New Products October 2020 

Slideshows

A look at some of the recently announced products from the dental laboratory industry.

October 2020 new dental lab products

According to 1989’s Back to the Future Part II, by 2015, we would have video billboards, flying cars, and hover boards. We certainly got those billboards (yay), but the film missed the boat on the airborne items. For all the technologies that it mistakenly prophesied we’d have by now, there are just as many advances it didn’t anticipate, such as smartphones, global positioning systems, and digital dentistry. In fact, if the movie had predicted that dentists would be creating crowns right in the office, it might have lost some believability at that time.

Even crazier: Dentures can now be designed on a computer and materialize seemingly out of nowhere, thanks to 3D printing. CAD/CAM has made the creation of dental prosthetics less expensive, more predictable, and endlessly reproducible. In 2020, digital dentures are on the cutting edge of dental prosthetics.

Historically, dentures were made by hand. But in 2012, labs were able to use a computer to design and create dentures. The 2 methods for denture fabrication are milling and 3D-printing.

Milling is a subtractive process; that is, a block of material is loaded into a milling machine and little by little, the machine carves away bits of the block. On the other hand is 3D printing, an additive process: The 3D printer creates the denture components out of resin, just a fraction of a millimeter at a time.

In each method, the teeth and the baseplate are created separately, and after some processing, the teeth are cemented into the baseplate. Both methods have pros and their cons.

“Over the years, the demand for dentures has increased, due to an aging population,” Lisa Aguirre, product manager of dental solutions for DGSHAPE Americas, a Roland DGA company, says. “The traditional denture-making process continues to provide high-quality, predictable results; however, the process is time-consuming, messy, and labor-intensive for laboratory technicians. This lengthy process includes multiple visits for the patient and 4- to 6-week turnaround times from start to finish.”

Digital fabrication techniques remove those hurdles. “It’s gone fully digital, which means that you can now not only take a scan in from an intraoral scanner or an impression stone [but also] develop it using the different softwares,” Todd Rutkus, CDT, support and training specialist at Benco Dental, says. “You can develop this new denture fully on the screen and then print it. And there are different ways you can print it out. One way is printing the base and then taking the teeth off a card, using a resin to cement the teeth into that printed baseplate. They can literally print the baseplate and print the teeth and put them together.”

Nakanishi Dental Lab in Bellevue, Washington, is a great example of how one lab’s journey toward digital dentures has paralleled the larger industry. Nakanishi has followed dental lab industry methods and trends for almost 70 years, starting with current co-owner Megan Nakanishi’s grandfather and then moving to her father.

“Digital dentures have been this elusive thing for several years now,” Nakanishi says. “Early on, we invested in a digital denture system, but it wasn’t truly a digital denture at that point. There were some digital aspects to it, but the result was still a traditional denture. Although our company was—and still is—committed to digital workflows, we very quickly reverted back to our old ways, because we said, ‘This digital denture is too expensive and takes too long to produce for something that is no better than our traditional denture.’

“We decided at that point to hold off on pursuing digital dentures until there was truly a digital solution,” Nakanishi continues. “We sat on the sidelines for many years until finally Dentsply and Carbon came out with the Lucitone Digital Print [LDP] 3D-printed denture. When our team first saw that denture, we all looked at each other like ‘OK, this is the real deal.’ The LDP denture is a true digital denture that provides our clients and their patients with benefits that traditional dentures just cannot provide. It’s ‘better, faster, cheaper,’ and our team is excited.”

Labs that embrace CAD/CAM see a clear benefit to the method and seem eager to promote the technology, where appropriate. “Our goal is to do everything as digital as possible,” Conrad Rensburg, owner and head of dental implants at Absolute Dental Services, says. “We’re obviously heavily invested in Carbon with the Lucitone 3D print material. We also do very limited milling of dentures, and then we also have hand processing. We’re doing about 80% digital. We’re trying to transition our customer base to as much digital as possible. As soon as we have a case delivered, we have a digital archive of that file. And if that patient comes back 4 years from now, we can print out the original try-in, they refresh the intaglio, and we go straight to finish. So, it’s a much smoother workflow if you do it digitally than it is by hand.”

The gee-whiz aspect aside, the creation of digital dentures offers obvious advantages for the lab technician, clinician, and patient.

“Conventionally processed dentures undergo polymerization shrinkage, so CAD/CAM-milled, complete dentures are a much, much better fit, intraorally, than the conventional ones,” Nadim Z. Baba, DMD, MSD, FACP, a professor in the Advanced Dental Education Program in Implant Dentistry at Loma Linda University School of Dentistry, says. “The second advantage is that the prepolymerized acrylic resin has improved physical properties. Because the material is much stronger,…it can be milled in a thinner layer, so it makes it more comfortable for the patient. When produced, the CAD/CAM PMMA [poly(methyl methacrylate)] blocks are prepolymerized and fabricated under vacuum with 5 to 6 bars of pressure. For this reason, they have a higher degree of monomer conversion [less residual monomer], they have less porosity [and] are more dense, and the polymerization shrinkage has already taken place.”

