What the Fairy Godmother of Digital Tech Didn't Tell Us

Take the time to explain to your employees the importance of digital technology to the laboratory’s viability and to their economic future. Reassure your technical personnel that digital technology is here to replace older technology in the same way injection molding replaced hand-packed dentures or induction casting replaced broken-arm casting machines. Clearly describe how your employees will use the new software, 3D printers, milling machines, outsource partners, etc. Maintaining an open dialogue will avoid creating an environment in which technicians are fearful of change and losing their jobs.

Digital manufacturing follows two schools of thought. The first relies on laboratory partners to bear the capital cost of equipment and provide design services, the fabrication of wax patterns, sintered copings, and milled restorations in ceramic or metal from your STL scan files. The second focuses on the laboratory’s investment in the capital equipment for manufacturing. Outsourcing to laboratory partners allows you to offer a wide array of products to your customers while maintaining a tight control of operating capital, i.e., lower inventory and no lease or loan payments.

However, outsourcing is not without challenges. Turnaround time and weather-related delays in delivery services are ever-present issues. In most cases, insourcing will provide a higher profit margin on your restorations, even considering the capital cost of a lease or loan payment along with a service contract on the equipment. Although you can control your turnaround better, you still have the challenges of learning to work with new materials and choosing the optimal equipment to manufacture restorations that your customers will prescribe day after day, while knowing that whatever you purchase will be replaced with the next best thing before you can complete your payments to the bank.

If you have a 3D printer that you rely on for your wax patterns, then you will require a second printer or a mill to back up the primary printer when it malfunctions. Many resellers and manufacturers will offer to print or mill those wax patterns from your designed STL files, but that will cost the laboratory in additional days to complete the case, shipping charges, and perhaps for the printing service. The more you come to rely on digital to create restorations, the more you will require redundancy in scanners, mills, printers, computers, and personnel who are trained to both use and maintain this equipment.

Keeping pace with software advances and continually training technicians to be proficient with the full capabilities of the design software is a constant challenge. CAM equipment is evolving so quickly that after 6 months of use, you may be using antiquated technology. For those CAM systems that you’ve leased or purchased, you must be diligent about installing firmware upgrades to keep the hardware operating efficiently. The constant evolution of digital equipment and software systems requires an enormous commitment to keep pace with all these updates so your laboratory remains a viable competitor in today’s marketplace.

3D printers, milling machines, and the like are all subject to breakdowns, even when such equipment is properly cleaned and maintained. The service contracts for such machines are a necessary evil because laboratories with these agreements get equipment repaired faster than those without a contract. In addition, annual licensing fees for software and the ongoing costs associated with IT for the CAD workstations and network are part of the costs. This is a lot of overhead to absorb while trying to increase profit margins.

When a 3D printer fails or a bur breaks in a milling machine, no one pauses to calculate the cost of the lost print cartridge, the bur, or the puck of material. Many who have adopted 3D printing have witnessed problems related to the poor manufacturing of 3D print cartridges, some of which are replaced at no charge, while others are not. Although the latest generation of printers and mills are better than ever, you should still perform due diligence with manufacturers (and laboratory owners who are already using the equipment) before you purchase or lease.

Most scanners (and some milling machines) are packaged with computers. Many instances have occurred in which the computer cannot adequately operate the software (and in some cases hardware) when designing large cases of 8 units or more. Be sure to work with manufacturers in obtaining computers specifications prior to purchase. If the manufacturer will not upgrade the specs to meet your requirements, work directly with your IT vendor to build CAD workstations to meet best-practice specs.

Every time you perform a software update, you potentially unleash a “ghost in the machine.” Be cognizant that Windows® updates can affect CAD/CAM programs; antivirus updates can cause communication issues between scanners, mills, printers, etc.; and DME files from outsource partners are compatible only with specific versions of CAD/CAM software. So check with partners before upgrading your software. Also remember that although the latest version of software is available, it may serve your production consistency to wait until others have worked the bugs out before installing it on your system. Beyond the software issues, consider using APC power supplies on your printers, mills, and CAD/CAM workstations (just like you do for your servers). That way if the power is interrupted, you won’t skip a heartbeat in your production schedule.

Considering and embracing the challenges of digital manufacturing can be daunting, but it’s here to stay. As you move forward to digitizing your laboratory’s workflow, use best practices for making purchasing decisions and working with IT vendors. Document every item on your network for troubleshooting. Most of all, always have a Plan B for when an outsource partner can’t deliver or a piece of equipment needs repair.

Robert Gitman is the Company Administrator at Thayer Dental Laboratory in Mechanicsburg, Pennsylvania.