Table of Contents

Continuing Education
Cover Story

Inside Dental Technology

June 2014, Volume 5, Issue 6
Published by AEGIS Communications

The Three Levels of CAD/CAM Integration

Expanding your business with new technologies

By Susan van Kinsbergen

Digital technology is here to stay, and laboratory owners who wish to remain viable in the dental marketplace must begin to embrace this reality. Luckily, this ever-expanding digital world has made it easier than ever to incorporate CAD/CAM into a laboratory’s fabrication processes. In this article, the author will examine the pros and cons of three different pathways for integrating a digital workflow into a laboratory’s processes.

Level One: Complete Outsource

Laboratory technicians are artisans. Everything they do is hand-crafted exactly to their standards and they are accustomed to this manner of working. However, even in today’s advanced digital marketplace, many technicians are concerned that digital technology will negatively impact the quality of their products, and as such, do not feel comfortable using it. With the advances the dental industry has seen in CAD/CAM technology over just the last 5 years, these concerns are no longer a viable excuse for excluding digital technology from a laboratory’s fabrication processes. Even with these advances, some laboratories are still not ready to incorporate this technology in-house. However, with just a shipping box and a tape gun, these same laboratories can enjoy all of the advantages of the CAD/CAM technology by simply partnering with an outsource production center.

A wide variety of CAD/CAM products are now available through the use of an outsource production center, and all a laboratory needs to do to use their services is send the center their models. By using an outsource partner invested in a validated manufacturing process, laboratory owners find that their resulting restorations will be more accurate, precise, and consistent. Many outsource companies also offer design preview services so that laboratories know exactly what they will receive before it arrives in the mail. Partnering with an outsource center does not require any new equipment or software, and requires minimal training.

A potential downside of working with an outsource center rather than creating CAD/CAM restoration in house is a longer turnaround time due to travel necessities. Laboratory owners must also consider shipping and outsourcing costs.

Level Two: In-House CAD

As a laboratory owner grows more comfortable with digital technology, they may decide to purchase a scanner. With a scanner, the laboratory can scan models in-house and send the digital file to an outsource partner for design and fabrication, or have a technician digitally design the files in-house and send to an outsource center for fabrication. While the former scenario is advantageous for laboratories that do not have an in-house design technician, the latter gives the laboratory complete control over the design of their restorations. Design software allows for flexibility when a change needs to be made to a design, especially in a short time frame. The software will also check the parameters of the product being designed to make sure the designer stays within the manufacturer’s specifications.

With the incorporation of an in-house scanning system, a laboratory’s production levels will typically increase. Turnaround time will also be reduced by a few days because outsource partners receive the file instantaneously and immediately begins fabricating the restoration. One must still consider the time it takes to transport the final restoration, but shipping costs are reduced because heavy models are no longer being shipped back and forth.

The challenge many laboratories face when introducing scanners into their production workflow is the expense of the scanner and training. Choosing which technicians would be a best fit for the technology out of a large staff can be another challenge. The author recommends that laboratory owners consider a potential digital designer’s dental IQ first, and his or her computer skills second. A digital designer needs to understand tooth morphology and function if a CAD department is to run efficiently. A dental technician with experience in waxing or ceramics, as well as technological savvy, is an ideal fit for a digital design department.

Level Three: In-House Production

Level Three can the most advantageous for a dental laboratory, but is also the most financially daunting to achieve. If a laboratory has already incorporated scanning and digital design into the workflow, adding a mill to the mix can create a 22 hugely efficient CAD/CAM workflow. With in-house milling, laboratories will see increasingly accurate and consistent results, higher production levels from your employees, and lower labor costs. Even with an in-house milling system, laboratory owners may still choose to outsource some of their restorations, but it will no longer be a necessity.

However, laboratory owners must remember that a milling system can be a very expensive venture. Implementation can be costly, and all complicated machinery requires maintenance. It is important to calculate the laboratory’s return on investment before making a purchase.

Making the Right Decision

With three different levels of commitment, there is no time like the present to start pursuing CAD/CAM dentistry. Laboratory owners should consider all of their options and make the best decision for their own businesses.

About the author

Susan van Kinsbergen is the owner of SvK Consulting in Newport Beach, CA.