral scanner. Slim, lightweight, and ergonomically shaped, this handpiece-shaped scanner plugs into a computer’s USB port and displays scan data in full color. Scan files are in STL format; no spray powder is required; and no click fee charged. According to Dr. Duret, this technology will be offered on the market for less than $10,000 US.