Peter Kettle of DGSHAPE looks at the history of the dental restoration industry and describes how digital technology has been the catalyst for its evolution.
Who is DGSHAPE?
What connects digital dental milling and musical keyboards? In answer to that question, I’d like to take you on a brief trip through the history of DGSHAPE. DGSHAPE is a wholly owned subsidiary of Roland DG that focuses on the dental health care and industrial division of Roland DG.
Roland DG was formed from the Roland music company back in 1981. Back then, the technology didn’t exist to print musical scores in high quality. To solve this, Roland produced a plotting system which moved a pen in X and Y axes across a piece of paper to create the score. The accurate output caught the eye of architects and engineers who needed to create mechanical CAD drawings and Roland realised they had discovered a fertile new market.
Roland DG was formed to promote this product and by replacing the pen with different heads, they unlocked new capabilities. In 1986 Roland DG created the world’s first desktop CNC milling machine. From then they replaced the milling head for vinyl cutting blade, then a print head thus creating new products for a wide range of markets.
Entering the Dental Industry
Roland DG were pioneers of desktop milling. These machines were used in several industries, but because of their compact size, affordability and reliability, we began to see a rapid uptake of these products in education.
Because our core competence is in accurate motion control, we then found that jewellers started to use the education machines to produce very fine detail.
Roland DG then developed a machine specifically for the jewellery industry, but of course, the needs of the dental industry are very similar to jewellery – small, intricate milled items – leading us to develop machines specifically for the dental industry.
Dry Milling VS Wet Milling
As material science has advanced, DGSHAPE has evolved to create technology that best fits today’s dental laboratories. Broadly speaking, there are two different types of milling machine –wet and dry. Dry milling is best for wax, PMMA, PEEK, composite or zirconia. If you want to grind a glass-based ceramic, such as lithium disilicate, then you need a wet mill to cool the diamond-coated burs down.
People often ask why DGSHAPE doesn’t offer hybrid systems which allow both wet and dry milling. We believe that to gain the maximum efficiency from digital production, you need to maximize the production time. Clean-down and drying times between a wet operation and a dry operation take the machine out of action and reduce its productivity.
Also, for wet milling you need a very high-powered spindle and of course high power comes with high cost. All spindles have a life expectancy, so if they spend ninety percent of that time milling zirconia, which could have been done dry, then you’re not getting the most out of that spindle.
Innovation in Materials
There is a real desire in the industry to move away from metal and there are many reasons for that. From an aesthetic point of view, modern materials have high levels of translucency. These materials also have advantages in terms of compatibility, heat conductivity, taste, flexibility and weight. We’re now seeing that sixty percent of restorations globally are metal-free, and the most popular material overall is a zirconia.
Tens of thousands of zirconia units are produced across the world every day and as the uptake of in-house milling increases, so does the demand for the material. This demand encourages competition, which has led to an increase in the quality of the zirconia in terms of aesthetics and homogeneous density, and a reduction in the price.
With the cost of zirconia coming down, the quality going up, we can automatically produce a crown very quickly. As a result, more and more UK-based labs now offer full-contour zirconia crowns to NHS dentists and you can see the reasoning why. An NHS dentist will manage that outsourcing costs very wisely which means they’re not going to pay any more than they have to.
Automation is the Key
One factor that many lab owners fail to consider is the enormous cost in technician time to produce crowns in the traditional manner. By automating the bulk of this process, you reduce the technician’s time and the cost to the lab of producing that restoration.
Zirconia has become so popular now that DGSHAPE has developed a disk-changing system that can let the machine run twenty-four hours a day, seven days a week.
Even you don’t expect to produce six full disks of restorations in a twenty-four-hour period, you could fill the machine with the different pre-shaded zirconia disks or a combination of wax PMMA, PEEK – whatever your customers need.
Is the role of the technician at risk?
With such labour-saving devices, are milling machines to be feared by technicians? On the contrary, we never hear about labs making technicians redundant – what we hear is that many labs are struggling to recruit skilled technicians. Because the production methods are more efficient, the lab becomes more profitable and the quality in restorations improves.
That’s not saying that the machine can produce something better than a skilled technician. Quality improves because of the consistency in shape that the milling machines can deliver. Because the technicians aren’t spending time doing the donkey work, they can then spend more time on the porcelain side, building up more aesthetic restorations and focusing on the more interesting aspects of the work.
So as quality improves, and turnaround time reduces, customer retention increases, new customers are found, businesses thrive, and this is something we see on a regular basis when a lab goes digital. This means job security for the technicians working in the lab.
On the flip side, another lab without digital capabilities is potentially losing clients. So, investing in full CAD CAM system might seem expensive, not doing so could cost businesses more in the long run. Businesses which go digital grow and, for the technicians, they’re better place to work too.