3D printing – the pinnacle of productivity?

'The digital transformation is in full swing and is not for stragglers': Fabian Ebner presents a crown case using 3D printing, showing the benefits of using it in everyday dental work.

‘The digital transformation is in full swing and is not for stragglers’: Fabian Ebner presents a crown case using 3D printing, showing the benefits of using it in everyday dental work.

In our laboratory, we have already developed various additive process technologies that have been successfully implemented.

We would like to address the following question: what are the advantages of the additive process over the subtractive techniques?

Advantages and disadvantages

The two process technologies mentioned above complement each other perfectly, but do not put them on the same level.

Both have their specific advantages and disadvantages, which ensure that they are recommended for certain areas of application.

Instead of comparing them against each other, you should combine these technologies.

Figure 1: Thanks to the sensible combination of additive and subtractive CAD/CAM-based procedural techniques, the upper and lower jaw model can be printed on the basis of an intraoral scan. The trimmed crowns are designed and milled from IPS E.max CAD. The milled crowns and veneers are placed on the physical models.

As shown in Figure 1, additive and subtractive process technologies can already be usefully combined today.

For this case, the upper and lower model were 3D printed from a scan received from an intraoral scanner.

It is particularly important to ensure that the bite registration (scan in maximum intercuspidation) is secured.

The crowns and veneers were designed with CAD/CAM support, milled from IPS E.max ingots and then minimally veneered.

Clearly, this case had a full digital workflow approach.

Figure 2: The initial situation of the patient. She consulted with the dentist because she was dissatisfied with her gummy smile.

Benefits of technology

Some of the great advantages of CAD/CAM-supported dentistry are high reproducibility, absolute reliability and standardisation.

Digital workflow combines high quality and excellent patient care with low unit costs and optimised workflows.

As far as print times, there are currently no faster print times possible than with the Nextdent 5100.

We use it to print a full build platform – ie horizontal models – in 35 minutes.

In my opinion, 3D printing provides the right answer to the changed working requirements in the dental world.

Figure 3: In order to be able to determine an ideal length-width ratio, a digital smile design was carried out.

But how do you communicate to your customers the added value this new technology brings?

I now hold regular lectures with my practitioners. For example, Dr Bruno Valic and I lecture on the subject of ‘Digital dialog – workflow between dentist and dental technician’.

Patient case

The following patient case is intended to present a digital workflow as it appears daily in our laboratory routine.

The patient was unhappy with her gummy smile (Figure 2).

Our approach to cases like this is actually always the same. When planning the case, we used smile design and oral radiographs (Figure 3).

This was followed by a digital wax-up of the anterior teeth and the design of a surgical template – both using Exocad software (Figure 4).

Figure 4: A model of the actual situation, one of the digital wax-up and a surgical template for the required crown extension, were constructed in the CAD software.

To transfer the planned anterior model to the patient’s mouth, the wax up was printed (Figures 5 and 6).

Figure 7 shows the final result after surgical crown lengthening and restoration with veneers (teeth 13 to 23).

3D printing was used in this case, as this made it possible for visual preliminary planning (Digital Smile Design) 1: 1 in a standardised workflow.

In this way, the patient can see in advance how the anterior situation can be changed within a very short time.

Figure 5: The model printed in 35 minutes with the Nextdent 5100: One from the model with wax (left) and one from the initial situation.


Analogously, it is difficult or not at all possible to plan and work so predictably.

As was to be expected, there were no surprises or changes. And the satisfaction of the patient and of the dentist (Dr Bruno Valic) showed that we were on the right track.

Only through this combination and further constant digitalisation development can we offer an incredible list of possibilities.

My reasons for going digital were:

  • My demand for quality
  • The need to respond to changing customer needs
  • Advantages of time and cost savings
  • Possibility of counteracting the lack of the shortage of employees
  • A desire to inspire and motivate my staff with this technology
  • The question of how sensible it is today to still use certain concepts in analogue form.
Figure 6: The template for the crown extension was printed from the 30 printing plastic Nextdent SG (Surgical Guide). This material is produced using a standardised autoclave protocol and can be sterilised.

My company philosophy is: with the highest sense of aesthetics and the highest precision and with the latest technology, you will attract unique people to work with.

The digital transformation

The so-called Industry 4.0 and the further increasing of digitalisation of dental technology keeps us on our toes.

There are umpteen challenges to be mastered. However we should also keep the following in mind: ‘If you don’t keep up with the times, you’ll go with the times.’

The digital transformation is in full swing and is not for stragglers – it is no longer enough to jump on the bandwagon. You have to be able to lead it.

The challenge is to leave familiar structures in order to develop further.

Dentists will change their treatment modalities, and the dental laboratory must be ready to meet the new requirements.

It is up to us to recognise new development and to react in time to the digital transformation.

Figure 7: The end result of the digital workflow. The veneers used make it clear that the virtual planning of the digital smile design could be implemented with the aid of the CAD/CAM-support discusses.

Waiting and seeing is the wrong strategy – you have to become active yourself and always be up to date.

Nowadays, it is one of the requirements for dental technicians and dentists that they are familiar with the various software solutions.

In addition, they should be able to combine software solutions in order to be able to process and transmit the data correctly.

I am convinced that the transition to digital dental technology should be a step by step process.

That is, you should start one application and then, step-by-step, add several applications and workflows.

In this way you can slowly, but continuously, gain experience.

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