Ryan Hamm is the former Editorial Director for Dental Products Report and Digital Esthetics.

Ryan Hamm

Articles

Digital Esthetics looks at coming technologies that will impact the digital dental workflow, from 3D printing to augmented reality and more. 

8 emerging technologies that will change the dental laboratory

	It doesn’t take much imagination to see how new technologies impact the dental world. It’s usually just a question of how. While some innovations are iterative in nature-think software updates, or slight tweaks geared toward improved or faster usability-some new solutions are so big that the promise for drastic change is felt immediately. Consider the first intraoral scanner; the accuracy and results may have left something to be desired, but the potential was obvious.

One of the remarkable things about dental technology is how much it borrows from other industries-

 came from the manufacturing sector, and it just took some software tweaks to improve the accuracy. Material revolutions have been helped by breakthroughs in the health care sector, using regenerative materials originally developed for other uses in the body. Technologies that were invented without a thought to dentistry have been pulled over and changed dentistry and the dental laboratory forever.

The dental perspective: 6 coming technologies on the clinician side that are changing dentistry

	With that in mind, here are some consumer and medical technologies currently on the market that have the capacity to shape the dental world for years to come. Some of these technologies have started to come into materials and equipment dental technicians use every day, while others are years away-but all of them may change what dentistry is.

	Click the next button to check out the technologies that could change everything ... 

	While it’s often lumped in with virtual reality, 

 (AR) is its own technology with its own potential uses for the dental laboratory. Simply explained, AR is basically the merging of the “real” world with digitally-rendered graphics, often 3D. The easiest way to imagine it is by looking at your smartphone camera app, and imagining that what you see on your screen has something “fake” overlaid on it. That’s AR, in a nutshell.

Looking back: The predictions from industry voices for tech in 2017

	So far, it’s been tricky for anyone to gain significant traction in AR. Perhaps the most notable example was the release of Pokémon Go in 2016, which used the camera on peoples’ smartphones to blend computer “pocket monsters” with the real world. Snapchat also dabbles in AR with some of its filters that overlay graphics with actual images.

	For dentistry and dental labs, there are a myriad of applications that could eventually stem from AR technology. Imagine if patients could see an immediate image of their improved smile, in real time, based on actual STL files created with CAD software-in short, a super-accurate “try before you buy” AR filter that would help patients visualize the final restorative option. Other possible applications could include AR-powered glasses that allow technicians to keep shade guide, prescription details and other information handy when finishing, staining or polishing a final restoration. AR presents some exciting possibilities in dentistry.

	While gene-mapping is a relatively new technology, it presents some fascinating glimpses of how personalized care could look in the future. Right now, 

 are using gene mapping and DNA to explore individualized nutrition plans that could look wildly different from person to person.

	It’s easy to see how this kind of hyper-personalization could apply in the dental world. Imagine having access to a person’s genetic make-up so you’d be sure that a particular material type would work best in a patient’s mouth-you could make sure that any genetic history wouldn’t result in future problems. Additionally, dentists could use the same functionality to ensure that any bonding products they use for restorative work would behave with the genetic material of the patient.

Related: 10 implant trends you need to know

	For implant cases, the entire dental team could also track how bone growth happens in individual patients and what kind of osseointegration they can expect in a given case. As restorative and prosthetic dentistry becomes more and more personalized, the possibility of genetic information informing specific cases is an exciting possibility.

 has already taken the dental lab world by storm. But there is room to grow in the printing technology itself (not to mention the realm of 3D printing materials, which we cover in more detail on slides eight and nine).

	For starters, there’s Continuous Liquid Interface Production, a proprietary 3D printing technology owned by 

. This method of 3D printing is engineered to be around 100 times faster than current 3D printing speeds, and also has the added benefit of looking like a science fiction movie. Just watch 

and imagine if that was a denture being created before your eyes.

Must-read: What the future of 3D printing looks like

	Other 3D printing technologies are also drastically changing what labs can do in terms of cost, speed, accuracy or other factors. 3D printers that can print different materials from the same printer are already on the market, and as those improve, it’s easy to see how dental solutions needing different materials (say, removables) could someday be entirely printed. There may not be a more disruptive technology coming to dentistry than 3D printing, and what we’ve seen at this point is likely just a hint of what’s to come.

” is a catch-all term for non-computer “things” that are connected to the internet-think the refrigerator that can order groceries, or the Dash buttons that Amazon makes far too easy to buy. The idea behind it is that, eventually, all of our “things” will all be connected to each other and to information centers around the world.

. And if the consumer market is in any indication, that is only the beginning. Imagine dental technicians putting sensors into their crown build-up, including the placement during their CAD process. Or, imagine milling materials that conduct power to a “smart tooth” that can provide information on everything from patient activity levels, to bruxism, to brushing habits and more. A smart tooth could order new floss when tartar levels get too high, or even auto-schedule a dentist appointment when the tooth detects something is off in the oral cavity. For dental technicians, the tooth could even signal when it’s seated in a proper spot as determined in the design phase, making sure that remakes and pressure-related cracks are things of the past. Internet-connected teeth may sound bizarre, but they could have plenty of possibilities for dental labs. 

