3D Printing + Zirconia Implants + Dentist

[briansle]

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2011 Zironia Implants came out. Not sure on their success rate, but seems like they have a growing number of users especially outside the US. <I thought it was a joke too... but apparently they do ossseointegrate.>

3D <cadcam/cerec>printing is changing everything now. We can now print out firearms , makeup, almost everything. And these 3D printers are getting cheaper and cheaper by the day. May become common as computers.

Will we see the day where:

1. patient walks into office
2. dentist takes 3D imaging of patient.
3. mill a custom zirconia implant right infront of the patient, using a cheap 3D printer
   
4. place the one piece zirconia implant
5. patient returns 4-6months later, to have the final zirconia crown milled infront of him and cemented.

???
Crazy I know. But if Tesla and their supercharger stations have already made it possible for an electric car to go coast to coast, Can't tech make a fundamental impact in the dental industry as well? This would really give the dentist control over everything. And in turn you could pass the benefits onto the consumers.

 

[Shunwei]

I would probably wait a while before declaring zirconia osseointegration a success. Remember how they use to HA coat implants and found that it is not good after a while? In these cases, it's better to not go head in with the first wave but stay back and see what happens. As you say 3D printers are getting progressively cheaper so there is no rush.

 

[DrJeff]

It's got some big time future potential for sure. The one thing to keep in mind though is there are 2 distinct sides to dentistry. #1 the engineering/chemistry side of things, where we often have great control over the entire fabrication process from start to finish and then #2 the biology side of things, where we often THINK we have great control over the entire process from start to finish, but sometimes it turns out that we don't have nearly the control over things as we HOPED we did

When the engineering/chemistry side of things sync's up with the biology side of things (unless we as the clinician screw up ) we end up looking like rock stars to our patients. If the engineering/chemistry side of things far outpaces the biology side of things, well then in spite of our best clinical intentions we can often end up looking like the proverbial horses ass to our patients as we try and figure out what the heck didn't go as it was supposed to as we pain stakingly treatment planned the case out ahead of time

This is exactly why as a successful clinician we need to keep a bit of an air of humility about ourselves, since there are times when that ends up being the most important patient communication trait that we can have as we work through the myriad of clinical situations that we all go through as we PRACTICE dentistry!

 

[ktran17]

How important is familiarizing oneself with CAD? I did years of engineering research in UG, but I don't know if I should keep up to date my CAD skills. Don't most 3-d dental printers (cerec, e4d) have a pretty simplified OS interface?

For example, I don't plan on keeping my coding skills HTML5, python, VB, etc despite the fact that it might help my practice, slightly...

 

[DrJeff]

How important is familiarizing oneself with CAD? I did years of engineering research in UG, but I don't know if I should keep up to date my CAD skills. Don't most 3-d dental printers (cerec, e4d) have a pretty simplified OS interface?

For example, I don't plan on keeping my coding skills HTML5, python, VB, etc despite the fact that it might help my practice, slightly...

Most of the modern CAD/CAM systems are actually designed from the standpoint that once the training is complete, the majority of the overseeing of the design work and subsequent fabrication will/could be done by the dental assistant instead of the dentist (if they so choose to designate that responsibility). The actual design process is done by the software, with the ability of the operator to "tweak" any little things they so choose. The software is very user friendly, and in most cases will basically "warn" you if some of the tweak you may choose to do could result in some potential issues based upon the digital bite and the limitations of the restorative material of choice in the CAM process

 

[jeffity]

Don't confuse printing and milling (CADCAM). One is additive, one subtractive.

Just read a fun little blurb on this last night in adanews. Can't find a digital copy right now (on my phone). Mentioned how the additive process is what makes it more precise and how the whole process is faster and more cost effective. I only have preclinical exposure to CADCAM so far (we use E4D), but they warn us that you can tinker all day in the software trying to make it perfect when it's super magnified on a screen, but you're still limited by burs carving away at a block. Complete dentures seems to be a hot item of discussion.

Ktran, I've only used E4D, but the interface was simple. If you've been around computers enough to program, it'll be nothing to learn it. Feels more like graphics/imaging software (laso this margin, freehand that, click and drag that cusps). Kind of fun.

 

[Mackchops]

It's not as distant a future as you might imagine! I wouldn't get too hyped up over zirconia implants just yet… but the other stuff is already here. You can merge a CBCT with a benchtop scan of a diagnostic wax-up, and have a surgical guide made as well as a provisional before surgery. Then, the implant is placed guided right where it was planned to go and the provisional pops on with minimal adjustments. Use the same file for the final restoration. Amazing! Or check out Encode by 3i - take an intraoral scan of the healing abutment and the lab knows the implant size, placement, timing, etc. The manufacturing is getting pretty neat too - SLMing an RPD frame, milling eggshell provisionals, or printing full-countour wax for conventional casting of your copings. All cool stuff.

The denture side of things still has a ways to go. It's a great concept and will go far, but the technology isn't there yet.

And ktran, that you know what CAD and CAM mean (and that they're different!) puts you ahead of the pack for who these products are designed for. If you needed a degree in engineering to CAD something on a 3-shape you wouldn't find many labs that owned a 3-shape 🙂