Digital dentures also involve fewer visits to the dentist, a plus for both dentist and patient. “The number of visits that the patient has to [make] to the dentist is usually less now,” Dr Baba says. “Instead of the conventional 5 appointments for dentures, that could be shrunk. CAD/CAM dentures can offer up to 2 visits before the dentures can be delivered. Digital dentures can make it more cost-effective by decreasing the clinician’s overhead.”

Because the denture files are maintained on the lab’s computer, lost dentures are easily reproduced. “The lab technician keeps the denture data in his computer while he designs your dentures,” Dr Baba says. “So, God forbid the patient loses the denture—goes to the hospital and the hospital throws the denture in the garbage—what happens is that you can call the company, get these files, and make new dentures for the patient.”

Technicians realize their own benefits; namely, speed. “They do require a shorter time for the production when compared [with] conventional complete dentures,” Dr Baba says. “The second advantage is that the data require fewer lab steps. They don’t have to use any gypsum. They don’t have to use an articulator. They don’t have to use wax. It’s all digital. The digital software allows for a quicker analysis and faster denture teeth setup because they can flip the model and turn 60°, move the teeth with a lot of ease. It just needs a little bit of a learning curve to learn about the software. The lab technician can provide the clinician with a more accurate, high-quality, complete denture. Also, the dental technician is not exposed to monomer for the fabrication of removable prosthesis, so it makes it much healthier for [them].”

Maybe even more important is access to a fantastic tool that both crafts adventure and teaches the technician.

“It is definitely helping more, if you are driving the technician to give a superior product,” Chris Love, removables department manager at Absolute Dental Services, says. “If you want to just have somebody sit there and press a button and let the teeth be where they are, the CAD/CAM can definitely do that, but we actually look at a denture setup, and we’re able to follow what that doctor gave us. It’s a really good tool, as long as you’re using it as a tool rather than as something to speed up the process. It will speed up the process, but you’re also able to teach people a little bit easier about occlusal schemes, the way you’re able to manipulate the arches. I think it’s going to be a huge way to teach people more efficiency.”

Digital dentures face challenges to acceptance, such as convincing client doctors of the new process’ benefits. Traditional analogue methods remain prevalent and, for some doctors, very comfortable.

“It’s still very much entrenched,” Rutkus observes. “Digital [has grown] at an incredible pace the last 2 years; it’s probably grown by at least 50%. However, when you look at the overall picture of denture sales, it’s still a drop in the bucket of what is traditionally sold, as far as materials. So it’s gaining, and it’s gaining because the doctor wants to do stuff in his office, which, 10 years ago, wasn’t even thought of.”

“It’s a new way of producing dentures and educating your clients who have been doing dentures for decades in the same exact way,” Nakanishi adds. “Even though it’s a better product and it’s a better process and it saves them time and money, that change is always something to deal with.”

Another issue: Some dentists might want to just practice dentistry and not take on new roles. But Rutkus downplays that factor: “There used to be a saying, ‘No doctor wants to become a technician and waste his time doing this stuff. He’s always going to send it out to a lab,’” he says. “That’s not the case. The doctor’s saying, ‘Why should I pay a lab bill when I can do this stuff in-house?’”

The systems present their own challenges, which may or may not be insurmountable, depending on the lab. For instance, the expense may be an issue, especially for smaller labs. Depending on the system, the cost of equipment can be prohibitive, with some vendors charging yearly subscription fees.

“You must be prepared to invest in the equipment and materials,” Nakanishi says. “It can seem expensive at first, but the amount of time you are saving in labor can more than pay for the technology with the right amount of volume.”

From a practical standpoint, digital dentures do differ from conventionally made dentures, both in form and function.

“CAD/CAM dentures present several disadvantages when you compare them [with] conventionally processed, complete dentures,” Dr Baba says. “The first disadvantage is when you take manufactured denture teeth and you bond them manually to the milled denture bases, which means that even if you designed the dentures virtually and you bonded the teeth manually, they’re not going to go in the same position where you designed them on the computer. For that, what the lab technician needs to do is mount the dentures on an articulator to develop a balanced occlusion.”

Despite its convenience, CAD/CAM is not a turnkey solution, especially for clinicians. “Multiple CAD/CAM complete dentures need to be made before the clinician feels that they have mastered the system,” Dr Baba says. “There’s a learning curve, and this might cause some disappointment and less-than-ideal results. People are financially oriented, and they don’t want to learn something new, because they’re scared that it’s going to take away from their chair time and they’re never going to make enough money. But, like anything new, there’s a learning curve.”

The virtual nature of the dentures can pose another challenge. For some labs and clinicians, the ability to share those files electronically is a huge benefit—the files can be instantly transmitted. On the other hand, those who prefer to handle the physical device are at a disadvantage.

“Communication with the dental lab can become more challenging,” Dr Baba says. “It may require multiple efforts to resolve design-related issues. If you send me a conventional denture and you’re a lab technician, I’m going to look at it, and if I don’t like something, I heat the wax and move the teeth or write down: ‘Well, it looks like the central incisors are too long. Would you shorten them?’ Here, you’re going to send me a design over the computer. I can’t touch it. I can’t hold it in my hand. I just have to grab my mouse and move it. A lot of people are not comfortable with that, and they have difficulty communicating with the lab technician.”