	Earlier this year, the first robot designed for dental implant surgery 

. It’s designed to ensure accurate and precise oral surgery, specifically for implant cases and implant placements. And it’s also just a glimpse at how much robotics could change dentistry.

Looking back at 2012: How far has dentistry come?

	Currently, surgical robots are coming into their own in the medical field, and those innovations have 

. The intent of surgical robots is to allow more precise control over surgeries, ostensibly providing better care, less invasive procedures and improved healing times. Some researchers are even experimenting with completely hands-free surgeries-though these will likely always be a minority since quick reactions and critical thinking are key to any surgery.

	What could robotics bring to dentistry? Well, it’s obvious that dental surgery could eventually be robotized. But other areas could be helped by robotics as well. Perhaps a robot could be guided by a 3D CAD and CBCT scan to perfectly drill an implant site, followed by the perfect placement of a crown, all from the same scan file. Or, micro-robots could be used for minimally invasive, in-office procedures that used to require a large team and a surgical operatory.

	It seems like dental laboratories have heard the promise of 3D printing for years. And 3D printing has certainly made its mark on the dental workflow. Yet, what’s coming in 3D printing materials shows that what is currently happening in dental 3D printing is just the beginning.

Related: 7 ways 3D printing is already changing everything

are new advances in printable ceramics and metals

-both materials that have obvious implications for dentistry. Right now, these materials are in their early stages and are geared toward the manufacturing and hobbyist sector, neither of which require the hyper-accuracy that dentistry does. But early adopters of CAD/CAM remember how much the accuracy of manufacturing technology can be improved, and there’s no reason to think the same won’t happen with

	As material technology improves on the dental side, it’s easy to imagine how some of those materials could be adapted into 3D printing. It may not happen for some time, but it’s certainly possible to imagine that most restorations could someday be printed out of a biocompatible material that is as esthetic and strong as other options.

	Another exciting area of research with implications for dentistry is in the area of 

. Biomaterials are used to print final, organic prostheses that will be biocompatible and entirely accepted by the patient’s body. Some biomaterials use stem cells to create body parts, while others are complicated mixtures of existing organic material from non-human sources with human-made components. But the potential to create human tissue with these materials have endless possibilities for the dental market.

	It’s incredible to imagine that, someday, it may be possible to “print” a patient’s teeth using their own genetic material, making a restoration that is as natural as the teeth they were born with. Dental laboratories could also use biomaterials to print gingival segments that will fit and merge with existing gingival material, providing “dentures” that are actually just real teeth in real gums that can still be removed.

	Of all the technologies on this list, this is likely the tech that is already here-and that is invisible to most users. For a while now, dental technicians and dentists have had access to tremendous hardware that has made remarkable solutions a daily reality. And yet, sometimes that hardware was limited by what the software could do-limitations due to processing power, or in the ways the software was programmed.

Related: 6 tips for switching to digital dentistry

	All of that is quickly changing. Digital dental software is better and faster than ever, and will eventually help multiple-even complicated-restorative cases become so predictable that a computer can quickly and accurately design, virtually “place” and mill a perfect solution. As improvements to hardware and milling materials are also released, the software to take advantage of those improvements is rapidly progressing.

	Additionally, as more and more data is being collected in each case, it provides a way for 

artificial intelligence to offer immediate solutions

 and better treatment plans, based on all the data provided on a particular patient. If a computer notices that a patient’s bite has shifted over the course of a few appointments, that shift could be taken into account when the digital data is entered into the CAD process-suddenly, every crown, bridge or other restoration is even more unique than has ever been possible, because the machines are “learning” how to address problems before they start.

	Improvements in machine intelligence are going to impact every part of life in the next decades, and dentistry is no exception.

Digital Esthetics looks at coming technologies that will impact the digital dental workflow, from 3D printing to augmented reality and more. 

It doesn’t take much imagination to see how new technologies impact the dental world. It’s usually just a question of how.

	Dental materials have gone through a drastic change in the last decade. Long gone are the days when porcelain-fused-to-metal restorations using gold were the standard. Instead, dentists and patients have begun to explore the world of digital materials, from single-unit offerings created chairside to more elaborate restorative solutions offered by digital dental laboratories.

	One of the most recent innovations in digital dental materials has been the rise of new zirconia solutions that are extremely esthetic, formulated to mimic true tooth shade and dentition color. To find out how these materials are changing what practices can offer to patients, we spoke with Daxton Grubb, president of 

 in West Bartlett, Tennessee. He explained why dentists need to know about the changing dental materials world, what advantage new zirconias offer over past solutions and why his lab is excited about the digital future of dentistry.

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	Tell us a little bit about yourself and your lab.

	My educational background is in business with a double major in finance and management. In 2003, Randy Grubb, my father and CEO of R-dent, asked me about coming aboard and helping him grow his declining family business. Within a year and a half, we added a removable department to a very dominant fixed-only dental laboratory. In 2006, R-dent had grown from seven to 22 employees. Today, R-Dent Dental Laboratory is the largest independently owned full-service lab servicing Tennessee, Mississippi and Arkansas, employing over 60 people.

