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CAD/CAM technology and 3D printing have revolutionised the dental office, allowing for the efficient and precise fabrication of dental restorations. Among the industry leaders, Dentsply Sirona plays a pivotal role in advancing these fields. Max Milz is the group vice president for connected technology solutions at Dentsply Sirona. In this interview, he talks about the company’s digital dentistry product portfolio and the benefits for clinical workflows.
Renowned for its CEREC system, Dentsply Sirona further boasts a comprehensive portfolio that includes a cutting-edge 3D-printing solution. Mr Milz, how should dental professionals perceive and embrace the diverse array of these digital manufacturing technologies at their disposal?
For me, CEREC and in-office 3D printing are ideal partners—like a specialist and a generalist working together to achieve the best outcome for the patient.
CEREC is like a specialist in accurate and durable restorations with over 35 years’ experience. CEREC systems, such as Primemill, produce excellent clinical results leading to a high level of patient satisfaction and benefiting the practice economically. As pioneers in this field, we at Dentsply Sirona are especially proud that five million restorations are milled on CEREC machines around the world every year.
In-office 3D-printing solutions, such as Primeprint, are like generalists providing a broad spectrum of services. It is an exciting technology following in the footsteps of CEREC and leveraging some of the same technologies, such as accurate intra-oral scanning and CAD/CAM software. The differences lie in the manufacturing process. 3D printing is an additive manufacturing process in which 3D printers deposit liquid resins to create complex custom-made parts, essentially plastics. CEREC machines mill high-strength materials such as glass-ceramics or zirconia from pre-manufactured blocks.
As a provider of both solutions at scale, we see milling as ideal for manufacturing high-quality permanent restorations that last more than ten years. In-office 3D printing is great for making temporary and intermediate restorations and for other applications, such as surgical guides, models and splints.
Do you envision the emerging technology supplanting or augmenting conventional milling?
Together, CEREC and 3D printing can unlock a broad number of relevant indications for in-office manufacturing that can benefit both professionals and patients. In a nutshell, CEREC is for permanent restorations and 3D printing is for temporary applications. This is a result of two factors: the complexity of the product you can print or mill and the materials suitable for milling and printing.
3D printing allows you to work like an artist. You can design and manufacture any shape you can imagine, whereas milling is similar to the work of a sculptor, cutting and shaping a block into the desired final form. The flexibility of 3D printing comes at a price—material strength.
In-office 3D-printing solutions use resins that result in what are essentially plastic appliances, which have demonstrated lower material strengths than those of milling materials. Milling materials such as zirconia achieve up to five times higher material strength than composite resins. That is one of the reasons why milled crowns can last over ten years, for which there is extensive clinical evidence. The same cannot be said for printing materials.
The idea of printing permanent crowns is still in its early stages. Given the current lack of solid clinical evidence, dental practices printing crowns that are intended to remain in place permanently should be cautious. Advertisements by some companies imply the ability to print ceramic restorations. However, printer resins suitable for fabricating dental devices have a maximum filler content comparable to that of dental flowable composites.
Both CEREC and in-office 3D printing are highly attractive in terms of economics. A dental practice leveraging both milling and printing processes effectively will have satisfied patients and improved economics.
Both technologies are integrated into our DS Core digital platform, which allows you to use them side by side to increase the efficiency of your practice with integrated in-office manufacturing. Take an implant procedure, for example. After scanning your case, you can print the surgical guide and the temporary restoration and then mill the permanent restoration—all within your office.
“A dental practice leveraging both milling and printing processes effectively will have satisfied patients and improved economics.”
Dentsply Sirona is known as a pioneer in digital dentistry. What is the company’s vision for the future of dental care?
We believe that the future of dental care is about leveraging digitalisation to empower dental professionals to focus on what matters most: treating their patients to improve oral health. Digital solutions will be a part of every dental treatment because digital workflows create opportunities to make treatment easier, safer and more efficient and help dental professionals to spend more time with their patients.
Today, digital dentistry is not as easy as it should be. An increasing number of technologies—CBCT, CEREC, 3D printing and artificial intelligence—have entered the dental practice. It has become vital to integrate these technologies better with one another and to make them more accessible to dental professionals. The simplicity of digital workflows is key. Our approach to realising the future digital dental world is DS Core, which aims to integrate all the different technologies used in dentistry in an open and secure platform.
Could you please give us an overview of DS Core and its practical applications?
DS Core is our open digital platform integrating equipment, software and services to enable seamless workflows for dental professionals. Over time, it is our ambition to integrate all workflows on the platform to allow practices to work the way they want. The goals are simplicity, efficiency and flexibility.
Images such as scans are the starting point of digital workflows. That is why DS Core integrates patient media such as intra-oral scans and radiographs automatically in a single patient media file, allowing access from anywhere and secure sharing with other clinicians and laboratories. That is a huge efficiency improvement, especially for specialist practices with large referral networks. Many users tell us how much time they save as a result.
Based on the patient media, DS Core provides you with communication tools to consult with your patient in order to agree on the best treatment path forward.
It also already enables a broad range of different workflows: you can order restorations from your preferred laboratory partner, you can get clear aligners and designs for your 3D printer from our DS Core Create service, and you can integrate your CEREC and Primeprint for greater chairside efficiency.
Beyond that, DS Core allows better technical service for connected equipment from Dentsply Sirona through our DS Core Care programme, by means of which we can troubleshoot equipment issues faster and help customers get their machines back up and running—another major time-saver.
One of the great benefits of a digital platform is that users always access the latest version of DS Core directly through their web browser on any device. This also means no more time-consuming software updates or outdated PCs.
These functions of DS Core are only the beginning. Over the next few years, we will make a continuing stream of innovations automatically available to DS Core users. The platform will grow rapidly in response to the demands of its users.