CAD/CAM continues to evolve; for example, early 3D-printed dentures still required an analogue component.

“Ten years ago, we weren’t printing complete dentures,” Jeremy Wohlers, CDT, technical field consultant at Kulzer, says. “When it first came in, we were printing, basically, a wax version of the denture, and you still had to use traditional methods to make the denture because we didn’t have FDA [Food and Drug Administration]–approved products. The technology of being able to produce something with additive technology, meaning a printer—that’s now the current state that we’re in. The race is the products that we can print; not necessarily the restoration itself but actual printer material that we’re printing. It has to be FDA approved and designed to be used in the mouth for what we’re wanting it to do. We do work pretty hard to make sure that we’re part of the tip of the sword with technology when it comes to printing.”

Wohlers saw the advance of CAD/CAM technologies as they benefited, first, fixed restorations. As a removable restoration technician, he hoped that one day those same methods and processes could be applied to his field. “I wanted it to be the Jetsons-era of dentures,” he says. “It’s fun to watch. We are in the entry stages of it. There’s still so much more to come, but it’s changing every day.”

Even advanced milling had room for improvement. As 3D printing became a more viable option, labs realized both speed and capacity increases.

“If you look at a PM7, which is kind of the gold standard of milling dentures, you can probably mill about 2½ dentures a day because it’s not a continuous printing,” Rensburg says. “Ivoclar [Vivadent] just launched their Ivotion puck, which is a single puck with the teeth and base, all in one, but you’re still looking at about a 2½-hour process to mill a denture in that new puck.”

“You have to remember, the mill cannot mill the undercuts that the printer can print,” adds Love. “So, there [are] a few advantages of printing. To give you an idea, with 1 Carbon printer, we can run about 12 bases in a 2½-hour cycle. So we can run that, in a normal 8-hour day, 4 times. We can literally do, with 1 printer, 40 or 50 bases, compared to maybe 2 or 3 with milling.”

The size of the lab and how much work it does is an important determinant for the type of equipment used. “The milling unit, I would say, is more for a small lab or a small office that only wants to do 1 or 2 units of printing,” Rensburg observes. “The Carbon printer is more for higher-quality production-type labs. So, if you want to do more than, let’s say, 2 or 3 dentures a day, you can’t really invest in milling technology.”

One of the hurdles toward advancing the technology involves obtaining the FDA approvals needed for new materials and processes. “Every company has their own FDA approval process for their dentures, and, keep in mind, one thing is to have FDA-approved material, but the way that you use it—meaning that the printer, the way you cure it, all the way down to polish—that all has to be FDA approved,” Wohlers says. “We’re still, as an industry, constantly sending things into the FDA for approval, and it’s not just the product but also the process, and that takes time.”

Although 3D printing seems to be on the cutting edge of digital denture creation, for some, milling remains preferable. “3D-printed dentures have become a popular option for laboratories and clinicians over the years, as it provides fast denture development with, in most cases, a minimal investment,” Aguirre says. “However, 3D-printed dentures have recently received criticism over their durability, as well as the long-term health effects of resin, intraorally.

Milled dentures are becoming the preferred method of denture fabrication because of the precise, efficient digital workflows available; quick denture replication; and predictability of materials. Workflows for milled dentures, like DGSHAPE’s Denture Time-Reduction Kits, allow technicians to mill dentures out of any traditional pourable acrylic material, saving time and money. Milling has proved to provide predictable, long-lasting dentures.

A lot could be done with a DMC DeLorean retrofitted for time travel, including looking even further into the future of digital dentures. Unfortunately, the best we can do is ask professionals what they anticipate or would like to see.

“I expect to see the demand for digital dentures to continue to grow and evolve,” Aguirre says. “Digital workflows are becoming faster and more precise, without compromising the quality of the final prosthetic product.”

The technology behind CAD/CAM is certainly an arena experts have their eyes on, but materials also matter. “The ideal technology—that, hopefully, somebody will figure out tomorrow—is how to print ceramics or a ceramic/polymer-type material,” Rensburg says. “The milling technology has kind of run its course. We went through the phase where it wasn’t that good. And the problem with milling is that it’s slow. It’s arduous. It’s just as high maintenance on the machines. You lose burs, you lose your suction, units run dry, and you’ve got to replace those. It’s a very expensive technology, and it’s very limiting. Printing, on the other hand—you can print any undercuts without ever wondering about the accuracy. I’m thinking that the next big evolution in our industry is that we’ll start printing zirconia or start printing some type of ceramic material with a polymer bond that’s approved for long-term intraoral use.”

Whatever the future face of the technology, Dr Baba believes dentists who don’t embrace the technology will fall behind. “CAD/CAM dentures are the future,” he says. “I believe that every single clinician needs to learn how to do them. They deliver a better service for the patient… They give them less issues, like less sore spots, less visits. And there [are] a lot of studies that have shown that post-delivery visits are reduced with CAD/CAM dentures. The patient sits less in your chair. It’s more cost-effective. You make more money.”

