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Professional Courtesy: CAD/CAM Must Evolve to Remain Successful Thomas Giacobbi, DDS, FAGD, Editorial Director

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by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

What if I told you that from now on you could only use a particular brand of impression material with your favorite dental implant system? What if your orthodontic clear aligner company only accepted one brand of impression material? What if certain crowns could only be fabricated if you used a certain brand of impression material? If you used something else, then you must ask the lab for a different crown. What if your lab was unable to pour models when you send them an impression made from a particular brand of material? Such is the state of CAD/CAM dentistry (generic term for any system that can capture a digital impression) at the end of 2014.

There are many systems on the market and they are battling to differentiate themselves, but they are including uses of the technology in that battle. The battle should be over user interface, warranty, price, support, design and reputation, not about the procedures I can do or the materials I can use.

Some level of standardization is necessary for a new technology to flourish. One example worth noting is the positive impact that DICOM standards have had on the evolution of digital X-rays and CBCT in dentistry. Another organization, International Organization for Standardization (ISO) is already involved in setting standards for dental CAD/CAM. In 2012 they published ISO 12836 Dentistry- Digitizing devices for CAD/CAM systems for indirect dental restorations – Test methods for assessing accuracy. In addition, these are under development: ISO 18618 Dentistry- Interoperability of CAD/CAM Systems and ISO/CD 18845 Dentistry — CAD/CAM systems — Accuracy of machined indirect restorations — Test methods and marking. It is not clear how these ISO Standards might impact this rapidly growing category, but my optimistic side is hopeful for a positive outcome.

How would I define a positive outcome? What would I like to see in this category? I would like to pick any CAD/CAM machine on the market and take impressions for anything I would like. If I choose to provide same day dentistry then I would like to mill any block on the market. Let me be clear, this is not a wish that all the machines are the same and we remove competition. Instead, differentiation and competition should focus on user interface, warranty, price, support, design and reputation. There are many brands of impression material on the market and while some would claim impression material has become a commodity, the price and performance of the market share leaders would refute that claim.

When it comes to technology, many companies want to compare themselves to Apple. Let's compare CAD/CAM to smartphones. The worldwide smartphone market is valued in the hundreds of billions of dollars so the competition is fierce. If we look simply at the major operating system platforms of Android, iOS, Windows Phone and BlackBerry — every one of their phones can make and receive calls, take a photo, send a text or keep a calendar of appointments. In other words, every smartphone offers a feature set available on every other smartphone and they differentiate themselves with user interface, warranty, price, support, design and reputation. I have an iPhone and I receive email from my Yahoo, Gmail, Microsoft Outlook and iCloud accounts. Apple competes directly with Microsoft and Google on many fronts, but they are smart enough to understand where they need to have cooperation.

I think the current evolution of CAD/CAM is hindered by exclusive agreements, limitations in file compatibility and material options. This landscape creates confusion for dentists contemplating a purchase. The ultimate resolution will require some cooperation and a willingness to create devices that are not limited by the implant I want to capture or the material I plan to mill. This phenomenal technology is here to stay and I sincerely hope that it will achieve broad adoption in our profession.

Interested in the latest dental industry news and new products? Check out Townie News Wire on Dentaltown.com and YouTube. I can be reached via email at Tom@Dentaltown.com or Twitter @ddsTom.



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September 2025
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