Start-to-finish systems

The digital technology currently available to dental laboratories opens numerous new opportunities for collaboration and outsourcing, but there are plenty of options for labs looking to incorporate CAD/CAM production without relinquishing control of any part of the workflow.

Complete CAD/CAM systems-comprised of a scanner, software/workstation and a mill, often designed and manufactured by one company-can provide an entry into CAD/CAM or a solid expansion choice for labs already scanning or designing digital restorations. These stand-alone CAD/CAM systems such as Amann Girrbach’s Ceramill, DENTSPLY Prosthetics’ Cercon^® or BIOMET 3i’s Incise, among others, provide labs with a digital workflow that takes a case from a physical or digital impression to completed prosthetic quickly and accurately without any part of the process being completed outside of the lab.

Packaged together

Working with a complete CAD/CAM system where every component comes from the same company offers labs a number of advantages, not the least of which is efficiency. Because the scanner, software and mill were all designed together, the workflow between parts of the system is seamless and training on the technology is simplified because technicians only need to learn one interface, rather than having to understand how to transfer data from one company’s software to hardware from another company, Amann Girrbach America President Todd Larson said.

Having one source for the technology is advantageous whenever a lab using the system is looking to improve their work. When there are any questions about how some part of the process is supposed to be completed, a lab with a complete CAD/CAM system knows exactly where to turn for troubleshooting assistance. DENTSPLY Prosthetics Product Manager Erica Henny said labs using Cercon will notice this cohesiveness and support from the moment they adopt the system.

“The Cercon CAD/CAM system was developed to work as a cohesive unit,” she said. “When a lab purchases the Cercon eye scanner, Cercon art software and Cercon brain expert mill from DENTSPLY, an installation technician is sent to the lab to install and then a training expert is sent to educate the lab on how to use the software.”

While these systems might be designed and supported by one company, they are not always designed to work in isolation. Larson said a big advantage to the Ceramill system is that it is a complete system, but with open architecture software capable of working with data from scanners and software made by other companies. This means the system can be a good expansion choice for labs already into CAD/CAM production in one way or another.

“Every dental laboratory technology we develop and introduce to the market focuses on LEAN manufacturing principles-Faster, Better, Cheaper,” Larson said. “The Ceramill CAD/CAM system is a ‘complete’ open architecture system that seamlessly provides the dental laboratory with the latest advanced technology and ability to grow and expand their business.”

Single source benefits

Larson said it is not difficult to show labs how adding such a system can provide solid return on investment because in-house CAD/CAM production is both efficient and cost effective, especially because most of these systems do not charge a per-unit clock or dongle fee. With complete control of the production process, labs with a system such as Ceramill can complete cases more rapidly while maximizing the use of milled materials. This can add up to large savings for labs currently sending a large amount of work to a milling center.

“A laboratory does not have to relinquish models or have their production affected by weather or shipping issues to and from a milling center,” Larson said. “You can scan and mill a single unit or up to 24-26 units on one blank in a variety of materials. The fully landed cost per unit is around $10 out of the Ceramill system. This represents a substantial savings versus the cost per unit from a milling center.”

Having the ability to complete every step of the process in-house can speed up a lab’s production, and Henny said a big advantage of Cercon is that it is among the least expensive complete systems on the market, but still offers labs a range of options. Those options include not only in-lab milling of zirconia and base cast resin, but also the ability to outsource to the company’s Compartis^® manufacturing facility for greater material options and implant bar fabrication.

“The biggest advantage a lab gains by adding a CAD/CAM system with an in-lab milling machine, like the Cercon^® brain expert, is flexibility,” she said. 

And like all technology, the improvement process is never ending. Purchasing a complete system makes it easier for a company to update the software in ways that enhance the capabilities of the related hardware. Henny said forthcoming updates to the Cercon art software will provide for the design of custom implant abutments as well as full-contour zirconia crowns.

With the ability to mill zirconia and acrylic materials, the Ceramill Motion provides a launching point for in-house production, and the Ceramill Mind software features a virtual articulator and the ability to import data directly from intraoral scanners, which means labs looking to work completely digital can skip model fabrication when they choose to. Larson said the system is designed to give labs a hub from which to control just about any digital production workflow they choose to work with. 

“We can import data from intraoral scanners, third party scanners and export data to milling centers, wax printers, whatever the end user desires,” he said. “You only need one system to communicate with the world.”

While the footprint of these systems is small compared with the industrial scale mills used at large production centers, Larson said labs investing in his company’s tabletop mill are not sacrificing accuracy or quality in the finishing restorations. He said he often demonstrates how well-designed the Ceramill Motion is by putting the mill to work while it is set up on a card table, “to show the lack of vibration our mill produces without any loss of accuracy in the final product.”

A complete fit

Determining if a complete CAD/CAM system is a good fit for an individual lab requires some inward analysis. It’s not just about the size of a lab taking advantage of the scalability of digital workflows. Larson said the Ceramill system is currently the top system in European dental laboratories and is in use in labs ranging from single technician operations to businesses with 500 employees.

The common factor linking those labs is the desire to increase their efficiency in certain areas of production by controlling the pace of the work and reducing per unit manufacturing costs. The system has proven to be especially beneficial to labs looking to reduce sizable monthly outsource expenses, he said.

“Labs with large outsource bills who have brought the Ceramill system in-house have commented to us their immediate and positive ROI, reduction in production costs, faster turnaround to their customers and exceptional quality product,” Larson said.

Henny said many mid-sized dental labs benefit greatly from adding the in-lab CAD/CAM capabilities of the Cercon system, and those benefits can be realized quickly because of the system’s ease of use. Still, the system really fits with any lab looking to invest in growing its business by reducing the time it takes to complete a case and return it to the dental practice.

“An in-lab milling system is perfect for dental labs that base their business around quick delivery,” she said.