He also looks to the ability of milling dentures from a single piece of monolithic material. “The teeth and the base are in 1 piece,” the dentist/educator says. “The teeth are not bonded anymore to the base. This makes the denture stronger, makes them more esthetic, and makes them nicer looking for the patient. So this is coming, and it’s coming fast. Ivoclar has launched the Ivotion system, and I think it’s going to be a very promising, phenomenal way of doing dentures.”

Intraoral scanning makes the CAD/CAM process easier, faster, and more accurate than physical impressions. Dr Baba wants to see that method advance even further. “I would like to be able to have a patient sit down in a CBCT-style machine and then scan his arches and his soft tissue,” he says. “Then, from there, they can design his dentures. I don’t know if it’s going to happen, but this is something that I would really love to see.”

There is a concern for labs as the ease of prosthetics creation advances. Specifically, if it becomes too easy, will labs, ultimately, be removed from the process?

“I love how simplified and streamlined the digital denture process is,” Nakanishi says. “But there is that thought [that] if it’s too easy, is the lab really necessary in the process? But where labs can add value now is on the technical side, by being a great resource for dentists. Many of our clients refer dentures out, but if we can help them through the process and be the catalyst for them to add a new profit center to their practice, how valuable are we now?

“We know the demand is there,” she continues. “Ten thousand baby boomers retire every single day. The demand for dentures is here. So now it’s just being able to capture that demand and help our clients feel comfortable along the way.”

Ultimately, the future is hazy, but whoever gets there first will likely define the shape of things to come.

“The answer is: Nobody knows,” Rutkus observes. “But as far as where it’s going to go, the only downfall of printing right now is time. Printing is like making a cake. Most people do 2 layers, and those layers are thick. They don’t have a lot of detail to do a 4-layer cake. It’s got much more detail, much more filling. So the problem with printing is [that] the more detail you have, the slower it goes, because it has to do more layers. I see that continue to get better. It has to…nobody can wait 2 hours for a denture.”

He likens it to chairside milling crowns. “That whole chairside industry exploded,” he continues. “And I see the same thing happening with the printing industry. They just need to get over this hump of the timing. They need a quantum leap in technology to get them through this slow, layer-by-layer printing. I think it’s coming. There are a ton of companies working on it very hard, because everybody knows that whoever gets there first wins with that technology. I’m sure that patients will be there, as well.”

Back to the Future Part II is a great movie, and for all the technologies and advances it got wrong, there are plenty it got right, but still some that it didn’t predict. Happily, even though digital dentures weren’t on its radar, this technological advance has certainly been welcomed by dentistry.

Articles

Digital dentures are the future, and the future is now.

Not Your Grandfather’s False Teeth

When Oscar Buenrostro first looked into the NextDent 5100 printer from 3D Systems, he thought some of the features and benefits seemed a little too good to be true. Having worked in the laboratory division of DenMat for close to a decade, he has worked with a number of 3D printers, and some just didn’t perform as well as expected, while most didn’t deliver on all of their promises.

That all changed when he tested and then started working with 3D Systems’ NextDent 5100. Before deciding on purchasing the technology, Buenrostro wanted to take the high-speed printer on a few test drives. He had been intrigued when he learned of the printer’s speed and capabilities, but he needed to know if it could really perform that well in his laboratory.

“We tried multiple printers and noticed they didn’t have the speed and accuracy we were looking for,” he says. “They weren’t speeding things up, and we also came across 3D printers that just didn’t have the quality we were looking for. We definitely experimented a lot with 3D printers until we came across the NextDent 5100, and after a couple days our model output definitely increased.”

Buenrostro who is a Model Shop, Milling & 3D Printing Supervisor, says DenMat has worked with this printer for more than a year and the results have been quite impressive. Using the NextDent 5100’s high precision vertical stacked printing for orthodontic models has given the team a big boost in production. The laboratory uses the NextDent 5100 3D printer and the range and diversity of NextDent materials for the production of orthodontic dental models, crown and bridge solutions, implant models for diagnostics, and impression trays.

“They loaned us the printer and let us try it for three months, customers were really confident about the diagnostic models and the precision,” says Buenrostro. “The NextDent 5100 is a very simple and easy to use solution, and offers the precision and part quality that we need for our applications.”

The auto-stacking feature in 3D Sprint® for high precision vertical stacked printing of orthodontic models provides advanced productivity for a very high volume application. Integrating the NextDent 5100 3D printer, NextDent Model 2.0 material and a proprietary, high precision stacked build in 3D Sprint, the one-click automated solution has helped DenMat increase its output of orthodontic models, producing up to 96 models in an 8 hour shift. Employing this solution results in increased productivity while reducing resource consumption including materials and labor.

“With the stack option feature, it is just amazing,” he says. “Now we’re able to print anywhere from 96 orthodontic models to over a hundred in an eight hour shift.” Buenrostro says the technology makes his laboratory team so much more efficient on a regular basis.

“With the majority of cases DenMat is able to print 36 models every two hours, which means I can assign our 3D printing technician other tasks and still have multiple jobs in the queue ready to start once the 5100 is done printing its current job,” he adds.

The accuracy of the printer allows DenMat to use it for a variety of cases, including SnapOn Smile cases, and the software is easy to master, according to Buenrostro.

