IDS 2017 Digital Workflow Solutions

From chairside to the laboratory, digital solutions dominated this year’s exhibition

Foot-numbing, back-breaking, exhausting, but exhilarating, the 5-day mega-event, the 37th International Dental Show (IDS), came to a close on Saturday, March 25, after hosting an unprecedented 155,000 attendees from 157 countries. A melting pot of ethnicities, religions, and languages, dental professionals visiting the Cologne fair found themselves excitedly negotiating a maze of exhibition halls housing booths and dental solutions from more than 2,300 companies from 59 countries.

Although it is nearly impossible to visit every exhibitor over the course of the event, it was easy this time for the Inside Dental Technology team to pick up on the show’s central theme—digital workflow. From the dental practice to the laboratory and the technological advances that connect the two into a seamless network, the show floor teemed with digital solutions and workflows for diagnosing, treatment planning, and restorative processing.

3D printing technology took center stage this IDS as myriad companies both large and small displayed their additive solutions for printing everything from simple models and wax forms to the more complex, long-term, tooth-colored temporaries, and metal substructures, as well as temporary and permanent digitally manufactured full dentures. With faster output times at higher resolutions, additive solutions for both the dental practice and dental laboratory were on display. Most interesting were those showcased by large manufacturers already invested in milling technologies. Many were small-footprint 3D print devices intended for the dental practice. It will be interesting to watch the evolution of 3D printing and how this technology will complement or replace some processing functions now relegated to subtractive technologies, or offer combined additive/subtractive solutions.

Digital full denture solutions and materials expanded this year, with laboratories now having the choice of partnering with manufacturer-specific centralized production centers or bringing the process in-house for design, milling, or printing. Many of the additive materials on display are not yet available, but, according to manufacturer representatives, will be by the third quarter this year.

The proliferation of open-architecture digital impression devices has encouraged several new entries into the chairside milling arena. Once dominated by only two players, chairside milling expanded to four or five options in recent years and now has doubled again in number. This is a trend no doubt influenced by the ability of dentists to now mill full-contour zirconia chairside either in the green state with fast sintering or in the hard state with no post-processing other than polishing and seating.

Following is an overview of some of the innovations our team uncovered at the IDS. Not all receive mention here, but more can be viewed on IDT’s Facebook page.

Additive Additions

More than 25 companies showcased their additive manufacturing solutions in the exhibit halls.

Kulzer introduced the cara Print 4.0, which 3D prints monochrome dental appliances using a high-quality photopolymer. The machine is intended for both beginners and more experienced users, printing most restorations in 1 hour or less.

Roland launched the DWP-80S, which it says is the first 3D printer specifically intended for printing custom trays and base plates for digital dentures. The company worked with a laboratory that does one-quarter of all dentures in Japan to develop the machine.

Planmeca CAD/CAM Solutions showed the new Planmeca Creo, a 3D printer for creating objects such as models and surgical guides.

Straumann unveiled the Straumann P Series, which it says is the fastest solution on the market, printing drill templates or temporaries in approximately 16 minutes.

EnvisionTEC displayed its cDLM (continuous Digital Light Manufacturing) technology, which it says is five times faster than DLP, in the Perfactory Vida cDLM and Perfactory Micro cDLM.

Valplast® says its r.Pod desktop 3D printer is the first extrusion-based 3D printer for dental use, printing Valplast partials, digital models, custom impression trays, soft-tissue gingiva, and more.

3D Systems unveiled its new Figure 4 platform for dental applications, powered by a form of stereolithography (SLA) that the company says is more than 50 times faster than conventional SLA systems.

Formlabs showed the Form 2 printer and Dental Model Resin, which it says is on par with the resins of established, large-format dental 3D printers that cost 20 times more than the Form 2.

SprintRay Inc. boasted that the wireless MoonRay D is the world’s first desktop 3D printer calibrated for digital dentistry, thanks to its RayOne DLP projector and RayWare Dental software.

Structo introduced its MSLA technology, similar to DLP, in its DentaForm and OrthoForm printers. The DentaForm prints within 50-μm accuracy, can produce up to 30 models in 90 minutes, and is already being used by one of the largest laboratories in the US, according to Structo.

ConceptLaser collaborated with Follow-Me! Technology and Datron to integrate their 3D metal printing, CAM software, and milling technologies, respectively, to create a hybrid printing/milling manufacturing process.

Bego introduced its new Varseo S, with a build plate approximately 30% larger than the original Varseo and a compact, stylish design.

