Imagine the ability to fabricate a restoration before the patient's tooth is even prepped. Thanks to a new system in development from B&D, you may soon be able to do just that.
The company previewed its new Digital Prep Guide, currently in beta testing, at the Dental Laboratory Owners' Association of California's (DLOAC) CAD/CAM Expo and Symposium in November in Garden Grove, CA. Here's how it works: at the patient's first visit, if the dentist doesn't have an intraoral scanner, he takes a conventional impression then sends it to the lab where the technician fabricates a model, scans it and sends the digital file back to the dentist.
The dentist then uses the digital file and special software to virtually prep the tooth. He digitally marks the margin, selects the degree of the prep angle and removes tooth structure by selecting various size burs; he then sends this data back to the lab. Using the virtual prep and special software, the lab designs and fabricates the finished crown and prints a resin prep guide for the dentist using a 3D printer.
At the patient's second visit, the dentist places the guide in the patient's mouth, inserts burs into grooves in the guide to prep the tooth and delivers the restoration. "The system reduces prep time for a single unit to three to five minutes and eliminates a temp as well as an additional patient visit," said Daniel Jung, B&D's President and CTO, who has been working on the product for the last year and a half with his 20-person R&D team. "We originally developed the system for Maryland-type bridges but we've expanded to full crowns and bridges and are also working on incorporating veneers." The system will be available early this year.
A recurring theme at the show was full contour restorations which continue to be touted for their labor-savings and profitability. "In 2008, the industry was at 75% PFM and 25% metal free and not that many people were doing full contour," said Kevin Mahan, Vice President of Sales, Jensen Dental. "Today, monolithic is king." Here are other highlights of the DLOAC event:
New Intraoral Scanners Hit the Market
Despite the fact that dentists continue to be slow to adopt digital impression techniques, the systems are still regarded as the future of dentistry given their benefits and the fact that new models are smaller, easier to use and less expensive than their predecessors. "I'm convinced we're heading away from stone models," said Dr. Russell Giordano, DMD, DMSc, FADM, Associate Professor and Director of Biomaterials at the Boston University Goldman School of Dental Medicine. "All dental schools are acquiring digital impression systems and we're moving forward, not backward."
Two new second-generation systems have recently hit the market. 3M ESPE's 3M™ True Definition Scanner features a small ergonomic wand and costs $11,995—the most economical unit on the market&coupled with data plans starting at $199 a month. Henry Schein and Benco sell, install and support the device which can be connected to chairside and lab-based mills including the E4D Mill.
Sirona's new CEREC® Omnicam features a camera that moves over the teeth to produce photorealistic 3D data in full color—an industry first. The powder-free system also offers a new, ergonomic handpiece and is priced at $68,995.
TRIOS, the much-anticipated intraoral scanner from 3Shape, is now available in the U.S. Retailing between $30,000-$40,000, it doesn't require the use of spray, captures more than 3,000 2D images per second and includes tools that allow the dentist to edit his scans. TRIOS resellers include Biodenta, Biolase, CadBlu, 3DBioCAD and KastleMills in Canada.
Since it's widely agreed that traditional impressions will be here for some time, Dental Wings has come up with an interim solution: it's developing an impression scanner for the dental office. Similar to the company's iseries impression scanner for the laboratory, the easy-to-use scanner allows the dentist to scan traditional impressions in the office and transfer the digital data to the lab. While these types of systems don't solve the core problem of poor impression-taking techniques, they don't require the dentist to change his technique, further digitizes the fabrication process and helps "bridge the gap" until more dentists get on board with intraoral scanners.
New digital systems and processes eliminate the need for a traditional, poured up model and materials for printed models are also being improved. For instance, 3D Systems now offers VisiJet® PearlStone which produces models with a dental stone-like appearance. The material is used with the company's ProJet® MP 3500 model printer.
CAD/CAM Software Continues to be Enhanced
Software continues to advance rapidly and several manufacturers announced system enhancements and new indications, many of which are related to implants. Nobel Biocare offered a limited release of its new software, Nobel Procera 4.7, which allows users to design and fabricate titanium abutments. Watch for the full scale release next month at LAB DAY™ Chicago.
