Thanks to the growing popularity and acceptance of CAD/CAM technology, the product landscape is changing rapidly. New equipment manufacturers have entered the marketplace. Established manufacturers are adding components to their systems to give users more purchase options and lower-priced equipment. There are new substructure materials being introduced as well as a wealth of veneering porcelains with coefficients of thermal expansions specific to the substructure materials.
But these developments also create a challenge for owners and managers because they have more technology to learn and compare. Attendees at the DLOAC's 2nd annual CAD/CAM Technology Symposium and Expo in California in October had a chance to learn first-hand about the product developments in the marketplace. In addition to the exhibit hall in which attendees could test drive CAD/CAM systems, there were manufacturer presentations offering overviews of their systems, as well as a look at new developments on the horizon.
Here are some of the highlights (note: LMT is only reporting on the CAD/CAM systems and companies that were present at the DLOAC meeting):
Cerasys System. A new player in the marketplace, this in-house CAD/CAM system was developed in conjunction with Imesa Dental Laboratory, Santa Fe Springs, California. President Tim McKimson, Cerasys America, explained that the system fabricates up to eight-unit restorations for anterior applications and can mill 20 units in eight hours. Designed for the small- to mid-sized lab, the system costs $49,500; you can also purchase an additional scanner for $15,000; the company also sells its own pre-sintered, 95% zirconia oxide blocks, Cerasys-ZR. "We offer three different block sizes that are affordably priced. Material costs average about $20 per unit," said McKimson.
Cercon System. Vince Tauro, Dentsply Prosthetics' west coast manager of technical resources, described the Cercon Art, the new CAD component of the Cercon system. The original system--now referred to as Cercon Classic--was a CAM-only system, meaning the technician made the waxup and then used the Cercon Classic to scan and mill zirconia single units and bridges. Cercon Art is a scanner used for virtual design and eliminates the need for manual waxup. Currently, Cercon Art is only for single units but by the spring, it will be able to scan bridges.
Cerec inLab. Lab owner Ed Flocken, CDT, Henderson, North Carolina, described his "life-changing" experience with Sirona's Cerec inLab (which is distributed through Patterson Dental Supply). "My lab has been totally metal-free for two years and my income has doubled thanks to CAD/CAM," said Flocken. "The future of dentistry lies in the technology today." He has recently purchased the company's latest addition to the system, the inEos Dental Digitizer, which he referred to as "my new employee that has reduced my labor costs by 35-40% because of its rapid scanning capabilities." The system can be used to fabricate copings, bridge frameworks, inlays, onlays and crowns from Vita InCeram Alumina, Spinell and Zirconia, Patterson's ProCad and Ivoclar Vivadent's new IPS e.max.
Etkon Dental CAD/CAM. Used in Europe for over five years, etkonUSA was launched in the spring of 2005 with the Central Milling Center beginning production for the U.S. market in September. It can be used to mill inlays, onlays, Maryland bridges, telescoping and full contoured crowns and up to 16-unit roundhouses in virtually any material but "the company is focused on the four materials of the future: titanium, chrome cobalt, plastic polymide for temporaries and zirconium oxide," said Peter Parsinen, president. The laboratory only buys the scanner, which costs $26,900, and the milling is done at Etkon's milling center in Arlington, Texas (Dallas/Fort Worth area).
Everest System. Kavo's system can be used for milling zirconia (HIP and pre-sintered), metals, plastic, leucite glass and Ivoclar's new IPS e.max materials; restoration options include inlays, onlays, full crowns, frameworks and up to full arches (constructed in segments of 47mm). Kavo Product Manager Chris Kirykowicz detailed the features of the system, including five-axis milling which gives you a very refined material finish, ability to mill complex shapes, check bite function to verify the occlusion, a virtual wax knife to construct pontics and shape connectors and the ability to mill up to 20 units in eight hours. You can purchase a stand-alone scanner and/or the self-contained milling and sintering furnace.
Hint-els and Katana Systems. Chuck Warren, CDT, dental technical consultant for Darby/Noritake, elaborated on both of these new systems from Darby to be launched in January, 2006. The German-developed Hint-els system can fabricate up to 10-unit restorations with 5-micron margin integrity from alumina, zirconia, sintered ceramic and alloys as well as hybrid restorations such as copings combined with full contour crowns. The Katana system can mill up to six-unit restorations using 10 different shades of zirconia blocks; it has 10-micron margin integrity. Both systems can be purchased as a complete CAD/CAM system or you can purchase the scanner and have the milling done at Darby's facility.
Lava System. Jim Buchanan, sales and marketing manager for 3M ESPE, discussed the Lava system, which currently can mill zirconia single crowns and two- to four-unit bridges including splinted and cantilever bridges, offers eight shades of copings and frameworks and is sold as a complete in-house CAD/CAM system. 3M has established authorized Lava milling centers throughout the U.S. that fabricate the understructures, meaning any lab can send a model to a milling center and thus offer Lava restorations. A software upgrade due in November will enable milling of up to six units and in 2006, labs will be able to purchase a remote scanner so they can scan in-house and send the digital file to a Lava milling center. Buchanan touted 3M's extensive marketing efforts to develop a branded restoration that works in conjunction with a wide variety of branded ancillary products, including the new Lava Ceram made specifically for Lava substructures.
Procera System. With over six million Procera units placed worldwide, Nobel Biocare's system is considered the pioneer of CAD/CAM technology. To illustrate the time-effectiveness of the technology, Jeff McMann, Nobel Biocare, compared the average fabrication times of restorative techniques; for example, it takes 65 minutes to make a conventional custom abutment compared to 35 minutes for a Procera custom abutment; 95 minutes to fabricate a PFM unit versus 79 minutes for a Procera crown. The company offers two scanners--Procera Piccolo for single alumina and zirconia units and the Procera Forte for two- to four-unit bridges and zirconia custom abutments--and all milling is done at the company's Mahwah, New Jersey facility.
Zeno Tec System. Making its U.S. debut at the show, Wieland's Zeno Tec system includes two models. The 4030 is a desktop version for up to 14-unit bridges made out of green-stage ceramics and resin only; it can mill approximately 80 units per day and the complete system costs $145,000. The larger 4820 can mill up to 14-unit bridges from zirconia, alumina, resin and non-precious metals, and has a capacity of about 120 units per day and a $195,000 price tag for the complete system. Dr. Volker Winter described how the shape of the patented blanks maximizes output per blank (between 20 and 30 units) and that the blanks can be removed and reused, saving on material costs which he estimates are about $20 per unit. There are no key or dongle fees (per-unit fees required with some systems).
