Wednesday, 17 April, 2024

31 Jul 2019 | eLABORATE

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My lab went digital and we’ll never go back

By John Batchelor

I've been working digitally for about six or seven years. When we first got into it, I think the challenge for us was just the fear and learning new software. The first time that you see the computer screen and all the buttons, you think where do you start?

As a prosthetic and orthodontic lab, we were not used to digital workflows or investing in hardware. Whereas crown and bridge laboratories have traditionally been quicker to adapt to digital and purchase equipment like, furnaces and mills.

For us, using 3Shape scanners and software have been very good. The workflows are similarly designed to the analog ones that we are used to. You just need a different mindset.

Start basic

I think that like anything, your digital journey starts with a first step. And as a prosthetic lab, I think you need to start basic. You can begin with special trays, chrome partials and RPDs.

In our case, our biggest challenge was trying to stay focused, because you want to do so much. You get excited because you can now do RPDs, splint design, dentures... But what we needed to do was slow down.

So, we ended up saying, OK, this is what we want to learn first - and that was RPDs. And then we'll learn to design our special trays and then move on to designing digital dentures.

I believe that once you learn the basics, you can expand on what you want to achieve. You get used to the software and the workflows.

You can move on to doing full uppers, lowers, you can do copy dentures. We now do copy dentures, which I refer to as relines. Being able to do adjustments on an immediate denture is just such a big advantage with the digital workflow.

For our younger technicians and clinicians coming through, they were quick to adapt. It's an evolution. I've been in dentistry for a number of years. I can remember plaster of Paris impressions. Then along came alginate... poly-ethers, gypsum, implants... digital is just the evolution of what we have always been doing. But we found that by switching to a digital workflow, it has just made our lab so much more efficient in the way we operate. It's also great for the environment - there's less wastage. There are just so many plus sides. I would never go back.

Choosing hardware

Because we're a prosthetic and orthodontic lab, when it came to hardware, we naturally chose the 3Shape D2000 benchtop laboratory scanner because it could scan upper and lower models all at once. So, for us, it was more of an orthodontic-based decision.

Now I would say that with the launch of the E4 scanner and the other E scanners, which are all very good scanners, that our prosthetics laboratories will consider an E4 scanner because they are so fast.

One of the things that we appreciate about 3Shape, as compared to the other programs that I have played around with, is the ongoing development of their software. They come out with major updates every year, so it's a very, very good program. And one that continues to improve.

I remember reading a 3Shape brochure back in 2012 that said "the digital denture is coming soon".

Well once the software was able to record vertical dimensions, that's when the lights went on. It became a reality and today, it's really a good workflow.

With the new 2019 Dental System software, instead of a mono block, we can now mill from 3-7 or 4-4, 2-2, 1-1, so you can get a lot more out of your puck. It's great for the environment as there's less wastage. When we come to a patient with a large diastema, we can mill 2-2, 2-3, 2-8 on one side and the same on the other side. We're saving on material costs and again, the environment benefits.

From a clinician's perspective, I think that diagnostics with 3Shape software is fantastic. You might have a patient that has a delayed immediate and you have forgotten vertical dimension or the bite. You can still construct a digital denture and they can take that home.

If you have a patient that has worn their posterior teeth or support and have gone from a class I to a class III and you want to rehabilitate that patient, you can quickly create digital dentures and send them home. For me, digital diagnostics has been excellent.

Being a hands-on technician, I don't like to hear myself say that I will take a far better impression with a printed special tray than one I've crafted myself. But in the end, it's about consistency. If you want a 3mm spacer, it's uniform. Whereas when we work in the analog world, the wets might be a bit firm.

And now with the developments going on in 3D printing, digital is becoming even more cost-effective. For example, you can print your work overnight. When I was at IDS, I saw so many good printers. There's a lot of great technology out there now.

So for example if you're a lab making RPD's, all you may need to start with is some design software and a printer. You can then use your standard casting techniques for now and maybe get into laser sintering at a later date. Basically you don't need to purchase all the equipment at once.

3D printers are also more relevant than ever due to the tremendous growth of intraoral scanners. What we've noticed over the last six to eight months is that we're receiving quite a few scans from our KVRs, dentists, from in and around New Zealand. It's really becoming the norm right now.

I think as technicians we need to remember, that a butterfly started off life as a caterpillar. When you go digital, you have to go back to being a caterpillar. Learn the basics and then you can advance to becoming a butterfly.

With digital, you'll be able to do what you do now, only much more efficiently. I would never go back.

Duchenne Dental Services

Duchenne Dental Services is a Canterbury, New Zealand owned company and has been operating since 1983, with 12 practices throughout the South Island.

It is the South Island's leading denture company, specialising in complete denture services.

Formerly known as JB's Dental, the company was first established by John Batchelor in 1983. Since then, his team has been providing a wealth of knowledge and delivering a large range of treatment options. These range from precision crafted dentures, the Duchenne Implant denture system, many types of partial dentures and of course, fitted mouthguards.

Now, with twelve clinics throughout the South Island of New Zealand and a state-of-the-art laboratory (the only one of its kind in New Zealand), Duchenne Dental Services stays at the forefront of patient-orientated care and treatment. As a result, they are able to consistently deliver the most appropriate and cost-effective treatment solutions.

Their clients receive the highest level of care and the most functional and natural aesthetic results that best suit individual needs are consistently produced. This allows patients the confidence to get on living life to the fullest, with a confident smile.

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