Implementing CAD/CAM into Your Laboratory

First, evaluate affordability. Can your current business support the financial commitment needed to bring CAD/CAM in-house? This will be accomplished through a simple return on investment (ROI) analysis. If you are outsourcing production to a US milling center, determine the average monthly cost. Next, look at a well-integrated, open-architecture CAD/CAM solution that includes a scanner, CAD and CAM software, a dry 5-axis mill that will mill zirconia, wax, and PMMA, and a sintering furnace. The total cost is about $60,000. Generally, if you have decent credit, the cost of borrowing $10,000 over 5 years is $200 per month. Thus, a $60,000 CAD/CAM package should cost about $1,200 per month. That said, if your monthly outsource bill is in the range of $1,500, you are close to affordability. If your monthly outsource bill is $2,000, you will become more profitable. If not, you may want to consider starting with a scanner and CAD first. This is a good idea either way, as it will reduce the initial learning curve to just scan and design. This is also nice as you will work more efficiently with your current milling center—no more shipping of models nor paying for design. Best of all, you will have full control of your design, as well as access to products you likely do not currently have. An open-architecture scanner alone starts at about $20,000, or $400 per month, and the rest of the equipment can be added at any time in the future.

When looking at the financial model, you should also be calculating the savings from the federal tax code Section 179. This tax break enables you to write off up to $500,000 for capital equipment purchases per year on your tax return. When calculating how this tax savings works, you can figure about a third of the actual cost will be taken from your tax burden the year you purchase the equipment. In the case of the complete $60,000 CAD/CAM system, the after-tax savings will result in a cost that is reduced to about $40K. I would suggest speaking with your accountant to get an exact tax savings figure.

Once you determine that the ROI works, you should do some homework to determine which solution and distributor will be best for your specific needs. Keep in mind that the choices are many, and most distributors sell a single solution, so it’s difficult to get an honest comparative analysis.

A good place to learn about distributors and CAD/CAM systems is at dentllabnetwork.com. This is a free website where technicians post on all sorts of topics and the CAD/CAM posts are very plentiful. Here you will receive honest opinions from technicians who have made the investment and are using the solution daily.

Once you have determined which solution(s) are best for your specific needs, I would suggest working with a distributor that offers best-in-class training and tech support. CAD/CAM is a totally different means of manufacturing. Without proper support, laboratories will likely have problems that result in lost labor, materials, and delays of case delivery. That said, it’s not necessarily the best idea to buy from the least expensive distributor, as doing so can cost you considerably more than the savings at purchase. Keep in mind, a 5% higher price on the system costs only $60 a month on the loan or lease. If you are having significant technical problems the cost will be considerably more expensive than $60 a month. Go for best-in-class support.

Once you have placed the order, it’s time to determine who in your laboratory will scan, design, operate the CAM, and mill your cases. Depending on the size of your laboratory, this may involve several different staff members. I like the idea of having a model person handle scanning, a waxer for design or CAD, and an individual who is computer-literate and can tinker with machines for CAM and milling. If your laboratory is small, you may want one primary person doing the entire job with a helper or backup.

Keep in mind, a CAD/CAM system can easily produce the work of 5 technicians. As a result, if you have only one trained operator for the entire system and the operator is on vacation, you will be shut down. Make sure you cross-train and have a good outsource partner for these occasions.

Bob Cohen, CDT, is the President of CAP and Advanced Dental Technologies, both in Stoneham, Mass.