VOCO showed its SolFlex printer, which it says takes up approximately the same amount of space as a traditional 2D printer.

Several companies advertised printers priced at less than $5,000, including XYZPrinting, a Dutch company planning on opening an office in California, whose Nobel 1.0 was priced below €2,000.

SLM technology was on display as well, with at least two companies showing in-house solutions. Realizer introduced the SLM 50, which it says is the first desktop SLM machine for manufacturing metal components. SLM Solutions, meanwhile, displayed the SLM 280 2.0, with multi-beam technology.

Major advances in additive materials appear to be on the horizon. EnvisionTEC CEO Al Siblani said his company expects to have FDA clearance to deliver the first permanent restoration material by the end of this year. DWS said by the end of the year it expects FDA clearance for a resin infiltrated with nano-ceramic as a Class II temporary solution. CAD BLU said it expects FDA clearance for long-term denture bases later this year. Natural Dental Implants announced the development of a 3D printed version of its REPLICATE Tooth, a titanium-zirconia solution.

Whip Mix, Prodways, MicroNX, Voxeltek, Dentis, Rapid Shape, Sisma, Dreve, and RayDent also displayed 3D printing solutions.

Digital Dentures

One of the last major frontiers for digitization in indirect restorative dentistry is approaching quickly: digital dentures.

Amann Girrbach and VITA discussed a partnership whereby VITA will produce the consumables and Amann Girrbach the technology for a CAD/CAM solution with the teeth and gingival puck milled separately and adhesively merging the two.

Ivoclar Vivadent displayed a solution with its large tooth library available digitally and able to be digitally manipulated and subsequently milled, along with a gingival puck. The components are then bonded and reloaded in the mill for a nice finish.

Merz Dental presented its Baltic Denture Solution, a system that uses thermoplastics to attain vertical dimension and approximation of vertical occlusion. The plastics are placed in warm water, allowing the denture mockup to conform to the patient’s oral environment. Then a scannable impression material is placed and the intaglio side is captured. The entire upper and lower arches are then scanned, digitally designed, and milled.

AvaDent Digital Dental Solutions and Kulzer’s Pala Digital Dentures, the first two digital denture systems, were also on display, as were millable partial denture solutions such as Solvay Dental 360’s Ultaire AKP, a polymer intended to be easily millable for crown-and-bridge laboratories.

Chairside Chase

Several companies introduced chairside milling solutions, beginning with Ivoclar Vivadent unveiling the compact PrograMill One at a press event the day before the IDS exhibit floors opened. The company also introduced three larger PrograMill machines for laboratories.

Dentsply Sirona, Straumann, Carestream Dental, VHF, and others also promoted their chairside solutions, and exocad introduced its new ChairsideCAD software.

Chairside milling’s popularity almost certainly is being directly impacted by developments in digital impression scanning.

3Shape introduced the first wireless impression scanner with the latest TRIOS. Medit, known for its desktop scanners, announced an intraoral device called the i500 that it says will have “disruptive” pricing when it is released early next year. GC offered a sneak peek of its new Aadva IOS 200, with an ergonomically designed handpiece and intuitive workflow. Planmeca CAD/CAM Solutions showed its new, ultra-fast PlanScan SOLO. Dental Wings displayed its new powder-free Dental Wings Intraoral Scanner. 3DISC launched the Heron IOS, designed for maximum ease of use for the most popular indications. Condor displayed its new software-based scanner.

Companies such as Densys 3D and Adin Digital displayed economically priced units aimed at dentists who have been hesitant due to the cost.

If one thing was clear, it was that laboratories must be prepared for the chairside movement to continue and possibly even pick up speed.

Many More

Not every interesting product at the IDS fell into a major category.

Perhaps one of the most compelling products was PIC Dental’s 3D camera, which creates a photographic scan with specific flags and a triangulated algorithm to establish in software the exact location of implants. The software generates an STL file that can be integrated into popular CAD programs and used with design, potentially eliminating the need for a verification jig to check the fit and passivity of a large-span implant-supported prosthesis.

exocad, 3Shape, and EGS each introduced smile design software. SCHUPP Ceramics presented a high-speed, discoloration-free sintering furnace set. Nobel Biocare and Kavo touted a system to connect the workflow “from diagnostics to final restoration,” including Kavo’s new mill and Nobel Biocare’s DTX Studio software.

For both dentists and laboratories, the message was clear throughout the IDS: Digital dentistry is just getting started.