“Everything from the file preparation and placement is done within the software just by selecting the pre-filled prompted steps. The software truly does all the work, saving on labor costs,” he says, speaking to his experience with the 3D Sprint workflow. “The software is adamantly straightforward—in such a way that models get started within 2 minutes. There’s no prolonged process of having to adjust or stack the models.”

The NextDent 5100 printer is performing so well that Buenrostro expects DenMat to look into new tasks to take advantage of the technology and the advanced resins.

“We actually just got some resin for dentures. So that is going to be another little project that we’re going to tag on that printer, to see how that turns out on the NextDent 5100,” the DenMat supervisor says. “This printer has been awesome for us and it may turn out to get even better.”

The 3D Systems NextDent 5100 printer is helping DenMat’s laboratory division see a big jump in efficiency, production.  

Closer Look: A fast, accurate 3D printer that boosts production

in the dental field and practicing in both the clinical area (expanded function dental assistant) and the laboratory (in-house and commercial lab), I have experienced the transformation of the profession.

At first the crown and bridge (C&B) departments benefited from the introduction of trends in so-called digital dentistry, but not until recently did 3D printers and design software enter the area of dentures and removable partial dentures (RPDs).

Now the RPD department in Vega’s Dental Laboratory Solutions, located in Lima, Ohio, depends on the proper functioning and workflow of my scanner and printer, just as the C&B department depends on digital scans and milling machines.

Since I have 60 percent of my clients with traditional dental practices, I am allowed to make an unhurried transition in a staggered manner that permitted me to avoid a very expensive investment.

After going through an orientation process and attending several courses, I was convinced that an open system would serve best as my introduction to the digital world. An open system would give me the opportunity to benefit not only from the materials and platforms provided by a company but also let me integrate and adapt materials from other brands.

My real intention was to get some help to manufacture my metal frameworks. During my orientation, I was attracted to the idea of scanning my models to send the files digitally and receive back an almost finished metal frame without going through the extensive work of designing, duplicating, waxing, casting, and finishing (just typing all that hurts my fingers). Even for those who send the models, a digital workflow like this could be of benefit. Travel time and shipping cost are reduced or even eliminated.

Shining 3D DS-EX would start my transition from an analog to a digital lab. The transition was made with both my new scanner and the help of third parties to manufacture for me. With that alone, I was immersed in a world of new opportunities.

After some weeks, I felt comfortable and confident, with a clear view of my next step. At the time, with a minimum investment and the help of new contacts, I observed a substantial economy of both cost and time of the process.

It was time for the second step. Until then, 100% of the production of the C&B department had been delegated: A client sent a case to me, I sent it to a third party, and they manufactured it in its entirety at a price that allowed us to win a limited profit. Making the laboratory participate in this percentage would represent an increase in production.

Now came the task of training and investing in equipment for the C&B department. Once ready, using third parties to design and mill, only staining and glazing were needed. With this new department running, more and better growth options emerged, of course accompanied by new challenges. Emptying impressions and making C&B models was not part of my plan.

The third step began with the arrival of AccuFab-D1, a Shining DLP 3D printer. This open system, in addition to having its own variety of materials, accepts the incursion of resins from other well-known brands. Vega’s Dental Laboratory Solutions adds digital models and more to the digital workflow. This made me curious to design and go after the addition of digital dentures.

Following my interest in designing, I opted for exocad, which, in addition to being an open system, is compatible and fits well with my other Shining 3D equipment. exocad provides a complete software solution for digital dentistry.

Today I can confirm that if the development of a digital workflow with limited investment is possible in a staggered way, then in return, it will offer an opportunity for growth. Of course, none of this would be possible without the support of suppliers and the technical support provided by Aurident.

Today, our dental laboratory scans, designs, and prints a good percentage of our total production (See 

for examples). This change to digital offers not only more opportunity, but also many more options for clients.

Digital Workflows

We are seriously considering adding a second printer and updating the scanner for the DS-EX Pro, which I used at Lab Day Chicago 2020. The fact that the camera moves to extend the scanning range and has more veils and more accurate cameras than previous generations surely makes it my correct choice.

To complete the family of Shining 3D products, the first generation of IOS Aoralscan was released in 2020 and it is designed to allow dentists to easily introduce their traditional practices to digital workflow. Unfortunately, after the launch in Chicago, the coronavirus pandemic spread in such a way that it limited many dental practices.

In what is and will be a new reality of life and doing business, implementing a digital workflow is an excellent alternative. The fact that clinicians can send their dental work to their respective laboratories through an email offers not only a real economic opportunity, but also reduces the possibility of contagion by contact.

In the same way that technology allows us to remain connected with friends and family during quarantine, digital dentistry also allows us to maintain a safe and more efficient working relationship between the dentist and the laboratory.

Shining 3D and Exocad allowed this dental laboratory to make a stepwise transition to a more technological approach, without an exaggerated investment and with the help of third parties. 

How to make the conversion from analog to digital 

Many large format printers are prohibitively expensive to purchase and maintain and don’t deliver sufficiently accurate results

Balancing throughput and quality to meet the accuracy demands is difficult.

