No other specialty has been impacted by CAD/CAM technology more than C&B. Digitization has transformed this department over the last decade, allowing laboratory owners to streamline, simplify and improve laboratory processes.
From expanded indications to software upgrades and increased material options, manufacturers are continuously striving to improve laboratory capabilities and product offerings. Here's a look at some key developments:
Digitizing of the manual waxup process. Kiss your wax spatulas goodbye: wax printers use additive technology to build up waxups layer by layer, and many CAD/CAM milling systems now mill copings and frameworks from wax or resin blanks that are then cast using traditional methods. In the pressables arena, some systems feature a file-splitting option that allows you to design a virtual coping or framework and full contour simultaneously, output them in two different materials, then invest and press them together.
Milled full contour restorations are possible with a growing number of manufacturers' systems. These restorations are popular because the digital fabrication process saves labor, and they're stronger throughout compared to a layered crown. Anatomical full crowns can be milled out of Ivoclar Vivadent's Empress CAD and e.max CAD or Vita's Mark II feldspathic ceramic, then stained. Or, you can fabricate an overpressed full crown by milling a full contour waxup out of wax or resin and then investing and pressing it to a coping.
Microwave sintering of zirconia restorations cuts the sintering time of traditional methods by more than half and allows the laboratory to deliver a same-day zirconia restoration. While this development is still in its infancy, two companies—CeraSys and Digital Dental Lab—currently offer microwave sintering and more manufacturers will likely develop this technology so laboratories can provide faster, more efficient service to dentist-clients.
Although the following advances affect the specialties across the board, the biggest impact has been felt in the C&B department:
Changing business models. While lab-to-lab outsourcing is not new in our industry, CAD/CAM has brought it to a whole new level. According to an LMT e-survey, of those who offer CAD/CAM-fabricated restorations, 60% have the understructures fabricated by an outside laboratory.
The technology has also opened the door to new business models for manufacturers. In the late 90s, Nobel Biocare was the first manufacturer to offer CAD/CAM laboratory services to its customers and, since then, several other manufacturers have followed suit with milling, scanning and printing services.
Increase in open architecture systems. More and more manufacturers are partnering with one another to create compatibility between systems, giving users access to a wider range of input and output devices and indications. For instance, labs with a 3M Lava scanner can now send digital files to Astra Tech for fabrication of Atlantis™ patient-specific abutments.
Since this trend gives laboratories more output options than ever before, it will likely lead to a boom in stand-alone scanner sales, a less expensive alternative that allows the laboratory to buy only the scanner to scan and design its own restorations and then send the data off-site for fabrication.
Digital impressions continue to generate excitement in the laboratory community because they eliminate laboratories' number-one headache: inadequate impressions. By capturing a digital image and being able to review it on screen, dentists can see and correct problems before sending the image to the lab. Three systems are currently available: 3M ESPE's Lava™ Chairside Oral Scanner (C.O.S.), Cadent's iTero™ and Sirona's CEREC AC.
A new impression scanner for the laboratory from Nobel Biocare—the NobelProcera Scanner which will be formally launched this month at LMT LAB DAY®—uses unique, patented scanning technology to scan either an impression or a batch of dies. The resulting CAD designs will be available in a variety of new materials for PFM, bar and telescopic case solutions. While it doesn't solve the core problem of poor impression-taking techniques, it eliminates model pouring and is yet another aspect of their work technicians can digitize.
How technology and restorative changes are impacting the specialties
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