CAD/CAM from the tech advisor’s perspective

Today, Dr. Davis called to tell me how pleasantly surprised he was that the crown seated in less than three minutes with absolutely zero adjustments.

Sounds far-fetched, right?

Well, it didn’t actually happen ... yet. But if the rate that technology has been advancing is any indication, a scenario like I just described may only be a few short years away and wouldn’t surprise me at all.

I recently turned 30, which means I’ve been in the dental laboratory industry for 10 years, and in a single decade, our business has undergone a technical revolution the likes of which is rarely seen in other trades. Compared to the methods that I learned at the beginning of my career, the evolution of CAD/CAM dentistry is doing in moments what used to take hours. If I had told you 10 years ago about the staggering levels of detail and accuracy that have become commonplace today, you might have called me crazy. However, today, you would have to be crazy not to take advantage of this technology.

We’re all familiar with the benefits and time savings associated with this new technology, but just like every other aspect of our industry, CAD/CAM zirconia restorations come with their own set of challenges and idiosyncrasies, which I have had to learn and adapt to.

Along with the extreme levels of detail and accuracy detected by the scanners comes very little room for error, especially on the margins of a crown or coping. Because the scanners and milling machines truly are “what you see is what you get” systems, marginal adjustments by doctors can become problematic and cause openings that prevent the restoration from seating fully and properly. I always advise doctors that time spent making sure a prep is clean and free of defects is time saved seating the final zirconia restoration.

Another technical issue I often see has to do with the physical properties of zirconia itself. Being the hardest member of the all-ceramic family means that grinding and adjusting the substructure after sintering can be very difficult and time consuming. This being the case, technicians and advisors have had to become even more vigilant in our attention to design details on the front-end of the process.

Details like the number of abutments in a bridge can make all the difference in the world with a zirconia case. During the cooling period after sintering, a bridge with too few abutments can undergo torsional flexion, which will cause rocking in the bridge.

Learning about these issues and how zirconia behaves has been part of my journey as a technical advisor during our industry-wide paradigm shift in esthetic dentistry. As the demand for all-ceramic products increases, industry icons that made their livings on “old school” PFMs have had to adjust.

I didn’t realize just how much they needed to adjust until we saw KDZ™ (Keating Dental Zirconia) become our best-selling product. As an industry leader, Keating Dental Arts has become a source of answers and advice for both doctors who want to grow their practice and embrace new technology, as well as our laboratory friends who utilize our Milling Center for substructures.

Learning the answers, gaining the experience and seeking education are at the foundation of being a technical advisor.

Our job is to become experts and masters of new technology and to pass that knowledge along to our colleagues.

Informing your clients about scanning, designing, milling, sintering, strength, shading and cementation makes you the technical authority and will help augment your entire business.

We’re entering a new golden age of dental technology, and CAD/CAM is leading the way. Designing crowns on a smart phone might not be here yet, but it could be just over the horizon. I’ll let you know as soon as I download that app.

About the author

Kevin Kim began in the dental lab industry as an outside sales representative for a small lab in Anaheim, Calif. While attending Los Angeles City College’s dental technology program, he was taken under the wing of the late John C. Ness, CDT, of Productivity Training Corporation. Currently, Kim works as a technical advisor for Keating Dental Arts in Irvine, Calif.