Formlabs is offering this powerful technology to a new group of users at an accessible price while maintaining a professional quality

The Form 3BL dental and medical 3D printer is optimized for biocompatible materials

3D print large-scale parts or many smaller parts in a single build, with stunning surface finish and detail

A build volume of 33.5 × 20 × 30 cm (13.2 × 7.9 × 11.8 in), five times larger build volume than the Formlabs Form 3B desktop SLA 3D printer

An intuitive workflow, with automatic resin dispensing, simple print preparation software, and a simpleinterface

A robust end-to-end system designed for nonstop throughput with minimal intervention

Access to Formlabs’ extensive materials library, ensuring a stable supply chain and access to the resins needed for any project—including biocompatible materials

Healthcare providers can meet the tight deliverable windows needed

Formlabs’ new dental and medical 3D printer expands the company’s line of large format  stereolithography (SLA) 3D printers. 

Intuitive, cost-effective large-scale 3D printer 

Rigid systems restricting the dental CAD/CAM workflow and limitations with scanner performance and software capabilities reduce lab efficiency

Dental lab scanners are often limited when it comes to use cases, compatibility with articulators or design software, or the flexibility of their workflow.

The scanner can be used for all possible dental indications, including implants, replica dentures, impressions, etc.

Full arches can be scanned in just 8 seconds

Thanks to an open system, the T710’s scan data is compatible with any design software

Full-size articulator scanning is possible for all currently available models for easy integration

The customizable workflow guarantees supreme flexibility and performance optimization

Thanks to four 5 MP high-resolution cameras, 4-micron accuracy, and no blind spots, the scanner delivers high quality results for increased customer
satisfaction

The Medit T710 can be used to scan all indications, is compatible with any design software, and allows for a fully customizable workflow, providing freedom from the technical limitations that plague the industry.

Enhancing dental lab capacity, performance

It can be difficult to find high quality CAD/CAM instruments that last a long time

Remakes can be required if excessive heat and cutting force are created by using lesser quality milling burs.

Unique coating gives users longer wear and improved efficiency, which leads to reduced milling costs

Reduce remakes by lowering excessive heat and cutting force often required by using lesser quality milling burs

Ample chip space guarantees efficient chip removal

Polished flutes provide bur-free, clean milling results

Engineered for superior cutting performance resulting in a smoother surface quality

SSWhite Dura Burs for Roland milling machines are built to last against the hardest materials, including zirconium and PMMA, as well as soft materials like wax blanks. the optimal design of the bur leads to a long-life advantage compared to other competitive burs

SS White DuraDi™ and LAZER SHARP™ for Roland® milling machines are designed for long life and superior cutting.

Solve My Problem: Milling burs built to last against the hardest materials

Surveying the lab scanner landscape

A roundup of some of the newest dental laboratory scanners around.

Surveying the Lab Scanner Landscape

Over the years we have witnessed and enjoyed the benefits of CAD/CAM technology and material advancements. These advancements are now being coupled with advancements in support products that pair perfectly with today’s modern materials. Harvest Dental’s Speed Polish is an example of an advanced support product.

Harvest Dental released Speed Polish at this year’s Chicago Mid-Winter Meeting. On the surface it appears similar to other polishes available today. It is not until the user experiences polishing a restoration with Speed Polish that its rewarding qualities shine.

Speed Polish is a proprietary combination of diamond and alumina which was developed for the efficient polishing of ZrO

 restorations. Harvest Dental’s products constantly not only meet, but exceed the demands of the most discerning technicians.

Harvest Dental recommends using a #9 Robison short stiff brush, onto which the polish can be loaded slowly at a speed not greater than 5000 rpm. Once the brush is loaded, the technician can begin to polish the restoration using slow speed and high pressure 

During the review of Speed Polish, multiple benefits of the product stood out which make it quite different than other products currently available.

Speed Polish was designed for use with ZrO

 restorations which it polishes within seconds to a high luster, while not being so abrasive as to cause a loss of fine detail 

. The speed in which the polish performs stays true to its name. It was also noted that it performed equally well on layered ceramics 

Another tremendous benefit is the fact that Speed Polish is water soluble. This is a massive benefit and a great aid when cleaning off restorations. Comparable products that are not water-soluble lead to difficulty in removing remaining residue. With these products, a steamer is needed. This can be detrimental to ceramic restorations as the use of a steamer can introduce the possibility of thermal shock. The use of steam is completely avoided with Speed Polish, which is cleaned with water and a brush, or a simple cloth 

at a glance

The proprietary blend of Speed Polish incorporates a binder into its formula, allowing it to load exceptionally well to the brush, which results in minimal wasted material.

With technicians today concentrating on their health more than ever, and the fact that keeping a healthy laboratory environment has always been challenging, this binder is a key to the most remarkable quality of Speed Polish. While it maintains the ability to efficiently polish restorations, it is dust free due to the proprietary binder. According to Harvest Dental, this is by design and possibly the trait that breaks the mold, sets Speed Polish apart from other products, and places it in front of the pack.

Previous polishing products had a tendency to create fine particulate dust which would cover a work surface and even build up on a technician’s mask. Harvest Dental’s Speed Polish is a great supporting product that exhibits multiple advancements and benefits, and also aids the technician and laboratory in helping to create a healthier work environment.

