CAD/CAM is now our third technician

Installing a state-of-the-art CAD/CAM system is a big decision for any 2-man dental lab to make, yet for Fusion Dental Laboratory in the Brisbane suburb of Stones Corner, doing so has been a resounding success.

In fact, a year after installing a VHF S1 5-axis milling unit, the laboratory has already installed a second unit to keep up!

"The need to install a second mill was an outcome we never expected when we went digital a year ago," said Douglas White, principal of Fusion Dental Laboratory. "However, once you go down this path and convert your laboratory to digital workflows, there's no going back and you find more and more tasks to automate."

Mr White said that his decision to install VHF mills was based on the support offered by local supplier Henry Schein's Connect Dental, together with the mills high quality, accuracy and speed. Plus, the price was an affordable investment for the 2-man operation.

"I looked at the available technology and eventually purchased an open, hybrid solution that allows me to combine outstanding technologies from different manufacturers, but importantly, all sold and supported in Australia by Henry Schein Connect Dental. This combination gives us the solution we need, a proven support structure and technologies that are continually being developed and enhanced through software upgrades."

Fusion Dental Laboratory initially took delivery of a 3Shape D900 benchtop scanner with 3Shape Dental Designer software including modules for implants, models, bars and splints; a VHF S1 5-axis milling unit; and a Vita Zyrcomat 6000MS sintering furnace, all from Henry Schein Connect Dental. A year later, the lab installed the additional VHF S1 5-axis milling unit which, by that stage, incorporated wet milling capability.

"When we originally purchased the VHF S1, it was dry-only. When we bought the second mill a year later, it also included wet milling capability. So we now use the original mill for wax, full contour zirconia, chrome or abutments and the wet mill for wax, Vita Suprinity or IPS e.max.

"We invested in the second mill because we had too much work to put through one mill alone and it was hampering our workflow. The mill would be cutting 20-30 units of wax for pressing and we'd be waiting for it to finish so we could mill zirconia. With two mills, we can mill wax and zirconia simultaneously; CAD/CAM, in effect, has become our third technician.

"Sometimes we mill e.max restorations directly and sometimes we mill wax and press. Apart from the argument that some people believe pressed e.max fits better, you quickly learn that the overriding consideration when CAD/CAM is an option always goes back to efficiency.

"It takes around 30 minutes to mill an e.max crown, so if I have six units, then that will take 3 hours of milling time. Alternatively, it takes 10 minutes to press a unit from the milled wax-up.

"IPS e.max also only comes in blocks, not discs. At present, the holder for the VHF unit only takes 3 blocks. When the 6-block holder is released soon, we will revisit this again and look at the most efficient path to take based on the situation and outcomes required."

Mr White said that changing over to digital workflows is a massive learning curve that initially "steals" more time than you imagine.

"3Shape Dental Designer is straightforward and easy to understand from the outset; however, to become really proficient takes time. As a technician brought up classically on the bench, I have taken the time to learn exactly how far I can push the software to get the results I want. You can just pump out restorations quickly if that is your goal, but equally, if you invest time in learning the system well, there is real scope for technicians to utilise their individual flair when creating designs digitally.

"We essentially try and combine classical techniques with modern technology to produce the best result possible."

Mr White said that going digital hasn't increased the lab's turnover per se, but labour and materials costs have reduced considerably. "We're also no longer in here on weekends to get the work done and we have excess capacity now to take on more work in the future," he said.

"It's not for everyone, but if you have the volume of work and the desire to embrace technology, it is worth considering.

"My advice for anyone looking at going digital is to do your research first. Product choice is important - it has to meet your needs - but you also need to know how good the after sales support is and how often both the CAD and CAM software is updated. Software that is updated regularly delivers more features and can increase the efficiency of your mill significantly. Also, try and buy everything from the one supplier - that way, if there is a problem, there is one point of contact to get it resolved. And finally, don't be scared to give it a go. You will be surprised at just how far technology has come."