	Why should dentists care about the materials their labs are using? As long as it’s cheap, does it matter?

	It absolutely matters. We are at a crossroads in the industry where zirconia prices are continuing to drop and with that so does the quality of the zirconia. At the end of the day, we want what’s best for the patient. The bottom line is, all zirconias aren’t equal, and the differences in how they are manufactured can present significant differences.

	Could you give a brief rundown of the evolution of digital materials and, in particular, zirconia and super translucent zirconia?

	When zirconia was first introduced to dentistry, the material was snow white and very opaque. At the time, 3M was the leader in this market, and they quickly developed acid-based coloring liquids for shading their materials before sintering.

	Next came pre-shaded discs. With these, labs could eliminate acid-based liquids from the workflow and just mill the restoration from the correct pre-shaded disc. These monochromatic pre-shaded discs are still popular today.

	In 2014, multi-shaded or multi-layered discs that mimic natural dentition with cervical, mid-body and enamel shades built into each disc were introduced and they were very well accepted by the industry. At that time, most zirconia materials had a 1100 MPa flexural strength and were more opaque (40% light transmission at 1 MM) than natural dentition.

	The following year, a new generation of cubic zirconia was introduced. This new category of zirconia more closely matched the needed translucency of teeth (49% light transmission at 1 MM), but to reach that level the flexural strength was reduced to 600-700 MPa. At 600 MPa this new product was still 50 percent stronger than lithium disilicate (LO), and unlike LO, this zirconia had nearly zero strength degradation over time.

	Next came multi-layered zirconia. These materials, such as [Zirlux Anterior Multi], are likely the highest quality, most esthetic materials available today. They are made from the cubic powder material and are multi-layered for what is the most lifelike monolithic ceramic restoration available. For all your zirconia single crowns and small bridges, these are the best materials offered in dentistry.  

More from the author: 7 MORE of the craziest impressions you've ever seen

	How long have you been using the original Zirlux and how long have you been using the latest product, Zirlux Anterior Multi?

	We have been using Zirlux Zirconia in our lab since the original Zirlux FC came to market. We continued to adopt the next generations of Zirlux Zirconia into our production and are excited by offering Zirlux Anterior Multi. We’ve found that a multi-layer zirconia is a great restorative choice for the anterior and our doctors have been very happy with the esthetics.

	What is your favorite quality offered by Zirlux Anterior Multi?

	This material is consistent. Time and time again I can achieve the esthetic results for a variety of indications without sacrificing strength. I know I’m delivering the patient the finest quality restoration.

	What’s been the reaction from your dental clients who have received restorations using the material?

	Because I can achieve consistent results with Zirlux Anterior Multi, my doctors trust that they’re getting consistent restorations and providing patients with the best quality product.

Read more: Looking back to 2012: How far we've come

	Patients have more confidence with a natural looking smile knowing that their restoration will last.

	What advantages do you think Zirlux Anterior Multi offers over other alternatives? Why have dentists and patients responded positively to the material?

	Zirlux Anterior Multi offers more strength and range of indications than lithium disilicate. The discs have full gradient shading to match the incisal, dentin and gingiva of natural dentition, so they’re a fantastic solution for anterior restorations. This has been the most translucent of all the high-translucent lines of [full contour zirconia] we have tested, by far!

	What do dentists need to know about CAD/CAM and the digital workflow, in your opinion? How has that changed what your lab can do?

 is the present and will continue to be the future. Adopting digital technology opens many doors to attracting more business and expanding your current offerings as well as giving your dentist office or lab a competitive advantage. Intraoral scanners ensure fewer remakes due to improved accuracy compared to traditional impressions that can warp. It allows us to isolate variables on both sides, which is key to consistently between any dentist and lab relationship.

	In your opinion, how do today’s workflow and materials compare to restorative options of the past?

	Traditional impressions can warp, providing an inaccurate fit and margin errors with restorations and lead to remakes-intraoral scanners provide a solution to this problem. Today, there are more indications available due to the variety of materials. Zirconia provides a stronger, more translucent product compared to past materials in a quicker amount of time.

	No matter what lab you are using, be aware of what brand zirconia they are using, and unless you have the upmost trust for your lab already, do your homework on the brand of zirconia they are using. After all, these are YOUR patients, not the lab’s; you owe this to them.

How new types of zirconia are enabling better esthetics and improved patient care.  

What digital materials mean for dentistry

Each year, new technologies emerge in the dental world that change and improve existing workflows. While some innovations are iterative in nature-think software updates or slight tweaks geared toward improved or faster usability-some new solutions are so big that the promise for drastic change is felt immediately. Consider the first intraoral scanner; the accuracy and results may have left something to be desired, but the potential was obvious.

One of the remarkable things about dental technology is how much it borrows from other industries-CAD/CAM came from the manufacturing sector, and it just took some software tweaks to improve the accuracy. Material revolutions have been helped by breakthroughs in the health care sector, using regenerative materials originally developed for other uses in the body. Technologies that were invented without a thought to dentistry have been pulled over and changed dentistry forever.

With that in mind, here are some consumer and medical technologies currently on the market that have the capacity to shape the dental world for years to come. Some of these technologies have started to come into dentistry, while others are years away-but all of them may change what dentistry is.