Harvest Dental’s products constantly meet and exceed the demands of the most discerning technicians.This product is in line with all of Harvest’s other offerings, which not only perform as advertised, but surpass expectations with additional benefits. Speed Polish delivers and lives up to its motto: Time is Precious!

Polish efficiently with this paste ready to support the advanced materials you use.

Benchmark: Speed Polish from Harvest Dental

Success or failure, communication is a key component that can influence the outcome of every case that comes through a dental lab. Often, it’s the effectiveness of this communication between the practice and your lab that determines if the case meets the expectation of the doctor and the patient. Breakdowns in communication can mean incorrect information is used while designing and fabricating the restoration, which will then lead to a restoration that doesn’t provide proper fit, function, or esthetics.

Communicating is a two-way process, and it’s certainly not always the lab’s fault when key details get missed in the clinic-lab communication process. However, even when the communication breakdowns are clearly the fault of the practice, if the case doesn’t turn out as planned, the lab is the party that will need to remake the restoration. This means making sure you receive all the information you need and a process for managing questions or problems as they arise is extremely important for dental labs. With that in mind, here are a pair of tips from members of the 

 Editorial Advisory Board to help you improve the lines of communication between your lab and the practices sending you cases.

“Today more than ever HIPAA-compliant communication has come front and center in dental technology. Communication with clinicians is crucial to success of a case, these communications have become difficult to do while maintaining HIPAA compliance. This is partially due to the fact that some of today’s HIPAA compliance software has been difficult to communicate through, but I have found a compliant communications platform that works for me.

Awrel App

), invented by Dr Arnie Rosen, is what we use to communicate with our clinicians. Awrel is a free, encrypted text messaging app that is HIPAA compliant. The app is simple to use and follows today’s text messaging format in which you can send text messages, upload and send photos as well as files—all while remaining secure and observing HIPAA compliance.”

“When we speak of the need for communication in the fabrication of removable prosthetics, I take a proactive approach which not only includes the clinician, but also the patient.

“One way I do this is on specific cases that involve restoring only one arch is to provide a faux opposing appliance which is used to communicate the need for cross arch posterior support. In cases where patients are edentulous posteriorly, I place teeth which are made by duplicating denture teeth in self-cure resin on a baseplate. This not only aids in the arranging of teeth on the definitive appliance to be made in ideal positions, but also illustrates the need for support to adequately provide function expected from the new prosthetic to the patient.

Removables communication tips

“Many times, this communicates to the patient the need for ‘back teeth’ and they move toward considering either a definitive opposing restoration, or if a definitive restoration is economically unfeasible, converting the try-in set up to a wearable provisional one.”

These tips are just a few of the many ways dental labs can take charge to make sure communication with clinicians about cases includes every detail you need to complete your work, and that communication of patient health information is managed via secure, HIPAA-compliant channels.

A pair of expert technicians share some of their favorites tools and tricks for improving communication with dentists.

 2 easy ways to improve communication about cases

The Zir-Perfect CAD/CAM Zirconia Disc, a highly translucent zirconia, is designed to provide superb strength and durability, long-term stability, high natural translucency, and excellent esthetics to ensure a beautiful and stable restoration. Introduced in March 2020 by Dental Creations,Zir-Perfect features a 3-point flexural strength of 1200 Mpa after sintering and a natural translucency of 43%. Compatible with most CAD/CAM machines, the Zir-Perfect Zirconia Disc reportedly creates long-lasting restorations that have a beautiful appearance and function like a natural tooth.

“I currently work in conjunction with Dental Creations to help test new products,” says Joey Dvorak, CDT crown and bridge manager at CenTex Dental Lab, a state-of-the-art full-service dental lab in Waco, Texas. “In 2019, Dental Creations asked me to test the Zir-Perfect Zirconia Disc to determine how it compared with other zirconia products. I was very impressed. It is a high-quality, very clean zirconia and is easy to handle. The units looked so natural that the doctors couldn’t tell the difference.”

Many CAD/CAM materials are susceptible to fractures, undermining a restoration’s integrity. Even with its high translucency, Zir-Perfect maintains its superb strength and provides strong resistance to corrosion and long-term stability.

“There are a lot of forces in the mouth, so the flexural strength of a zirconia product is key to its durability,” Dvorak says. ”Zir-Perfect is the perfect blend of strength and translucency, 2 key features that both a dentist and a patient are looking for in a restoration.”

Zir-Perfect comes in 98-by-14-mm discs and is available in 9 shades, including white for use with dip stains. “When I first started working with zirconia more than 20 years ago, it was very dull and only available in 1 color that didn’t match natural teeth,” Dvorak says. “We had to stain it to try and get a closer match, which was very tedious and time-consuming. With Zir-Perfect, we choose the closest shade and do almost nothing else to it. It’s a huge time-saver, and the restoration blends so well with the patient’s natural teeth that you can hardly tell them apart.”

Zir-Perfect is suitable for a variety of restorations, including crowns, bridges, and implants. “I can make just about anything in the mouth out of it,” Dvorak says. “[Although] posterior teeth are the bread and butter of our business, Zir-Perfect is pretty enough to use for anterior teeth too.”

