LMT attends the 2009 IDS in Cologne, Germany, to find the latest innovations in dental technology that are digitizing and streamlining laboratory workflow and processes.
What recession? The crowds at this year's International Dental Show (IDS) made it easy to forget the turbulent global economy outside the exhibit hall walls. Over 100,000 attendees came to see more than 1,100 new products from over 1,800 exhibitors during the five-day event, held in March in Cologne, Germany. U.S. attendees and manufacturers alike were dazzled by the sheer number of CAD/CAM companies at the show—a reported 170 were there—and the huge CAD/CAM presence made it crystal clear that digital dentistry is here to stay. "In dentistry, there's no going back," says Dell Dine, vice president of research and development for National Dentex. "CAD/CAM has made the transition from fascination to business as usual."
Digitizing and streamlining workflow and processes was the key trend at this year's show, and the movement towards open CAD/CAM systems and partnerships has exploded. A growing number of manufacturers' systems are compatible with other companies' hardware and software, allowing manufacturers and laboratory users alike to mix-and-match the components they want to offer. "Companies that already have systems are broadening their appeal by opening them up," says Dine. "The open system concept is becoming more practical than it has been in the past. It's a clear indication that this piece of our industry is maturing."
The overall sentiment is that software is outpacing hardware in terms of advancement. "The progress in CAD software was really impressive," says Bob Slominski, co-owner of Dental Crafters in Marshfield, Wisconsin, who evaluated eight different packages at the show. "When you have different software for scanning, designing and milling, uploading and transferring the files to each package is cumbersome. Now software packages are more comprehensive—one will include both scanning and design software for instance—and it's easier to get to the finished product and easier to learn the systems."
Scanners from industry leader 3Shape were part of nearly 20 different CAD/CAM systems at the show and the company also launched several new products, including its impression scanner that allows you to scan an impression to create a digital model. The D700 Scanner scans any impression material—as well as full gypsum models 40% faster than the previous D640 scanner—using a two-camera, three-axis system for more precise detail. The model is digitally designed and then the file is sent to a model-making machine for production of a physical model, reducing turnaround time by eliminating traditional model making and allowing CAD design and manufacturing of the restoration to start immediately. Currently 3Shape products are only available through a network of distributors.
Other companies are also involved in this new impression-scanning technology. At LMT Lab Day® in February, Nobel Biocare launched the NobelProcera™ optical scanner that scans impressions and models using conoscopic holography technology. After scanning, the lab digitally designs the model and restoration, sends the digital data to one of Nobel Biocare's centralized manufacturing centers, and then receives an acrylic model with the coping or abutment in place (see LMT's January issue for more information). IMTEC, a 3M Company, has also developed the technology and showed a prototype that uses Cone Beam technology—the Sprite—at LMT Lab Day. Zahn Dental exclusively distributes the Dental Wings DW-IS Impression Scanner and the Dental Wings DW-5S Premium Package that scans impressions and models.
While impression scanning doesn't address poor impression-taking skills as intraoral scanners are touted to do, it allows laboratories to digitize yet another aspect of their work and to "bridge the gap" until intraoral scanners become standard.
Fueled by the impression and intra-oral scanner trend, model-making machines—which fabricate models from a digital file using milling or 3-D printing—are also expected to grow in popularity. 3D Systems currently offers the model-making technology and Wieland and EnvisionTEC both launched new units at the show. Wieland's Zenotec T1 is a new five-axis simultaneous high-speed milling system that mills complete arch models as well as crowns, bridges and implant abutments. The system is compatible with intraoral, impression and model scanning technologies and mills models from a high-performance plastic; quadrants can be milled in just a few minutes. The desktop unit features auto retrieval of tools from the integrated tool disc located in the storage magazine and automatically checks tools for wear. The unit will be available in the U.S. at the end of the summer.
EnvisionTEC's Perfactory Hi Pix Printers accepts all STL files, and prints quadrant and full arch models in photopolymer that are then light cured. The Xede® fabricates up to 20 full anatomy models in one hour and the Xtreme® prints up to 10 full anatomy models every two hours; both are available exclusively through Zahn Dental.
Two companies, 3Shape and pritidenta, offer a new, cutting-edge communication tool: face scanners. Slated to be on the U.S. market later this year, 3Shape's Face Scanning solution takes three scans of a patient's face and teeth, as well as the model, and then combines them into one 3-D image. The 3Shape design software works with a library of tooth shapes so the patient can view before-and-after 3-D photos and the dentist can interactively update the C&B treatment plan while the patient is in the chair. Based on the agreed treatment plan, the dentist gets a prep guide that tells him how to prep the teeth in order to achieve the look. Finally, the desired C&B design is directly transferred to the prepared teeth and the restorations are manufactured by milling glass ceramic or by outputting them in wax and then pressing.
Also launched at the show, Pritidenta's 3-D Face Scanner works in a similar fashion but uses a library of pre-manufactured, standardized glass ceramic crowns that can be added to the image to create the desired look. The digital information for the selected crowns is then sent to a mill and--although the crowns are pre-milled and largely complete--they need a bit of final milling to make the crown fit the prep and establish proper contacts. This system will also be available to the U.S. market later this year.
Metal and Implant Trends
Laboratories now have more options for the automated production of metal copings. For instance, the Wol-Ceram System can now be used to fabricate metal copings. Here's how it works: The master die is coated with wax to allow the proper cement thickness followed by a thin liquid metal coating, then loaded into the machine which dips the die into a metal slip. Electrophoresis draws the metal particles to the die and, once it dries, it's removed from the waxed die and sintered.
From waxing to sintering, the technique completes a metal coping in one hour; eliminates burnout, casting, metal finishing; and costs about $30,000. The unit will process base metal alloy, palladium, silver and high noble alloys. Manufactured by Wol-Dent in Germany, the unit and metals will be distributed exclusively in the U.S. by GlobaLink Solutions Dental and availability is scheduled for September.
In the digital arena, the new SLM 50 from Realizer GmbH offers labs a more affordable, desktop-size unit for producing metal copings with rapid prototyping. Using selective laser melting, the metal parts are constructed from 3-D data layer by layer and up to 30 individual components can be manufactured concurrently. The unit is ideal for the production of crown and bridge frameworks and cobalt chrome brackets. "The SLM 50 is far smaller than the large SLM machines previously available on the market and therefore even works economically at low volumes," says Realizer's Peter Unterberg.
Just as in 2007, implant companies had a huge presence at the show. "The number of implant systems is overwhelming," says Tom Bormes, owner of Preat Corp. "It's clear that implants are leading the specialties and becoming a commodity. There's a lot more price competition than there used to be."
Bredent's booth especially generated excitement among attendees because it showcased live implant surgeries throughout the week. Inside a glass booth, patients received various implant solutions and—with the help of several cameras—the procedures were broadcast on screens mounted on the outside of the booth.
In addition to a growing number of companies offering mini implants, more manufacturers are also offering zirconia implants, which are biocompatible and esthetic because there's no metal shade to mask. In the U.S., zirconia implants are only currently available from Z-Systems AG; the Z-Look3 one-piece system was launched at the end of 2007. Another company, Straumann, is also launching Roxolid™, a gray-colored implant made of titanium and zirconium for added strength when placing smaller diameter implants. It will be available through a limited market release in the second quarter of 2009 and a full market release by the end of the year.
Editor's Note: The 2011 IDS will be held March 22-26 in Cologne, Germany.