6 Emerging Technologies that will Change Dentistry Forever

These innovations are already making waves in the broader world-and someday soon, they’ll have huge implications for dentistry.


Digital Esthetics looks at some more of the just plain weird impressions from dentistry. 

7 MORE of the craziest impressions you've ever seen

	In 2015, Digital Esthetics published an article on 10 of the craziest impressions we’d ever seen-and we were truly shocked at some of the bad, confusing and just plain 

, we’ve continued to be on the lookout for more shocking impressions. And it’s time to show you what we’ve found! One big takeaway is that traditional impressions are not alone in how crazy they are-as more dentists incorporate digital impression systems, we’re seeing more and more crazy digital impressions.

Read the article that started it all: 10 of the craziest impressions you've ever seen

	The future of dentistry may be digital-and there are certainly plenty of 

!-but that doesn’t change the fact that dentists and dental technicians still need training and a sense of artistry (not to mention patience) to get great results with digital tools.

	So without further ado, here are 7 MORE of the craziest impressions we’ve ever seen, as told by members of our editorial advisory board. 

	Click the next button to get started ...

“If that’s what you want us to print … OK!”

	Jason Atwood, CDT, Senior Digital Solutions Advisor of 

, has this story to share: “We had a doctor send this to use to make some digital models for case planning … he wondered why we asked him for a new scan! We were able to patch up the holes and distortions using some third-party software (non-dental) and printed the models for him complete with the molar coming out of the palate!”

In which Elizabeth Curran states the obvious …

Digital Esthetics editor: “Is there a story behind this?”

, CDT, RDT: “The story is, 'don't the docs look at what they send labs?' This is obvious.”

, notes that it’s important for clinicians to remember that scanners aren’t designed to overcome every obstacle in the mouth: “There are times that margins can be very hard to identify if there is slurry on them during the scanning process. The camera will not retract, so anything on the margins will come into dental CAD software as a solid. This type of issue will cause discrepancies in the margin area-the margins will likely be open. A couple of helpful tips are: Double pack chord and remove just the top chord before scanning the preparation area; and you may use Traxodent or a similar hemostasis and retraction material.”

 on a case where a missing data was the culprit: “Clinicians like to see broad contacts; in this particular case, we see the entire mesial of number 1 missing in the scan, making it impossible to design a crown with an accurate contact. This will cause either too tight contacts or open contacts. This can be a difficult area to capture, but one method used to achieve this area of data is to angle the scanner perpendicular or cross arch and then rotate it distally to fill in this area.”

, explains what happened to one poor patient: “The doctor had asked us to start on a new full lower denture case and sent preliminary impressions to fabricate custom trays. I’m normally pretty liberal when it comes to accepting preliminary impressions, since a lot of factors can be corrected in the final impression when custom trays are used. But even those tolerances have a threshold, and there was no way that we would have been able to use this impression. Right there smack in the middle of it was a perfect impression of the patient’s tongue. There was more tongue in the impression than alveolar ridge and no way that we would have been able to trim away the interference to fabricate even a custom tray. When we asked for a new one we got the usual ‘well, it’s hard to get the patient in again, just see what you can do with that one.’ We had similar issues with this dentist in the past and they were also notorious for letting their account go past due. This was the final straw so we sent back the case and haven’t worked with them since.”

 data comes through: “In this scan, on teeth numbers 20 and 21, there is a visible second layer of data causing an inaccurate representation of the opposing model. This type of problem may appear when the data is not meshing properly. It is always the best to delete the area and rescan this. A scan sent to the laboratory like this can cause a major misconception when designing the crowns. The laboratory may adjust the opposing to lower it; however, it would be a guessing game. The crowns would possibly be made too far out or in occlusion and there would be no reliable way to check jaw movements.

“In the same case on the opposite side of the arch (Fig. 2, left) we can see that the bite is incorrectly matched. This type of problem can be prevented by taking occlusal registration scans in the posterior of both sides of the arch.”

, took a slightly more positive spin on the notion of a “crazy impression”: "This is taking the idea of a crazy impression in a different direction. This was a crazy good intraoral scan (TRIOS) where the doctor got such a good scan the implant hex was actually captured relatively accurately. I have attached a few screen shots from the design software showing how well this was scanned. The crazy good four images shows the difference from the scan data to the implant hex from a file (

	Technology has long been a force for change in dentistry. Think back 20, 10 or even just five years ago-the industry looked drastically different, and day-to-day work involved tasks that have since been replaced by processing power and some clicks.

	At Digital Esthetics, we cover all the ways that technology continues to change the dental industry. And often, that includes products, software or new workflows that revolutionize what dentistry can do. With that in mind, with this issue-both a look back at 2016 and a look ahead to 2017-we wanted to hear from many of the players who make those new solutions.

	We asked all of them the same question: “How will technology change dentistry in 2017?”. We hope it gives you a glimpse into what’s to come, and helps you think through some of the opportunities to come in the next 12 months. So with that, here’s what they told us. 

