Has CAD/CAM already been a game changer in your practice? If you’re one of those clinicians who’s traded in messy impressions, tedious casting, long waits and lab fees for precision scanning and in-house fabrication of single crowns, the answer is probably yes. Your patients are getting faster, more efficient care, and your practice’s bottom line is reaping the rewards.
But what if CAD/CAM could do more for you – and for more of your patients?
“When you start to realize the benefits of in-house fabrication, such as reducing your lab bills, saving chair time, delivering a better clinical result and being more agile for your patients,” said Vince Sciore, a Patterson CAD/CAM specialist who focuses on scanning, milling and printing technology, “you will notice there are some elements of the practice you haven’t digitized yet or that you’re still lab-dependent on, and you’ll ask, ‘What else can I utilize CAD/CAM for?’”
“That’s where disc milling comes in,” he said.
FLEXIBILITY FOR YOUR PRACTICE
For many offices that have adopted CAD/CAM technology for restorations, the workflow when using a lab for dentures, full-arch implants and larger bridges adds time and more chair time to treat the patient. “Lab turnaround can be a big problem in general,” observed Sciore. “It can take awhile to receive the prosthesis, especially dentures.”
What many doctors don’t realize, he noted, is that the same disc milling process and materials used in the labs can be brought in-house. “Not only can you expand what you’re doing, but the system is very user-friendly, and there’s no sacrifice in quality,” he said. “And it’s a customizable, scalable solution, not one size fits all.”
The units that Patterson Dental sells reflect this range. In addition to block mills for individual or smaller restorations, abutments and surgical guides – like the Dentsply Sirona CEREC Primemill and MC X, the Planmeca PlanMill 35 and the vhf E4 and Z4 – Planmeca’s PlanMill 60 S and vhf’s E5 and R5 mills provide options for practices interested in disc milling, whether for a single office or a multilocation workload.
CUT COSTS AND TURNAROUND TIME, NOT QUALITY
A disc mill can be a significant investment; however, Sciore pointed out that it doesn’t take many cases to start seeing significant returns and increased cash flow. “You don’t need to be a large office to justify a disc mill. You can pay for a dry-only disc mill, like the vhf E5, by doing just a couple dentures or bridges a month,” he said. “Then you can start adding on procedures like multiunit cases, All-on-X and even cobalt-chromium frameworks. All these procedures will see a 40% to 95% decrease on cost and a significantly quicker turnaround, as you only have to wait a couple days for a lab to
digitally design the case.”
According to Sciore, most practices see a 3 to 10 times monthly return on these mills. “The sky is the limit when you start to expand beyond basic procedures,” he said.
Solutions also exist for practices looking to become fully lab independent. “We also carry disc mills that have wet/dry capabilities, such as the vhf R5 or Planmeca PlanMill 60 S,” noted Sciore. “Wet milling enables custom titanium abutments, bars, glass and metal frameworks. The R5 even has disc loading automation, so you can add up to 10 cases in the morning or at night and return with them all completed. This is a great option for high-volume offices.”
30 DAYS TO ROI
Sciore pointed out that investing in a mill doesn’t require extensive training in digital design, either. “Large practices, typically multi-doctor offices, might have an in-house lab technician who wants to learn how to digitally design these cases themselves,” he said. “But doctors who want to execute these advanced cases themselves without software knowledge can utilize a vast network of CAD design services. They just scan, send to the designer and receive the final design back to be fabricated in their mill.”
“If they convert to a digital process using a good scanner that can do digital dentures, not only can they turn the four, five or six appointments needed for traditional dentures into one or two appointments, they can take that a step further and fabricate a denture for the patient in as little as 24 hours, even when using a design service. Even same-day dentures are a possibility,”
Sciore continued. “These are the biggest benefits of digital dentures – the chair time and reduced cost of fabrication. My customers using these mills tell me they went from trying to figure out how to do fewer dentures, to dentures becoming one of their most profitable and enjoyable procedures.”
Sciore acknowledged the possibility of 3D-printing dentures. However, he noted that, unlike milling, 3D printing requires a commitment to post-processing. “With 3D printing dentures, you must print the teeth and base separately, cut the support off, cure them together, cure again if glazing and so on,” he explained. “With milling, there are single-piece denture discs. With those, you just mill the entire denture in one piece, polish and place.”
“For milling, I’d say about 30 days can be a realistic learning curve for most cases when using a design service, and you’re experiencing a pretty large financial benefit,” Sciore said.
Sciore has played a role in helping this benefit play out in many practices in his area. We’ve helped about 20 offices incorporate disc milling into their practices, all for different priorities and purposes,” he said. “One mostly Medicaid/Medicare practice fabricates over 300 dentures a year with an automated mill. A single-doctor office, trained five months ago, has already executed 89 multiunit zirconia cases/bridge units and 25 final dentures using an E5. Another smaller, five-operatory practice has fabricated 10 custom implant abutments in five months, saving $4,000 on top of other things he’s milling with the vhf E5.”
PARTNERING WITH PATTERSON FOR SUCCESS
Evolution in technology isn’t limited to clinical practice. As systems become more sophisticated, Patterson Dental representatives are constantly growing their knowledge as well. Sciore recalled his first experience helping a doctor implement disc milling in their practice a few years ago. “The doctor wanted to incorporate disc milling on more of a volume basis to lower their cost per unit,” Sciore explained. “I went through an exploration process with him, and we interviewed several different manufacturers together. And then I started to learn more and more about what disc milling could do.”
Today, Sciore conducts events dedicated to educating doctors on the possibilities of expanding procedures with disc milling, from focusing on specific steps involved in producing digital dentures to exploring the broad potential of CAD/CAM manufacturing, such as All-on-X and titanium abutments.
“Essentially,” Sciore concluded, “it’s a great solution for anyone who’s interested in expanding their CAD/CAM capabilities, whether they already do abutments and single units and want to digitize their processes for dentures, or they want to digitize multiunit or full-mouth rehab, because all the benefits of CAD/CAM for single units can now be realized for advanced procedures. That means cutting costs and delivering results at a fraction of the price, without sacrificing clinical quality – and sometimes increasing the clinical quality in the fit – all while delivering a better experience for patients.”
