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CAD/CAM: Creating Smiles with the CAD/CAM Advantage

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“CAD/CAM has revolutionized the way dentistry is practiced today and that rate of change is accelerating,” says Shaun Keating, CDT, owner of Keating Dental Arts (KDA) in Irvine, California. “Whether you are a clinician, technician or patient, you’re seeing the benefits of CAD/CAM in improved restorative outcomes through new materials, techniques, enhanced communication, convenience and economy. It’s great! The need for traditional impressions and models can be eliminated by intraoral scanning data coming to our laboratory for monolithic crowns. We’re able to pass the savings in shipping costs, materials and labor along to our clients. We’re also able to help our doctors improve the accuracy and predictability of implant placement through our investment in guided surgery.”

KDA was an early adopter of CAD/CAM, which is now an integral part of its laboratory processes. “To ensure chairside adjustments are kept to a minimum, we have a five-day or less turnaround on our crowns and bridge cases. CAD/CAM has helped with our internal systems which ensure this five-day schedule by allowing us to pour, trim and scan models and dies for these cases and have them milled or wax printed the day after we receive the impression. Of course the consistency of our workmanship is also increased through our use of CAD/CAM technology,” Keating says.

Intraoral scanning is gaining traction in restorative dentistry due to its convenience, accuracy and patient comfort. KDA receives these files daily from clients using the iTero, Lava COS and Cerec systems. “The manufacturer’s claims of reduced remakes are absolutely real,” Keating says. “Intraoral scanning eliminates the two most significant areas of inaccuracy in the restorative process, those of traditional impression and model creation. Even our most meticulous clients are seeing reduced remake percentages from their intraoral scanned cases. Some as low as zero percent.”

Many new flat-priced and aesthetic restorative materials are only available because of CAD/CAM technology. These include:
  • Keating Dental Zirconia (KDZ) family of products
  • KDZ Bruxer (monolithic Zirconia)
  • KDZ Ultra (with hand-layered Noritake porcelain)
  • KDZ Max (pressed with IPS e.max overlay)
  • Custom Milled CAD/CAM abutments in Titanium, Zirconium and GoldHue (Titanium)
  • Custom milled Titanium overdenture bars
  • Surgical guides (for all major implant systems)

Communication between clinicians and technicians is facilitated as well. “We are using Nobel Biocare’s NobelClinician and Straumann’s coDiagnostiX routinely in the laboratory to assist in the planning of implant cases. These systems allow the surgeon, restoring doctor and our technical team to analyze and confer on the CT data set in a 3D visualization to work out all aspects of the case before the implants are placed. When requested we provide a surgical template to be used for the precise placement of the implant. Our surgical templates assist the surgeon with location, angulation and depth of implant placement. This accuracy allows the clinician to maximize available bone, avoid anatomical constraints and offers patients immediate loading. Guided surgery allows the treatment triad (surgeon, restoring doctor and technician) to treat patients with marginal bone volume and quality as well as provide immediate loading of implants wherever possible,” Keating says.

“Keating Dental Arts customers have restoratively focused practices. They have an eye for great lab work and they also appreciate it. Theirs are often some of the highest producing practices in their area. They understand that the 13 percent of their chair time that is spent on their crown and bridge cases yield 33 percent of their total practice revenue.1 They’re not interested in a ‘cheap lab,’ but appreciate a good value,” Keating says.

“I couldn’t work without CAD/CAM today! We even design our partial frameworks with it,” Keating says. “CAD/CAM allows us to be more competitive in terms of consistency and price. We’ve trained our best technicians to use it so they can leverage their technical knowhow and skill to increase the number of cases they ‘touch’ each day. Our strategic use of CAD/CAM means we can have both very competitive pricing with extremely high quality. You’ve got to have the best people using all the best tools to excel in the dental lab profession. It’s a competitive market today, baby!”


References
  1. Source: Levin Group Data Center


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