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	Every technology we develop for the industry needs to be directed at helping dental professionals practice better, easier and faster. That’s nothing new; however, defining what is “better” can be a subjective question. Successful technology in the dental practice will be, to some extent, defined as helping provide better patient engagement. It will assist in elevating the patient experience by bringing them into the decision-making process in a way that makes sense to them. Technology will help patients feel more informed and empowered to make the best decisions and accept the best treatment. 

-Karen Burquest // global business leader for 3M’s Digital Oral Care Business

	The “automatization” of single crown restorations will carry on. Based on the rapidly growing penetration of intraoral scanners, model-free, super-quick CAD/CAM workflows and the availability of the respective materials, these kinds of restorations will move more and more into the office of the clinician. Digitalization and the incredible economies of scale of huge outsource milling centers will further drive down prices of single-crown restorations in zirconia, especially taking the rise of multi-layered zirconia with a minimum of manual labor involved into account. Dental laboratories will need to focus on complex, high-income restorations like full mouth restorations on implants and provide respective consulting to their clients in order to differentiate themselves from pure production centers.

-Christian Ermer // Head of Global Product Management at Amann Girrbach

	Dental technology has already changed by leaps and bounds over the past decade. Now that scanners, software and milling machines have come of age it’s time for 3D printing to be featured front and center. 2017 will be particularly exciting as we see more labs investing in a new crop of affordable desktop 3D printers that have recently become available to our industry. We will also see further progress with alternate 3D printing technologies such as fused filament fabrication and powder bed fusion. With new technologies will come new materials and new possibilities for what can be fabricated with digital manufacturing.

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	I believe technology will continue to drive the development of new and improved products and services throughout 2017, lowering the barrier to entry and encouraging increased adoption throughout dental laboratories nationwide. The laboratory will benefit through expanded product offerings and increased profitability. Technology will also allow the laboratory to become a consultant to their dentists, helping to plan the restoration process from the beginning; thus improving efficiency, quality and lowering costs, resulting in a better experience for the patient.

- Michael Clark // Argen Corp., SVP Domestic Sales

	The dental industry is experiencing rapid change driven by a variety technological of economic and educational factors. Historically, the best material for dental prosthetic restorations for reliability and durability has always been noble metal based alloys. With the aging patient base, the denture marketplace is also experiencing increased growth. Market trends have shifted to lower cost manufacturing including digital scanning and fabrication as well as less expensive materials, e.g., zirconia. Educationally, dental schools place less emphasis on the material aspects of dental prosthetics and promote digital restorations especially since the largest digital manufacturers freely provide equipment and materials. These trends require dental laboratories to move toward adapting digital dentistry and machineable materials such as those offered by Aurident, Inc. For more assistance, call Aurident at 800-422-7373.

- Bruce Spivack // Sales & Product Manager, Aurident, Inc.

	In 2017, the denture market will continue to grow by approximately 2.5 percent. Digital denture technology has evolved from its infancy to maturity. As conventional denture production capacity is decreasing, digital technology will be the major driver to meet the growing market demand. CAE (Computer Aided Engineering) provides the algorithms that are needed to manufacture true digital dentures, from impression scanning to computer aided manufacturing, deductive or additive. AvaDent Digital Denture technology offers dental professionals a versatile digital workflow with multiple entry levels that fit their business model and enable them to deliver digital dentures with unique product benefits to the patient. 

	Faster, less expensive computer technology enables enhanced, more robust and easier-to-use open-source software and intraoral scanner technology, making it easier for the clinician to acquire and implement a digital-dental manufacturing solution. Adopting a digital workflow will allow doctors to collaborate with their laboratories to more effectively review and plan cases in real-time, eliminating old manual, trial-and-error techniques. More sophisticated additive and subtractive manufacturing systems together with advancements in dental materials will enable doctors to minimize patient chair time and reduce costs while allowing the clinician to quickly and profitably provide a wider range of high-quality product offerings with increased clinical benefits and greater esthetics.

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	Dentistry is in the middle of a sea change; consolidation, shifting demographics and other factors are forcing the profession to evolve. Technology will play a central role-but will it be more portable, affordable and easy to implement? Look for technology providers to pioneer smaller, valuable and indispensable new tools. 

-John Bernhard // Director of Product Development, BIOLASE, Inc.

	Today, the vast majority of dental crowns prescribed in North America are monolithic. Until now, lithium disilicate (LD) has been prescribed by many as the standard of care, with adequate strength and “good enough” esthetics. In fact, through many tedious analog manufacturing processes, monolithic, monochromatic LD has led the market. More recently, companies (Amann Girrbach and Noritake) have developed far more esthetic multi layered, multi shaded zirconia discs that facilitate CAD/CAM manufacturing. These new materials are stronger, more esthetic, less costly and require much less labor for fabrication. In conclusion, the tipping point for esthetics and strength of CAD/CAM fabricated restoration has evolved and will play a big role in the coming years.

-Bob Cohen // Executive Director, Product Development & Clinical Education, CAP

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	Technology in 2017 will make dentistry a lot more exciting and lot easier. Take intraoral scanning, for instance. Because it’s digital, everything just drops into place-I don’t have to worry about the occlusions, the margins, contacts; it’s all designed on a computer, and that’s exciting to me. As for ease-of-use, I’m still astounded by how accurate everything is with my CS 3600 intraoral scanner and how much time it saves me. Plus, the turnaround time from submitting digital impressions to the lab to receiving the final restoration just makes everything so easy. 

