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ePaper created 2014-08-26, 21:44:32 | version 1.30.01
18 I I feature _ interview crucial in producing high-quality restorations, but withnewtechnologiesperhapstechnicianswhoare less skilled in traditional manual manufacturing techniques can produce high-quality restorations. _While everyone agrees that digital dentistry is thewayofthefuture,theredoesseemtobeonearea wherenoteveryoneagrees.Everyoneagreesthatthe firsttwostepsoftheprocess,thatistheacquisition of data via some form of scanning and CAD, are essential,butwhenitcomestotheCAMcomponent, thereseemstobeadivergenceofopinions. OneoftheotherspeakersatIDEMSingapore,MrRik Jacobs, seems to think that 3-D printing can already cope with most laboratory manufacturing and, once the latest biologically compatible materials currently being developed have been tested and approved, 3-D printing will be able to do everything, including im- plants.Doyouseethathappeningordoyouthinkpre- cisionmillingwillbewithusformanyyearstocome? Dr A. Agnini: We do not have much experience with 3-D printing machines. For sure, they will one day revolutionise the future of dentistry, but right now I do not think they can match the precision achieved by milling machines. For the time being, I think milling machines are a gold standard that will be difficult to surpass. _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 manu- facturingin-houseratherthanusingexternallabo- ratories? And if that is the case, what can laborato- riesandtechniciansdotoretaintheircustomers? Dr A. M. Agnini:Thein-housemillingprocessis ahottopicnowadaysindentistry.Everythinghasto begin and end with the quality of the final restora- tion in mind, and that will always have to be the de- ciding factor. Today, the clinician has the option of organising his or her work as he or she prefers, but doingeverythingbyhimselforherselfis,inouropin- ion, something that is not convenient or practical. It is a different matter if the clinician has in his or her clinic a well-trained dental team who can managethedigitalworkflowfrombeginningtoend. Suchateamwouldhavetoincludeanexpertdental techniciandevotedtostudyingandmasteringallof the latest digital possibilities. Only this way can this quality be achieved and the clinician be satisfied from a business and economic standpoint. Another solution is to team up with an external expert laboratory that can design, customise and produce the prosthetic elements. This way, one does not have to invest in the initial start-up costs involved in setting up a dental laboratory. Insummary,ontheonehand,thecraftsmanship of the dental technician cannot be replaced by dig- ital dentistry; it will still be necessary to work with someone in-house or externally who is capable and up-to-datewiththetechnology.Ontheotherhand, ifthedentallaboratorieswanttokeepthemselvesin business, they have to incorporate the latest digital solutions into their practice, understand and invest in them, and work out how to make the most of them. It is the only way dental laboratories will survive this digital dentistry era. _The buzzwords at this year’s IDEM Singapore were definitely “CAD/CAM” and “3-D printing”, but whatdoyoupredictthebuzzwordswillbein2018? Dr A. Agnini: I think in 2018 the buzzword will be “full digital workflow”, meaning a completely predictable digital process, and “full-arch rehabili- tation”. Today, it is still too early to manage complex cases with the intra-oral scanner; the average error is still too large._ Fig. 4_Surgical guide made with 3-D printer (Objet Eden260V, Stratasys) on the model. Fig. 5_Surgical guide made with 3-D printer (Objet Eden260V, Stratasys) in patients mouth. CAD/CAM 3_2014 Fig. 4 Fig. 5 CAD0314_16-18_Agnini 22.08.14 14:18 Seite 3