Themed Future Ready, Zahn Dental's 2009 Leadership Summit offered a comprehensive look at the transformation of our industry and how emerging technologies are changing the way laboratories operate on all levels.
"This is a pivotal time in our industry," said Dell Dine, vice president of research and development for National Dentex Corp., during his presentation at Zahn Dental's 2009 Leadership Summit on October 29-31 in Weston, Florida. Themed Future Ready, the highly interactive, information-packed program offered the 120 attendees from 50 different laboratories an in-depth look at the transformation of our industry and how emerging technologies are changing internal operations and workflow, improving accuracy and consistency, creating new business models and changing the dentist-laboratory relationship.
"In the next five years, digital technologies will increase the interdependency between the dentist and laboratory," said Jackson Brown, DDS, PhD, president of L. Jackson Brown Consulting, LLC. "The proximity of the lab and dentist will be less and less important. In the future, just as medical doctors are now practicing distance medicine, dentists will practice distance dentistry."
As technology evolves, the mindset of the laboratory owner needs to evolve as well. "Chairside CAD/CAM has been on the market for 20 years and, with about 10% of dentists having these systems, same-day dentistry is here to stay," said Dine. Many of those doctors still want to work with their laboratories so he recommends taking a proactive, partnership approach to work in harmony with those clients and understand their changing business models.
Referring to digital impressions as "the ramp to the digital highway," speaker Mike Kulwiec, CDT, owner of Dental Masters Laboratory in Santa Rosa, California, discussed the four digital impression-taking systems currently on the market: Cadent iTero, 3M ESPE's Lava COS, Sirona's CEREC Connect and Henry Schein's D4D. "These systems eliminate the variables inherent in conventional impressions such as the distortion of impression materials and gypsum. They can help the dentist improve his preparation skills because he can instantly see his scanned preps on the computer screen," said Kulwiec, who acknowledges that younger dentists are more inclined to adopt the technology.
Ultimately, digital technology will eliminate the need for a physical model but, in the interim, digitally fabricated models are becoming increasingly popular. These models can be fabricated by milling or printing from digital data captured through intraoral, impression or CT scanners.
Currently, there are three different commercially available technologies for printing digital models: envisionTEC Digital Light Projection Manufacturing (DLPM), stereolithography and jet printing. "There are challenges with any model printing system," explained Al Siblani, CEO of envisionTEC, GmbH. "The model is only as good as the initial scan; if the scan data from an impression or an intraoral scanner has problems, the printed model will too. The printer software needs the processing capability to accept the large amount of digital data that's required to fabricate models accurately in large quantities, the ability to produce models in gypsum-like material that's not brittle and easy to handle by the dental technician, and the ability to accurately register the upper and lower arches after printing."
Looking to the future, laboratories will become "centralized design centers capable of real-time, HIPAA-secure communication with their clients," said Lee Culp, CDT, vice president of dental technologies at D4D Technologies. "The lab won't be waxing, spruing, investing, casting or devesting. It will be using the same thought processes but different tools and materials, and there will still be room for craftsmanship."
Culp is involved in the development of the E4D Dentist and E4D Labworks™ systems, exclusively available through Henry Schein and Zahn Dental, respectively. E4D Labworks is a comprehensive scanning, designing and full contour milling system for the laboratory that can be used to fabricate full contour single-unit ceramic restorations (see Going Digital with Zahn Dental on previous page). "I'm anti-framework and I hate to wax; I want full contour that I can minimally layer or stain and glaze and get out the door quickly," said Culp.
The Consistency Factor
"The beauty of digital technologies is that they increase accuracy and consistency. As automation begins to eliminate the variables and inconsistency in restorations, your marketing efforts and customer service are going to give you a competitive advantage," said LMT Publisher Judy Fishman. "Since inconsistent quality is the number one reason dentists switch laboratories, when it comes to planning a marketing campaign, illustrating how your laboratory addresses consistency issues is a great attention grabber."
The thing is, said Fishman, "if the cover of your piece grabs attention using the consistency buzzword, you need to be absolutely sure the inside follows through with specific ways in which your laboratory creates that consistency. Inside, if you go right to your prices, for example, then before he's even seen your work, you've already over promised and under delivered."
Another business strategy that has built momentum for laboratory President and CEO Warren Rogers, Knight Dental Group, Oldsmar, Florida, is digital prescriptions. Several years ago, the lab began offering its clients the ability to submit prescriptions on its website via Henry Schein's DDX system. Now, about one-third of its clients are using the system and, because they're prompted to provide a complete and accurate prescription, he's seen a remarkable decline in remakes and Rx-entry time. As a result he now offers a $4.90 credit on each prescription submitted digitally and has eliminated one administrative staff member. His production scheduling has also improved because he knows about the incoming case as soon as the prescription is submitted, well before the case arrives at the lab.
"Digital prescriptions are much more accurate, and provide easier storage and the appropriate documentation, such as material selection and prescription changes, to protect you from liability and better comply with the FDA's GMPs," explained Rogers. In January, he's also going to start sending digital statements and expects to save about $6,000 per year on paper, postage and personnel time.
Going Digital With Zahn Dental
Zahn, a Henry Schein Company, is the exclusive distributor of a variety of open architecture digital technologies and services for its customers. Scanning: Dental Wings 3D Scanners that have 3- and 5-axis technology with full design capabilities.
Design: The DWOS™ (Dental Wings Operating System) enables the laboratory to design copings, bridges, full-contour anatomical overlays and implant abutments. The software also accepts digital impression data for immediate prosthetic design.
Printing: The EnvisionTEC HP DDP® and PixCera for rapid prototyping of anatomical waxups and the EnvisionTEC Perfactory® Xede Hi Pix Printers that create 3-D models using dental stone-like photopolymer-based materials. The EnvisionTEC PixCera is a new wax up printer from EnvisionTEC with a capacity of 35 copings in less than two-and-a-half hours.
Milling: The Noritake Katana H-18 mills YTZP zirconia substructures from single copings to bridges. The zirconia blocks are available in nine shades and are matched to Noritake's CZR layering porcelain or press-to ceramics.
Complete Scanning, Designing and Milling: E4D Labworks™ is a comprehensive restorative system with the ability to scan models or impressions and design up to 16 full anatomically contoured teeth simultaneously. Milling material options include IPS Empress CAD, IPS e.max CAD, 3M Paradigm C and 3M Paradigm MZ100.
Outsourcing Services: Custom Milling Center (CMC) offers laboratories a variety of services, including scanning, designing and milling. Its open architecture structure can receive STL files from almost any system, and can split the STL file to simultaneously mill a coping and print a full-contour waxup. CMC also mills Maryland bridges, custom abutments and Cadent™ iTero™ models.
Digital Dental Exchange: The DDX System integrates practice management and laboratory management software to provide more effective communication, efficient digital file management and case design collaboration between the dentist and the laboratory. It offers numerous advantages, including being able to complete prescriptions online, receive digital photos and other files attached directly to the case; and provide clients with the ability to track cases and deadlines, request pickups, and access their account balance and make secure payments. For more information, call Zahn at 800-496-9500.