-Stephen D. Poss // D.D.S., Poss Dental Designs, Brentwood, Tenn.

	There have been companies out there offering chairside digital smile workflows for quite some time; but I believe that 2017 is the year that people will really take notice of what has been tagged as “Emotional Dentistry”. Traditional treatment planning is becoming enhanced by digital technology. The use of photos, videos, and 3D digital mock ups are helping the patient to better visualize their own restorative work. This approach empowers them to take more ownership of the treatment process. The end result becomes a reflection of their own unique personality, enhancing the success of the treatment for all involved.

-Jason Atwood // Advisor: Education, Training and Technical Support, Core3dcentres North America

	For the past couple of decades, technology has revolutionized dentistry. Now, various technologies are beginning to communicate more with each other to create synergies. For example, dentists and laboratories see improved digital case communication with software like Sirona Connect. Cone beam technology and CAD/CAM integration allows dentists and laboratories to provide better and safer implant dentistry. Including the integration of dynamic TMJ tracking data allows dentists and laboratories to create restorations using live functional data. Dentsply Sirona is in a unique position for innovation and integration to create these overarching dental solutions that enable dentists and laboratories to work closely together to provide better, safer and faster dentistry for their patients. 

-Kassandra Brau // Laboratory CAD/CAM Marketing Manager at Dentsply Sirona

	Specific to implant dentistry, technology can greatly lend to efficiency in coordination and communication amongst treatment team members and patients alike, which ultimately leads to better outcomes. It also allows for simplicity and precision in case planning and assessment so solutions can be best tailored to each patient’s individual needs. Patients desire fewer office visits and reduced treatment times. Leveraging technology allows dental professionals to achieve higher patient satisfaction by meeting those patient expectations while increasing productivity in their practice/business, without compromise to reliable, long-term, results. For this reason, as Dentsply Sirona Implants, we are committed to innovation, improving clinical outcomes and patient experience to drive better, safer and faster dentistry.  

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	2017 will be an exciting year for 3D printing in the dental industry with major advancements in hardware and material. EnvisionTEC is excited to add even more applications to our in-office desktop printer, the Vida, which already is the most versatile 3D printer in the dental market. It’s capable of printing mouth guards to models to waxups. Some of those new applications will include the first-ever printed flexible indirect bonding trays. On the lab side, our new Vector and Vector Hi-Res will be able to print 20 models in two hours for Crown & Bridge and Ortho models.

	Digital Technology is just touching the surface of dentistry. New technologies that can be expected to launch in 2017 include laser milling, facial scanning, faster sintering and bio-compatible milling materials (milled and seated within an hour). Dentists are becoming more inclined to intraoral scanning and doing single-unit cases in their dental practices, thanks to improved materials that provide them more advantages with faster turn-around time. However, even with technology, the laboratory will still receive all cases such as long-span bridges, anteriors, removables and implant cases. Technology in 2017 will provide better patient care and improved communication between labs and dentists.

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	Restorative Dentistry is evolving from a manual labor into a digital data knowledge-based industry. This evolution started with digital scanning (chamber, CBCT, intraoral and impression) starting to feed massive amounts of digital data into a growing lab-based CAD/CAM industry. Now, clinicians want fewer errors, faster turnaround and improved quality of care based on digital workflows. With expanding choices and rapidly declining costs for chairside CAD/CAM systems and materials, clinicians are searching for the best solutions they can deploy today. Labs should promote themselves as digital business partners to their customers, offering open, cooperative CAD/CAM solutions and consulting.

	Formlabs believes that desktop 3D printing will democratize dentistry, be a key driver in growing the adoption of digital dentistry, and advance patient care by introducing solutions that enable personalized surgical planning and mass customization. It will allow applications never seen before in the desktop 3D printing space, such as high-precision drill guides from digital scan data for implant surgeries. Dental professionals can now move from a 3D model to a directly printed surgical guide at a quick turnaround and a tremendously affordable price, and have the ability and access to develop incredibly precise tools for surgical applications.

- Dávid Lakatos // chief product officer at Formlabs

	Technology will continue to develop both in sophistication and in specific application to bring to bear safer, more predictable clinical solutions that allow dental professionals the opportunity to deliver better, more effective treatment solutions while helping drive down, in certain areas, the escalating costs of oral health care. At Kulzer Dental, our vision and, indeed, our absolute focus is to deliver upon the promise of our technologies; namely, we aim to help our customers realize significant savings or help them grow their businesses with truly integrated solutions in the form of hardware, software and services wrapped around our outstanding chemistries.

-Chris Holden // President-Heraeus Kulzer

	The gigantic progress of computer ability in recent years has enabled creating software and devices that are taking implant dentistry forward in a most significant way. Collaboration between implant producers and CAD/CAM software companies enables users to have computer-designed restorations on implants with accuracy. Computer planning of the position of implants in three dimensions and being able to design and produce a surgical guide accordingly gives the end user safety and accuracy. Cooperation between implant producers and software providers is essential for making the software usable with their the implant products.

