3Shape Vice President for Product Strategy, Rune Fisker talks about the digital denture workflow. Its benefits, challenges and where the industry is heading.
The days of the analog denture workflow are numbered. Vastly improved software, flexibility, and speed of processes, as well as better manufacturing equipment means that it will soon meet the same fate as its fellow analog workflows.
That’s a new reality. But it does not mean the end for technicians who specialize in making dentures. Instead, I believe, it’s an offer you can’t refuse: the opportunity to shift your expertise to a digital platform. Much like your fellow C&B professionals that have adopted CAD/CAM, it’s the prospect of working more efficiently in a cleaner environment and achieving predictable, optimal results.
Furthermore, once 3D printers begin producing resilient and esthetically acceptable dentures, the industry will really undergo a major revolution. As a dental technician, you need to be prepared.
In the words of CDT, Justin Marks, “unless you’re planning to retire in 5 or 10 years, you need to look at these technologies.”
And just to throw a little more wood on the fire, the most recent 3Shape Marketing Survey found that 50% of practices plan to buy an intraoral scanner in the next three years. As lab, you will be receiving digital impressions.
The fully digital workflow for RPDs (Removable Partial Dentures) is primetime – here and now.
Every day I speak with labs that are successfully designing and manufacturing their RPD frameworks using digital workflows. They begin with intraoral scans and end with casting or laser sintering.
What has changed is the software.
3Shape Dental System enables you to start your RPD digital workflow with virtual teeth. You create better frameworks by placing virtual crowns to guide your frame design. A change in the workflow that helps to optimize stability, improve esthetics, and is simply, not possible in the analog workflow.
The digital workflow also includes advantages like sharing and saving configurations, flexibility, time and material efficiency, and digital accuracy and predictability. You are no longer just saving time and steps in the workflow, you save costs in materials and reduce environmental impact. Not to mention, cleaning up your lab.
And importantly, if you’re still receiving analog impressions from your dentist, you can simply convert them to digital models with a 3Shape scanner and software.
Technicians using laser sinters tell me that going digital has reduced normal production time by 60-70%, and that they are creating designs in less than 15 minutes. If you’re a lab that produces RPDs, the digital workflow is for you.
There are several different denture solutions out there. From Avadent to Ivoclar Vivadent, companies are developing strong solutions to make digital dentures a reality. Because 3Shape is an open system, it connects you with all these. We have created validated scanning and design workflows with each.
Similarly, there are four main types of manufacturing methods with Avadent and Baltic having their own proprietary workflows. The four main manufacturing methods are Monoblock for injection; Premanufactured teeth; Milled teeth & denture base and 3D Printed dentures. 3Shape provides predictable workflows for all four.
For now, going digital with your denture workflow means that you are digitizing many of your workflow steps. The various software solutions eliminate steps in the workflow like Try-ins, but in reality, you are doing what you’ve always done, only digitally.
Technology, however, is rapidly changing. Scanning and CAD is getting better and nearly all denture workflows are supported. Mills are more efficient and materials more robust and esthetic.
Making the most of manufacturing options
Better materials mean more manufacturing options. The four most widely used manufacturing methods each have their pros and cons. (See my chart below). For example, Monoblocks can be used for injection, which makes it low cost, but the workflow is labor-intensive.
Likewise, premanufactured teeth are a terrific esthetic solution but again, labor-intensive, as you try to solve contact and occlusion challenges while gluing and modifying teeth in the denture base.
The third manufacturing option is milled teeth and denture base.
Much of the workflow involves printing or milling so you are not doing too much with your hands. For example, so much of the Ivoclar Vivadent workflow is CAD/CAM-based that it has reduced labor time by 50%. However, you are still milling longer.
As mentioned, I believe the quantum leap will take place when 3D printing fully arrives. When material challenges, like strength and esthetics, can match what we do now with mills and our hands, the revolution begins. And I believe this will happen sooner than many expect.
As a technician, you have your favorite workflows for creating dentures. CAD/CAM solutions like 3Shape Dental Design software help you to digitalize and in many cases, improve and eliminate steps in these workflows.
For example, with 3Shape, you can custom design and manufacture impression trays very cost-effectively. With the software, you can design a custom tray in just five to seven minutes.
Different components of the digital workflow, like scanners, enable you to scan models and wax-rims as well as impressions, including AMDs, 3D Bite Plates, and duplicate dentures. You just bring the data into your software for design and later, send when applicable, for CAM manufacture.
As with RPD design, there is so much more you can do when you digitally design full dentures. From removing teeth to placing them, digital denture design is a much more efficient and comprehensive solution. And, in the words of fellow CDTs, “it’s fun.”
Bringing the patient into the design process
Getting patients involved in their treatment impacts outcome success. Dentists rave about the power of sharing intraoral scans and treatment proposals onscreen, the “wow effect” for engaging patients.
3Shape Dental System gets you, the lab technician, involved too. It lets you show off. For example, Dental System’s RealView application links 2D and 3D images onscreen for you. Enabling you to create and share near photo-realistic visualizations of patient-cases by bringing together the patient’s face and teeth designed in 3D.
With RealView, you create a mockup of your design for the patient to see onscreen. In reality, they virtually try out their new smile. You then complete your design based on feedback from the patient and doctor.
CAD/CAM is making so many steps in your workflow simpler and more enjoyable to work with. The digital workflow can reduce the number of visits and chair time. And lastly, because the denture workflow is simplified, more crown and bridge technicians are also doing it.
If you are a denture-maker and not working digitally yet, you need to start. Open solutions like 3Shape make your job so much easier. Together, we are changing dentistry.
The pros and cons of the 4 most common digital denture manufacturing workflows:
|Monoblock for injection||Low material cost||Not fully digital
Not very productive
|Premanufactured Teeth||High esthetic solution||Cumbersome to glue in teeth
Difficult contacts & occlusion
Problematic to reduce teeth
|Milled teeth & denture base||Low labor needs and no teeth stock
Modify teeth e.g. single arch & RPD
|Milling time and overall cost|
|3D Printed dentures||Very cost efficient
Modify teeth e.g. single arch & RPD
No teeth stock
|Sufficient material properties
Not as esthetic