The shifting ­production of crowns and bridges

Modern day dental laboratories are currently operating in a constantly evolving environment. New technologies and changes in preferred materials are altering the way dental labs operate and produce various restorations. Additionally, the rise in the dental implant category has added to the shift in the U.S. dental lab’s production mix. Even with these changes, crown and bridge production still makes up a dominant part of the core dental lab manufacturing output, as a typical dental lab will produce an average of 350 crowns and 112 bridge units in a month.

Market factors

A variety of current market dynamics have increased the overall demand for higher production throughout and quicker turnaround of crowns and bridges. Factors such as the rise in life expectancy in the United States have greatly driven the need for more crowns and bridges in our senior demographics. In addition, the obsession with the cosmetic value of a “good smile” through reality TV shows and Hollywood style icons has increased the demand for esthetic dentistry in the United States.

Crown and bridge restorations were typically driven by optimal dental structure and support, but now patients expect to achieve enhanced esthetics with their dental restorations. Technologies, offshore manufacturing, a changing labor pool and new preferred materials will continue to impact the production of crowns and bridges.

Over the past year, growth in digital dentistry continued to play an important role, with CAD/CAM all-ceramic crown and bridge production in dental labs increasing 2.9% when compared with the previous year.

Impact by lab size

Approximately half of larger sized labs have completely embraced the CAD/CAM technologies (both scanners and milling systems) in their labs, as this technology serves as a competitive advantage against offshore outsourcing. This technology actually creates new and more desirable jobs, as the software requires digital designers to work alongside the equipment.

Furthermore, for these larger labs, CAD/CAM technology has the capability to lower production costs when used on a daily basis. Web portals between dental labs and dentists have made it easier to process crown and bridge orders, creating a more cost effective and convenient solution for both labs and dentists. As dental labs continue to incorporate CAD/CAM technology, they also will produce more crown and bridge restorations without added labor costs.

However, smaller labs are slower to adopt the technology, as roughly 40% indicate they outsource all CAD/CAM restorations. This outsourcing strategy allows smaller labs to offer various CAD/CAM all-ceramic solutions without the initial capital expenditure.

Materials shift

As the market research indicates, the dental lab industry is witnessing a steady shift from porcelain fused to metal (PFMs) to all-ceramic crowns and bridges as materials and CAD/CAM systems continue to improve. The use of metal in dental restorations also has raised a variety of concerns because metal-based crowns can cause tissue sensitivity and allergic reactions in some people, and they lack the esthetic properties of all-ceramics.

In the last few years, the shift away from PFMs has been accelerated by the rising cost of precious metals. But, even as all-ceramics grow, PFMs still account for more than half of the crown and bridge restorations. To compete, labs have migrated from High Noble to Noble and Non-Precious alloys, with only 38% of PFMs using High Noble alloy.

Over the coming years, crown and bridge production will continue to evolve as the market dynamics change. A constantly evolving world of technology, increased life expectancies and emphasis on dental esthetics will continue to influence patient requests, dental restorative solutions offered by the dentist and the way dental labs operate. Dental laboratories will continue to adapt to meet the needs of their customers.