-Dr. Roy Leshem // CEO, HI-TEC IMPLANTS LTD

Trending article: The state of 3D printing

	Throughout 2017, we’ll continue to see advancements in restorative materials while the processes surrounding these materials will continue to grow into more integrated and elegant workflows. Technology will drive improved visual case communication between the dentist and the dental laboratory to result in greater predictability for patient-specific esthetic outcomes. Further, hardware and software will simplify the decision making for restorative material type, shade and translucency. Importantly, it’s not only technology that will change dentistry in 2017, it’s the people. Deeper relationships with the right manufacturers or distribution partners for technology implementation will be a prerequisite for successful change.

-Dr. Michael Gaglio // SVP Marketing & Digital Communications, Ivoclar Vivadent

	When you hear the word “technology,” you initially think about big equipment like lasers. But it’s important to remember that technology is driven by the little things we do every day. When I graduated from dental school, we had two filling materials: gold and amalgam, inert metals that did nothing to help healing. Today, we have filling materials that actually help heal the tooth and make it stronger. With materials getting harder, the continued improvement of diamond burs is more important than ever. Doctors and patients alike benefit from technology, and sometimes it’s the small things that make the biggest difference. 

Trending article: Technique: Using digital impressions for better implants

	In light of ever-changing technology, communication channels, expectation management and demanding timelines between the patient, dentist and the laboratory are critical. Advances in digital dentistry and a seamless workflow benefit all involved in the process. Smart and forward-looking material options must support these advances while meeting and exceeding expectations. Kuraray Noritake Dental provides proven, time-tested zirconia solutions to the laboratory with KATANA for single-unit to full-arch; cement and bonding solutions with PANAVIA V5 and PANAVIA SA Cement Plus for the dentist; and consistent, strong and esthetic outcomes that make patients happy to smile.

-Lawrence Zeno // Sr. Lab Sales Manager/National Accounts, Dental Division, Kuraray America, Inc.

	Working with a number of labs around the world, I’ve found labs are focusing on innovative ways to help their staff with the day-to-day lab operations. One way is with the use of advanced technology and the right software solutions. I’ve seen labs create efficient lab environments with the ability to automate customer relations and real-time case management, tasking and scheduling. Most importantly, customer service is what will separate a lab from their competitors. Labs using digital technology are able to provide real-time automated customer services, resulting in retaining customers, acquiring new ones and ultimately growing their business.

-Gary Bagheri // CEO, Magic Touch Software International

	Technology will continue to transform dentistry in 2017 by increasing efficiency, which is essential to maintaining a competitive edge in the market. Technology purchased just two years ago has been eclipsed by the current technology in terms of speed, ease of use and versatility. Technology that several years ago was exorbitantly expensive has come down in price, making cutting-edge products more affordable for dental professionals. Holding on to outdated technology that is beyond its ROI greatly inhibits competitiveness, and will ultimately produce negative economic effects, which is why new technology is essential to stay competitive.

Trending article: How to use a 3D printer for model work

	With the evolution of digital workflows in 2017, treatment outcomes and processes will further improve. We’ll continue to see more automation of processes for both clinicians and dental laboratories, and enhanced digital collaboration. The kind of automation we are introducing will enable clinicians and their teams to collaborate more effectively. The goal is to achieve quality treatment according to a three-visit approach-diagnosis, surgery (including provisionalization) and restoration, ensuring that the time spent with the patient is used as efficiently as possible. It is not about counting the seconds when the patient is in the chair; it is about making every second count.

-Dr. Pascal Kunz // Vice President Product Management Digital Dentistry, Nobel Biocare

We asked manufactures and innovators how technology will change dentistry in 2017. Here’s what they told us.

What 2017 holds for technology in dentistry

There’s no doubt digital dentistry has already changed how dental professionals work. But what will it do to their workflow in years to come? We spoke with 3Shape’s Sven Nonboe about the future of digital dentistry, what tough questions technicians and dentists need to answer and what kinds of innovations are just around the corner. Here’s what he told us: 

What’s your background and how did you come into the dental world?

	I’m a master of science; I used to work as a software developer. I joined 

 about eight years ago, and have been a product manager ever since, trying to understand what are the needs of the customers, and how we can take those needs and find a good solution to those, obviously in close cooperation with our developers to deliver the best products possible.

How has going digital helped labs and dentists?

	When I first started we could see that many Western labs were really struggling, keeping up with prices from low-cost countries. We could see the quality in the products that were delivered from those low-cost [options] could have been better. The labs were struggling, and the dentists were not all that happy. We could see that we could really come in and make a change for the better. What we’ve done since is we have automated a lot of the work, and we made it more precise. We made it easier, we made it higher quality all around. I’m really pleased to see that many of those cases that used to go abroad are now being handled locally by some of the local labs, providing better prices and higher quality to the benefit of not only the labs and dentists, but also obviously to the patients, which is the final goal.

With 3Shape already having orthodontics and dentures in its system, what do you see as the next thing that’s now possible with the digital workflow that maybe 10 years ago no one thought would be?

