Revolutionizing Dental Care: The Imperative Integration of Dental Lab Technicians into Clinical Practice

3D printing is omnipresent in dental laboratories globally. In this vastly digital world, the production of dental prostheses and appliances has undergone a transformation driven 100% by digital processes. Instead of a plastic bag with an impression as the starting point, the dental lab is now receiving a digital file from the Cloud. From this data, the final prosthesis or appliance must be manufactured.

Goodbye, plaster room. Hello, computer and 3D printer.

Digital processes also have a positive impact on the communication and relationship between dentists and technicians. Instead of a handwritten lab slip with short instructions tossed in the box with the impression, the technician has so much more information available and can communicate with the dentists using visual aids not available in the analog world. The impact of digitization in dentistry seems to have another effect that might become more and more visible in the future. Dental offices implementing more digital processes can benefit strongly from the presence of the dental technician in the building. If implemented correctly, this can reduce treatment times tremendously due to more efficient communication and resource allocation as well as reduced logistics requirements.

Due to enhanced collaboration with clinicians, in-house lab technicians are able to rapidly iterate on the design and production of patient-specific devices.

Harmonizing Precision: Bringing Lab Technicians into Dental Offices

The concept of dental technicians working in a dental practice is not new. In fact, in Germany for example, the concept of Praxislabor — a dental laboratory owned by and located in a dental office — is becoming a more commonplace occurrence. However, the ‘in-house technician’ referred to in this article is not completely the same. With the trend to bring digital dentistry solutions into the dental practice, this necessitates having someone on staff who possesses the skills and expertise to effectively operate the equipment. In many cases, dentists will rely on dental assistants for such tasks, but this doesn’t yield the same benefits as having a trained digital lab technician available.

While digital dentistry solutions streamline the production of patient-specific devices such as crowns, dentures, and nightguards, the entire process requires involvement from a highly trained expert. While making a mold of the patient’s mouth has been overtaken by digital impressions using a 3D scanner, the resulting digital file can’t be immediately sent to the 3D printer for production. There is additional work that needs to be done to the file to optimize it. Additionally, the 3D printed devices don’t come right out of the printer ready to be inserted in a patient’s mouth. Before the dentist can use a device for patient treatment, a few more actions are required to post-process the device to make it patient-ready. Having a dental technician who can optimize the patient scan, initiate the print jobs, and finish the appliances will have a significant, positive impact on the timelines and quality of the treatment.

An in-house lab technician brings proficiency in optimizing patient scans, initiating 3D print jobs, and post-processing that can positively impact treatment timelines and quality.

The benefits of in-house lab technicians include:

• Enhanced Collaboration between clinicians and lab technicians results in improved communication for better treatment outcomes.
• Streamlined Workflow enables real-time feedback for rapid iteration on device designs while in-house oversight of the production process including quality control yields faster issue identification and resolution.
• Supply Chain Control mitigates risks to delivery time, reduces costs required for transportation, and benefits the environment due to fewer logistics requirements.
• Improved patient experience as a result of fewer required visits for scans and fittings and the availability of quality provisional restorations during the same visit ultimately minimizing the impact of dental procedures on a patient’s life.

This trend of in-office technicians is already in practice with the most innovative clinicians, including Dr. Roxanne Lowenguth with Roc Perio & Implants in Rochester, New York. This periodontal surgical office was an early adopter of digital technology including going paperless and using digital radiography, CBCT, scanning, and implant planning. In 2018, the office fully committed to 3D printing becoming part of its workflow. After conducting a thorough evaluation of commercially available printers at that time, the practice selected what they considered to be the optimal digital dentistry solution.

Dr. Roxanne Lowenguth (left) with Matthew and Adam Jones (center and right) who lead the in-house lab at Roc Perio & Implants.

Dr. Lowenguth and her team fully leveraged their partnership with machine manufacturer to integrate the new technology into the office. “Not only is the technology and machine superior to others,” said Dr. Lowenguth, “but the education and training we received from the company was outstanding. From the moment our machine was delivered, we received pre-training instructions on setup, required materials, and lab/space requirements to plan our in-house training. Our liaison, April Newell RDH made herself available at any time to facilitate the process of integrating the the technology into our office. The training was seamless as we were afforded time to review the process and practice printing. