High Quality, Methodical Approach, Good Partners Are Key to CAD/CAM Success

Alexander Wünsche, CDT: I began working with a digital workflow very early; in Germany, I was one of the first in my area with a CAD system to design and outsource. It allowed me to do things I could not do previously. I also served as an outsource partner for friends and colleagues. I added different skills to my portfolio. Previously, the typical dental technician sat at the bench and worked very traditionally, so when I started my career, I never thought about sitting at a computer desk.

A huge emphasis for me in my career is to change the surroundings of a dental laboratory. It is definitely much cleaner now. It’s not as dusty anymore. It’s cleaner and smoother. This leads to advantages in predictability for consistency and quality.

IDT: Are there any specific capabilities that you added to your repertoire?

Wünsche: We can do everything we are doing now better with CAD/CAM. It starts with being able to plan a case digitally, which is much more predictable and accurate than what we were doing previously. Consider a full-mouth cosmetic implant reconstruction: It is almost impossible to get the same result with analog planning as we can get with today’s technology. Additionally, without CAD/CAM, we could not print models.

Printing is a huge technology and a huge advancement, but it is not yet 100% consistent. There have been huge improvements in recent years, but more needs to be done. Printing technology is definitely the future in our industry.

CAD/CAM helped us to develop different materials and work with different materials. Without milling, we could not work with zirconia. Among the polymers being developed now, some are pressable but most need to be milled. For temporaries, we can be so consistent; we can remill a temporary that breaks, without needing to re-wax and reprocess acrylic. Also, the quantity a laboratory can now produce compared with previously is a huge advantage.

IDT: How much difference does having the best machines and software make, compared with average products?

Wünsche: It is crucial to have the best equipment and best software possible, but what is the best? It is a relative answer. Everybody must find out for themselves what the best system and setup are for them. For me, it makes a huge difference working with a fantastic, smooth-running, high-quality system, compared with toys. There are a lot of toys on the market that are not serious equipment, and unfortunately, they are being used for medical products that are going into the human body. That is where I think it is crucial to have the best equipment and software. It can also be time saving. The support is usually much better on high-quality equipment. You just have a very smooth, efficiently running system.

IDT: For mid-sized laboratories similar to yours, what are the most important considerations in setting up and optimizing a digital workflow?

Wünsche: In a mid-sized laboratory, you definitely still need to be very careful with your ROI and your cash flow. It must be done step by step; I would not suggest diving into an investment in a huge system with multiple machines. At Zahntechnique, we invested first in a scanner and worked with a good outsource partner on our scanned and designed products. Then we moved to the next step, investing in a milling machine, and then a second and a third milling machine. You need to be methodical in setting up your system. There are certain protocols and ground rules for how a digital laboratory and digital system should work, but every laboratory and every company must set up their own personalized system. That is very important, and it takes time. You should not be under the impression that a system will just work overnight. Sometimes the process takes weeks or months to really get running smoothly and become integrated with your workflow.

We also now have the advantages of being able to send technicians to courses for education. I am a strong believer in outside education, and we also offer a lot of education at our own institute.

IDT: How important is it to have a good manufacturer partner?

Wünsche: That is crucial. Even when you have a robust in-house production workflow, there are products you do not want to produce in-house—implant connections, for example. I do not mill connections to the implant itself. We have an authentic policy. If we have a Straumann implant, we utilize original, authentic Straumann parts for that implant.

A titanium bar is not milled here at Zahntechnique. We design the bar, and we send the model and the design to Straumann, and they fabricate the bar and send it to us. A titanium custom abutment is not getting milled in-house at Zahntechnique; we are utilizing Straumann as our outsource partner for that. Why? Because it is a very reliable company. I get a phenomenal-quality result back, much better than when I work with a third-party vendor and do not know what type of material they may be using. I know what they use at a high-quality manufacturer such as Straumann. Also, I get a good warranty with a good outside manufacturer.

A good partner is crucial also if your system is down; you need help—someone to whom you can send your cases to have them milled, printed, or fabricated in a timely manner.