Delcam's 2013 version of its DentCAD software, available in the first quarter of 2013, includes several new libraries for implant-based restorations, including implant, link abutment and dental bar attachment libraries. An updated release of its DentMILL software includes machine and fixture libraries for Roeders, DMG, AgieCharmilles and Roland.
Dental Wings and Straumann are expanding their partnership so Dental Wings takes over Straumann's CAD software development and coDiagnostiX implant software company, and Straumann increases its share in Dental Wings to 45%. Dental Wings is working on integrating both Straumann's CAD software and the coDiagnostiX implant planning software with its DWOS platform and plans to launch the new Straumann CARES 8.0 software early this year.
3Shape launches Dental System 2013 which offers a host of new features, including a bridge connector design and split-bridge tool, automatic crown and bridge design, ability to digitally design the implant bridge with gingiva and RealView Engine that provides a near photorealistic visualization of the case.
Expanding CAD/CAM's application to removables, both Dental Wings and 3Shape have plans to release full denture modules later this year. The 3Shape software allows users to virtually design the denture base, print it out via a 3D printer and then set teeth in the traditional way.
Given that software advances so quickly, 3Shape is also now offering a more affordable way for labs to access technology as it develops. Its CAD Points program allows 3Shape scanner users to access new software modules via a "pay-as-you-go" system rather than purchasing a full module.
For instance, if a lab wants to design implant abutments using the 3Shape implant abutment module but doesn't yet have the demand to warrant the $2,500 investment, it can purchase points to use towards each case. One hundred CAD points cost about $160 and a typical abutment case uses nine CAD points. Labs can order CAD points instantly through the Webshop feature in the 3Shape software.
More Hardware Options
Several manufacturers introduced new and updated versions of hardware that offer more indications, features and better performance. For instance, Schutz launched a new desktop-size scanner, the Tizian Smart-Scan which features a 70% faster scan time than the previous-generation model. The unit costs $30,000 which includes the scanner, scan/design software and computer.
Ideal for labs fabricating abutments and bars, the HDD1 scanner from Esprit Dental offers high definition scans and accurate detail. The company's DDS Studio 2012 CAD software accepts data from the HDD1 scanner and 3M True Definition intraoral scanners. The HDD1/DDS Studio 2012 system retails for $37,990, including a 16-GB computer and one-day training course.
EnvisionTEC launched its smallest 3D printer yet: the Perfactory® Micro Digital Dental Printer (DDP). The $21,000 desktop unit, which includes software and training, produces up to 10 detailed crowns or copings per build in two-and-a-half hours that can then be cast or pressed.
Manufacturers Expanding CAD/CAM Services
Manufacturers who've gotten involved in the subcontracting sector continue to expand their offerings to better service laboratory customers. For instance, the Argen Digital Center now offers noble and non-precious Selective Laser Melted (SLM) substructures, precious metal substructures, wax patterns and 3Shape scanners. Argen is also beta testing a Digital Captek solution, allowing labs to utilize a digital channel to receive Captek restorations.
Preat now offers titanium and Co/Cr implant structures printed via SLM with a pearl-retention finish. It accepts Imetrix files—and plans to accept 3Shape files soon—scans and designs the bars via its in-house center, PRISM, and has the bars printed in Belgium; turnaround time is five to seven working days.
In partnership with Zfx GmbH, Zimmer now distributes Zfx products, including Zfx CAD software and scanners. It also offers CAD/CAM services—including crown and bridge components, bars and titanium and zirconia abutments—through its new Zfx milling center in Carlsbad, CA.
Hungary-based Kerox Dental is a new player in the materials market. With 30 years' experience in ceramic production and customers in 45 countries, the company holds several patents for its isostatically pressed, highly translucent Zircostar® zirconia blocks which are compatible with a variety of milling systems. For more information, contact William Leo Jr., Managing Director, North America, at 706-754-5357 (office) or 706-968-4893 (cell).
Noel Laboratories in Atascadero, CA, a laboratory with 35 years of experience, has launched a milling center. Its 13-person lab/milling center staff uses 3Shape scanners and Origin mills to fabricate milled zirconia copings, crowns and bridges. It accepts .stl files and can also scan and design restorations from your model or die or duplicate your waxup. For more information, call 800-575-4442 and 805-461-6635.