	With full dentures, which is now supported in 

, we kind of cover the last missing indication. There is also a big, big trend to go monolithic with materials that look really great and that have different shades in the materials. So I think there’s a lot coming from a material and a production point of view, not so much on new indications.

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Speaking as someone who works on the CAD/CAM side, how do you think it’s possible that scanner, and even milling manufacturers, can keep up with all the material trends?

	We do a lot of in-house development and we constantly say, “OK, how can we take it a step further, how can we innovate.” The last big innovation we had in lab scanners was that we introduced the D-2000 where you can have both the upper and lower. You can scan the whole case just in one operation. 

Sven Nonboe of 3Shape explains how digital tools are shaping the industry, and what dental professionals need to know about the years to come.

The tough questions redefining dentistry

	Digital Esthetics exists because our editorial team truly believes that technology has changed the dental workflow forever.

	So with that in mind, we recently reached out to our editorial advisory board with a simple question: In 2016, what were the technologies that changed/improved the dental/lab workflow, and why were they so revolutionary?

	The iTero Element features a tablet instead of a PC to run the software and the stand-mounted tablet is easy to move and easy to use. The new camera is smaller than the old unit, and even though we didn’t have issues with the size of the old camera, this one is easier to use and also has a much thinner and lighter cable. However, the real show stopper is the acquisition software itself. The Element takes images at a rate of 6,000 per second, which means it is acquiring incredible amounts of data at a speed that seems almost impossible to imagine. -

Dr. John Flucke, Chief Technology Editor, Dental Products Report

	02 | Li-Si press ingot and Li-Si porcelain system

	I always consider ingot opacity selections in order to mask prep color, as well as coping color to match adjacent teeth, especially in single anterior cases; but I also consider porcelain color even when I bake multiple time, because I do not like low values that result in a gray color. All of this is solved now with this incredible product from GC America. -

Luke S. Kahng, CDT, Owner LSK121 Oral Prosthetics

	This dental lab scanner allows the technician to place a full arch or full mouth rehab case on a fully adjustable articulator and scan the case to ensure the proper vertical dimension. Models of patient approved provisionals can also be cross-mounted and scanned; these files are then superimposed over the die scan for efficient and accurate design of final restorations. -

Shaun Keating, CDT, Founder of Keating Dental Arts

	The use of intraoral scanning has greatly reduced chair time and increased marginal fit all while increasing patient comfort and decreasing costs as most labs will offer a discount for submitting a digital file. -

	This new snap scan body doesn’t use a screw. This allows better/easier alignment in design software to get implant positioning. The use of a connection-specific, color-coded titanium sleeve also makes the seating surface of the scan body radio opaque, giving doctors a better view through X-ray as to confirming the seating of the part in the mouth. -

Mark Ferguson, General Manger of Vulcan Custom Dental

	For lab communication, there is nothing better than a photograph. That’s where the EyeSpecial C-II comes in. The camera is specifically designed for dentistry and allows for high-quality pictures to be taken with minimal training. Because it is so easy to use and so easy to acquire good high-resolution pictures, the EyeSpecial C-II can simplify the picture taking process. It has grid lines that allow the user to center the teeth and also keep them on the proper horizontal plane. It also has an exceptional depth of field. -

	This laboratory-based tracking software allows seamless integration of sales reports, customer interface and laboratory case work. Using the online portal, customers can pay their lab bills, schedule UPS pick-ups, add photographs to cases and contact the technician directly to add specific details to their lab RX. -

	Scan at speeds up to 40 percent faster with new ScanApp software, which increases productivity. The 

 scanner has precision within 10 microns and the expanded scanning stage can accommodate large articulators, eliminating the need for re-articulation in many cases. -

	09 | No-model ortho and digital DICOM files

	Gone are the days of alginate for study casts and the time and costly expense of pouring and trimming the casts. Not to mention cases to store and index them. Now with no-model ortho and merging that with a DICOM file from the CT scan, a digital tx pl can be generated for more esthetic and optimal outcomes. -

	Computers are now able to handle more data than ever before. This capability is showing itself in that technicians are designing larger and larger cases with confidence that the computer won’t crash. -

	11 | Intraoral scan bodies for implant work

	Digital dentists can now place an intraoral scan body, scan the case and send the file to the lab instead of taking a fixture-level impression. The intraoral scan allows simultaneous production of the abutment and crown, and most single unit restorations can be successfully fabricated without ever needing a model. -

 is a Dentsply Sirona software program that provides the dental student with an objective analysis of their tooth preparations. The student can compare their prep to an ideal master preparation. The preparation can be measured by the student to assess the amount of reduction compared to the master prep, undercuts on axial walls, parallelness and adequate occlusal reduction. My favorite application of the software is the analysis of the preparation margin. The software analysis tool identifies and helps the student visualize sharp margin edges as well as nick and notches, and smooth and rough margin surfaces.  -

Elizabeth Curran CDT, RDT; Assoc. Prof., Director Dental Laboratory Technology, A.T. Still University, Arizona School of Dentistry and Oral Health

DE Editorial Board members share the technologies they think changed and shaped the dental/lab workflow in 2016.