Posted: May 6, 2014
The brothers Dr Andrea Mastrorosa Agnini and Dr Alessandro Agnini presented a series of lectures on digital dentistry and mastering the fully digital workflow at IDEM Singapore 2014 last April
The doctors were two of the star speakers at the Dental Technician Forum introduced for the first time at this year’s IDEM Singapore. Between their packed schedule of lectures and open panel discussions the brothers took some time out to answer some questions on their experiences in Asia, the current state of digital dentistry, CAD/CAM, and 3D Printing, and the direction they see them developing in the future.
Q: Have you noticed any difference between Asian and European technicians when it comes to their familiarity with and adoption of the latest digital dentistry technology?
Dr Andrea Agnini: We have not really had the opportunity to work closely with any Asian technicians yet so we don’t know which technologies they are familiar with or which have already been widely adopted in Asia but what we have seen is that there is massive and growing interest in all aspects of digital dentistry, not only among the technicians but among all the elements that make up the modern dental team.
Dr Alessandro Agnini: Yes this is why you are seeing more events like the Dental Technician Forum at IDEM Singapore, and other similar events around Asia, just like you see in Europe and the United States. We were here in Singapore last November for the CAD/CAM conference and we will be back again later this year for another
Q: How have you found your Asian audiences here at IDEM Singapore? We have a reputation for being very shy when it comes to asking questions; have you been getting many questions or much feedback?
Dr Alessandro Agnini: Actually we have been getting quite a few questions from the floor and also via the SMS system they have been using for the Dental Technician Forum. There The audience can text any questions they have to a number and we can answer them after the presentation during the Q&A session.
Dr Andrea Agnini: The SMS system works really well because people can ask us anything and often they are asking us about something we have not had time to cover in the presentation or did not include because we were not sure if people would be interested. So afterwards when we get the questions we can cover that topic too.
Q: It has been suggested that Asia might not be as quick to adopt digital technologies as Europe and the United States because skilled labour costs here are still comparatively low so there are not the same savings to be made by giving some of the technicians’ jobs to machines. Do you think that is true?
Dr Andrea Agnini: You can’t just replace a technician with a machine. In Europe or anywhere else, you still need a dental technician who is well-trained in using all these new digital technologies; it is not easy for anyone approaching these new digital technologies for the first time. You need a lot of training if you are going to get a final restoration that is precise, predictable and gives you the same quality as that delivered via traditional protocols and craftsmen-technicians. So the digital software can help the clinician, the technician and the patient, but on their own they are not solving the problem; you still need a skilled person behind the machines to tell them what to do.
Dr Alessandro Agnini: The machine does not know what to do; it can’t look at a restoration and see where we need more support, or whether this molar needs to be done this way or another way. We need a person with the skills, knowledge and training to decide how to shape this framework if we are to have the outcome of long-term predictable restorations.
Q: But now, one, well-trained and knowledgeable technician using CAD/CAM can dramatically improve his productivity.
Dr Alessandro Agnini: That’s true, one advantage of CAD/CAM is you can speed up production, another advantage for the dental technician is you can reduce the variables without reducing the quality. The third advantage is that it can level the playing field between technicians and make standards more homogeneous. Before, especially for big restorations, the technicians' skill with their hands were crucial in producing high quality restorations, but with new technologies, perhaps technicians who are less skilled in traditional, manual manufacturing techniques can produce high quality restorations.
Q: While everyone agrees that digital dentistry is the way of the future, there does seem to be one area where not everyone agrees. Everyone agrees the first two steps of the process, ie, the acquisition of data via some form of scanning and CAD design are essential, but when it comes to the CAM component, there seems to be a divergence of opinions. One of the other speakers at IDEM Singapore, Mr Jacobs, seems to think that already 3D printing can cope with most laboratory manufacturing and once they have tested and approved the latest biologically compatible materials currently being developed, 3D printing will be able to do everything, including implants. Do you see that happening or do you think precision milling will be with us for many years to come?
Dr Alessandro Agnini: We do not have much experience with 3D printing machines. For sure, they will one day revolutionise the future of dentistry but right now I don’t think they can match the precision achieved by the milling machines. For the time being, I think milling machines are a gold standard which will be difficult to surpass.
Q: As scanning and CAD/CAM technologies, and especially the software that links the three stages, improve, do you think more dentists or at least the larger dental practices will start to do more manufacturing in-house rather than using external labs? And if that is the case what can labs and technicians do to retain their customers?
Dr Andrea Agnini: The in-house milling process is a hot topic nowadays in dentistry. But everything has to begin and end with the quality of the final restoration in mind, and that will always have to be the deciding factor. Today the clinician has the option of organising himself as he prefers but doing everything by himself is, in our opinion, something that is not convenient or practical at the end of the day.
It is a different matter if the clinician has in his clinic, a well-trained dental team, who can manage all the digital workflow from beginning to end. That team would have to include an expert dental technician, who can devote himself or herself to studying and mastering all of the new digital possibilities. Only this way can this quality be achieved and the clinician be satisfied from a business and economic stand point.
Another solution is to team up with an external expert lab which could design, customise and produce the prosthetic elements. This way, one doesn't have to invest in the initial start-up costs involved with setting up a dental lab.
In summary, the craftsmanship of the dental technician cannot be replaced by digital dentistry; it will still be necessary to work with someone in-house or external who is capable and up-to-date with the technology.On the other hand, if the dental labs want to keep themselves in business, they have to incorporate the new digital solutions into their practice, understand and invest in them and figure out how to make the most out of them. It is the only way dental labs will survive this digital dentistry era.
Q: The buzz words at this year’s IDEM Singapore were definitely CAD/CAM and 3D printing but what do you predict will be the buzz words by 2018?
Dr Alessandro Agnini: I think in 2018, the buzz words will be "Full Digital Workflows", meaning a completely predictable digital process also in the full arch rehabilitation. Today it is still too early to manage complex cases with the intra oral scanner - the average error is still too big.
Views: 63