SCCAN: Carving a path to success

CAD/CAM production in a dental lab needs to be a round-trip operation. The patient-specific information required to produce a restoration can be easily digitized, but the designs based on that information need to be exported from the computer in a physical form, and for labs fully committed to a digital production model, investing in a stand-alone mill can be a great way to take complete control of the finalized physical production.

Whether your lab is experienced in the scan and design sides of CAD/CAM and looking to bring the production in-house or completely new to the digital side of the industry but looking to remain self-sufficient, there are a wide range of mills currently available for milling different dental products. From tabletop-sized units to stand-alone systems, these open-architecture mills have a range of capabilities and can mill an array of materials, but the one thing they all bring to a lab is control.

“If they bring their own milling system in, then they have full control of the products being released,” said Chuck Warren, CDT, who runs Tempus Dental Laboratory in Springville, Utah, is an advisor for Wieland Dental and produces restorations on the company’s Zenotec T1.

Mill capabilities

Adding a mill allows a lab to reduce the time it takes to create a CAD/CAM restoration because nothing is being sent to an outsource partner, and in-house production can significantly reduce the cost per unit for the lab, said Steve Campbell, General Manager of B&D Dental Technologies. His company’s Origin line of mills range from a new tabletop-sized unit to the large scale Origin Pro Duo and are designed to provide a modular approach in terms of their capabilities.

This approach allows a lab to invest in a mill that will handle the materials they currently work with and then add new material options when there’s demand from customers or the lab is ready to drive the demand through additional capabilities. This means a lab can start milling in wax, zirconia, lithium disilicate, and expand into in-house custom abutment milling, and soon implant bars. Campbell said a big advantage a lab gains by adopting an open mill such as the Origin line is the optimized use of material gained from milling discs rather than single-use blocks.

“When considering a significant investment in a CAD/CAM system, astute lab owners calculate the production costs as well as the initial outlay,” he said. “In stark contrast to the blocks used in most of the existing desktop milling systems, the efficient disk utilization common to each of the Origin mills provides for some of the lowest expenses in the industry.”

Similarly, Warren said the way the T1 works with discs of material is one of the features that sets that mill apart from the many other milling systems he’s used during his more than a decade milling dental restorations. He likes the way the T1 can have a range of discs loaded in a stack so it can be programmed to produce a range of restorations from different materials and then set to run all night or over the course of a weekend.

The system is designed for easy loading of the materials, and Warren said this simple time savings adds up for his lab. While the T1 is strictly a dry mill so it won’t tackle titanium or lithium disilicate, which are both milled wet, he and his dentist clients are consistently impressed by what the 7-axis milling system can create from zirconia, PMMA, wax and a range of other materials. He keeps his mill loaded with an array of materials so it’s ready to go right away when his workflow calls for a new material to be milled.

“The T1 is exceptionally more efficient than all of the other milling systems that I’ve had and been exposed to in the sense that you can stack discs in and do multiple millings at the same time,” Warren said. “There’s enough blanks in this thing, you can mill all weekend.”

Putting it to use

Both the Origin mills and Wieland’s milling solutions are open-architecture technologies, which means any CAD file that can be exported in STL format can be sent to the mill for production. Warren said the CAM software that controls his T1 is designed for both new and experienced users.

It features presets for milling a range of restoration types from a range of materials. However, advanced users are able to customize those presets to maximize how material is used, speed up the milling process or do just about anything. The total control of the system even extends to when Warren isn’t in the lab, as the T1 can be controlled remotely so overnight or weekend milling runs can be monitored, and priorities can be changed via the Internet.

As his lab grew more and more focused on CAD/CAM production, Warren said the workflow shifted to take advantage of the efficiencies available. Rather than wax up designs by hand, every case at his lab is computer designed, with the waxup milled on the T1. Even though he’s been using milling systems for years, Warren said he is constantly amazed at how the capabilities of both the software and the hardware continue to get easier to use while producing more accurate and better looking restorations.

“It’s just a huge, huge time saver, and it doesn’t get tired,” he said. “It mills what I don’t think is capable of being milled.”
Training on these systems is provided at the time of purchase and both Warren and Campbell said technicians familiar with CAD/CAM production can be confidently running their mill after just a few days of training. Campbell said it might be a few weeks for labs completely new to digital production, but the modular nature of the Origin systems allows a lab to take on one production change at a time, adding new features and options whenever ready for that next step.

“A lab could start with dry milling of zirconia for both copings and full contour crowns. Then later they could add the wet metal milling module so that they could mill titanium copings and bridges and even full titanium abutments,” Campbell said. “The open architecture of the Origin CAD/CAM systems provides even more utilization, which helps to truly future proof a lab.”

When a mill makes sense

Knowing when a lab is ready to invest in a mill is important because while these systems bring major efficiencies and automate parts of the production process, they can represent a major investment for a lab. Campbell said labs with existing CAD/CAM business and large outsource expenses for production are good candidates for investing in a mill.
However, this does not mean mills such as the Origin systems or Wieland’s Zenotec T1 are just designed for large labs. Warren’s lab isn’t a huge operation, but he firmly believes his lab’s digital production capabilities are what keep them successful and allow them to compete in an ever more global dental laboratory industry.

“With a system like this one, you can compete worldwide,” he said. “The small lab, even up to the big lab is now all on a level playing field.”

Campbell said small labs with a business model that focuses on digital production will find there is an Origin mill able to meet their needs. Origin mills are used in large labs, milling centers but also in 2-technician operations. Having an Origin mill with its modular design allows the labs to focus on one area of the business or expand to other areas when ready. Labs of any size with in-house milling capabilities are completely set up to take in work from other labs. In this way, a lab investing in a milling system could look at turning a monthly outsource bill into monthly revenue.

Investing in a mill also is an investment in the lab as a business, Warren added. While technicians are valuable because of their knowledge and skills, those attributes aren’t easily passed on to new people, and this means the lab’s resale value is limited. However, a digital lab is something that can be sold and passed along to a new digital technician.

“You can teach somebody much, much quicker to design and contour and color a full zirconia crown than you can teach somebody to layer one,” said Warren, who added that investing in CAD/CAM production has been a winning move for his lab, and working with the technology keeps him energized about what he does every day.

“This is the best decision I’ve ever made in my entire dental career,” he said. “It’s exciting every time I sit down with it.”