The process is efficient, predictable, and precise. “I can usually get 10 to 15 units out of 1 Zir-Perfect puck,” Dvorak says. “We can make the product quicker and have more time to accentuate it, staining and glazing after sintering to match it perfectly to other teeth and look more enamel-like.”

The result is a beautiful, durable restoration that is a perfect fit. “With digital technology, it is all done on a computer screen, and the restoration is almost always a perfect fit,” Dvorak says. “We seldom do a remake anymore.”

According to Dvorak, zirconia now accounts for approximately 99.9% of restorations created at CenTex Dental Lab. “Almost all dentists are using zirconia now,” he says. “Occasionally, we still have a dentist request a metal restoration, but that is very rare.”

The Zir-Perfect CAD/CAM Zirconia Disc offers a unique blend of strength and translucency. “There are several companies that make a zirconia product, and I have been fortunate to work with many of them,” Dvorak says. “I can put Zir-Perfect next to any of my higher-priced zirconia, and there is no difference. It is a very high-quality product at a lower price point, making it a very reliable and profitable choice.”

The High Translucent Zir-Perfect CAD/CAM Zirconia Disc can ensure a natural-looking restoration without sacrificing strength

Create beautiful restorations that retain natural tooth function

Of paramount importance in the design and fabrication of hybrid implant retained bars is service longevity. After nearly 20 years of requests to service these types of dental prosthetics, it is now obvious that after poor design, poor surface-to-surface bonding is a big reason for in-service failure. An understanding of products that promote bonding and recommended procedures can assure the promised life expectancy of hybrid treatment (

Bonding primers specifically formulated to bond acrylic or composite to alloy, ceramic, or hybrid resin surfaces tend to be marginalized, but they should be a standard protocol in hybrid fabrication. Their advanced chemistry provides a sound anchor when applying layered top coats and prolongs or potentially eliminates the possibility of subsequent delamination due to the micro flexures that occur during prosthetic function. Completely eliminating eventual fatigue to failure is not possible because of the individual flexural properties of the combination of material used in the overall fabrication. The aim, then, is to extend the functional life of the prosthetic beyond, if possible, the patient’s life expectancy (

In a typical titanium hybrid bar, combinations of overlays to consider are the following:

Opaque to polymethyl methacrylate (PMMA), or composite

Products that this author uses are manufactured by GC Corporation. Other companies manufacture materials, but this article will explain the application techniques of GC products based on my success of use and familiarity (

For years, prior to hybrid fabrication, Metalprimer II has been the mainstay in my lab in the application of enhancing the bond of acrylic to chrome cobalt partial denture frames. I also now use an upgraded version, Metal Primer Z, in present metal bonding applications.

Use air abrasion of alloy surface with aluminum oxide to produce a satin surface. I use Cobra 50 micron, white, aluminous oxide from Renfert. After surface treatment, blow clean with air. Avoid using steam or air contaminated with oil or moisture, which can contaminate the micro textured surface, leading to possible delamination.

Apply a wetted but not saturated coating of Metal Primer Z. Avoid getting primer and/or opaque into the screw access holes on bar. Once the Metal Primer Z has air-dried, immediately apply opaque.

Cure using Gradia+  opaque is light curable (VLC) source. Preferred light source is either a GC Steplight or a Labolight Duo step mode. Other light sources include any VLC light box/halogen projector bulb source. A 20- to 30-second cure cycle is used with the preferred light sources. If using a nonpreferred source, this author recommends a longer 2-minute cycle and closer proximity to the light source. Also remember that several thin coats of opaque allow for better light source penetration and coverage compared with thick ones (

In the past, I have used several types of “air-dry” opaque products. They work well to mask, but even when dry, they dissolve when they come in contact with monomer in uncured acrylic. This reveals itself many times after curing a case as a pink swirling effect in the acrylic. This is why I switched to the light cure form of opaque. It’s much more stable when contacting poured, packed, or pressed acrylic, and I feel it has a more sincere bond to the primer.

Once the opaque has been sufficiently cured, apply a coating of GC Acrylic primer to the opaque surfaces that require acrylic.

Suggested curing is either a 20-second exposure under the Steplight mode or 3 minutes under full mode of the Labolight Duo curing unit.

Adapt acrylic (poured, packed, or injected) once exposed, do not touch the surface.

GC Acrylic primer raises the adhesiveness to acrylic resin (

PMMA to Lustre Paste, Composite, Optiglaze

Prior to the manufacture of GC Acrylic primer, the protocol for bonding composite to a completed PMMA denture was to use GC Composite primer. Although composite primer is adequate for this application, this author recommends substituting the acrylic primer for the above-mentioned layering.

Apply light air abrasion to the surface to be layered, followed by a coating of cured GC Acrylic primer

Proceed with application of composite, Lustre Paste, or Optiglaze and appropriate curing procedures for those products (

Although initially adding fabrication time and costs to the hybrid treatment, these bonding primer applications, coupled with sound design, are necessary additions to the hybrid bar fabrication workflow (

Understanding bonding can ensure the longevity of a hybrid treatment.

Dental Lab Products October 2020