For the fourth consecutive year, the DLOAC's International CAD/CAM Technology Symposium and Expo was a must-attend event for learning the latest in digital technology. Nearly 300 laboratory owners and managers, outsourcing centers and manufacturers were on hand for two days of lectures, demonstrations and exhibits, and LMT was there to cover the event.
"CAD/CAM requires a mindset of changing your business from analog to digital. Some of us will hold onto the doorframe kicking and screaming, but digital workflow is here to stay and allows you to move information much more quickly through a laboratory and offers a real benefit to labs," said CadBlu West's Mark Kosek, one of the presenters at the 2007 Dental Laboratory Owners Association of California's (DLOAC) fourth annual International CAD/CAM Technology Symposium and Expo, held in November at the Ritz Carlton in Pasadena, California.
Kosek echoed the theme of the event—how digitization streamlines, simplifies and improves laboratory processes—and the 16 CAD/CAM companies* on hand are clearly tailoring their products and services to achieve these goals. The area in which this is most evident is manufacturers' efforts to automate the manual waxup process for a variety of restorations. For example:
PFMs: Manufacturers are expanding their material options to include wax or resin blanks from which a coping or framework is milled and then cast using traditional methods. You can find this feature in systems from CadBlu, CMC, Dentsply, Digital Dental Lab, etkon, Glidewell Direct, KaVo, Sirona, U-Best and Wieland. 3M ESPE plans to offer wax blanks later this year.
Pressables: A file-splitting option offered by 3D Systems, CadBlu, CMC and Wieland allows you to design a virtual coping or framework and full contour simultaneously and then fabricate them out of two different materials; Kavo will offer this option later this year. For example, to create an all-ceramic unit, the coping can be milled out of zirconia and the full contour can be milled out of wax/resin or sent to a 3-D wax printer and then invested and pressed onto the coping using the usual technique.
Partial metal frameworks: Thanks to a new system from SensAble Technologies, working digitally is now available to a new segment of the CAD/CAM market: removable laboratories. First shown in the U.S. at Lab Day® East 2007 in Manhattan, the SensAble™ Dental Lab™ System allows you to scan and digitally design partial metal frameworks, output them in wax or resin via a 3-D printer, and then cast the frameworks in metal using conventional techniques. The system also fabricates crown and bridge substructures in the same fashion.
A unique feature of this system is the patented PHANTOM® Desktop™, a handheld device that uses haptic technology to allow you to actually feel the virtual model/framework as you design it on screen. The system is currently in field tests with several North American laboratories.
Digital impression-taking systems
In the lecture hall and on the exhibit hall floor, there was a buzz about digital impression-taking systems, and there will soon be three players in the marketplace:
Sirona, the first company to enter the digital impression-taking arena, is expanding its business model to link inLab® laboratories with dentists using the Cerec 3 chairside CAD/CAM system. It's offering a new FTP site, CEREC Connect, that enables the dentist to export his optical impression, fill out an online prescription and select one of the inLab laboratories from a drop-down list. The laboratory logs into the site, downloads the digital impression, designs the restoration and mills it with the inLab unit. The service is available to inLab laboratories and CEREC dentists at no charge; labs use their existing software and equipment, and dentists will receive an additional software component that allows them to easily transfer the digital prescription and impression data.
"Cerec 3 is currently used by 8% of dentists in the U.S. and while they primarily use the system for posterior restorations, our goal is to funnel those offices' anterior work to inLab laboratories," says Norbert Ulmer, director of laboratory CAD/CAM. The service is currently in beta testing and will be officially launched at Lab Day® Chicago next month.
Cerec 3 technology only uses a digital model, and initially the service will work the same way. However, in the second half of the year, Sirona plans to offer labs the option of creating a traditional model either through its infiniDent outsourcing service and, ultimately, right in the lab on the inLab MC XL. "Many labs prefer to work off of a model so our plan is not to insist on model-less dentistry," says Ulmer. "We want to give labs choices and let them decide on their own when they're ready to transition to working without one."
After acquiring Brontes Technologies in 2006, 3M ESPE begins its strategic launch of the Lava™ Chairside Oral Scanner (C.O.S.) this month by focusing on its authorized Lava Milling Centers and those labs' doctors. The company formally unveils the system—part of its Lava Precision Solution digital workflow—at LMT's Lab Day in February.
The Lava COS uses "3D in Motion" technology—not point-and-click technology—to capture the digital impression. After scanning, the dentist uses a touch screen to rotate and examine the digital scan, and sends the scan to the lab where a technician digitally sections the model and marks the margins. The file goes to 3M ESPE for digital articulation and ditching, and is then sent for model production using stereolithography where up to a full arch model can be made. "While the actual model is being produced, the laboratory can use the digital file to start the design of the final restoration at the same time—a significant time savings for the lab," says 3M ESPE's Jim Buchanan.
Cadent was also on hand with an update of its iTero™ system rollout, which began in June 2006. "Today iTero is in place in about 300 dental offices and 200 laboratories," says Simon Ghosh, regional director. "To date, we've done approximately 20,000 cases."
Here's how iTero works: Once the dentist takes the scan, the data is sent to Cadent in New Jersey where a preliminary digital design of the coping is created and then downloaded to the laboratory. The lab analyzes the design, makes modifications if necessary, then uploads the data to Cadent's facility. Milling machines produce models from a special material, and the case goes back to the laboratory where the restorations are fabricated.
System costs for the dentist are $18,000 and $25 per case. The cost for the laboratory is $2,500 which includes a computer, software and a stock of articulators, plus $20 per model (including one die) and $2 for each additional die.
The 16 CAD/CAM companies that made presentations at the meeting include: 3D Systems, 3M ESPE, CadBlu West, Cadent, Custom Milling Center, Dentsply Prosthetics, Digital Dental Lab, etkon USA, Glidewell Direct, imagen, KaVo Dental, Nobel Biocare, Patterson Dental Supply, SensAble Technologies, U-Best Dental Technology and Wieland Dental Technology.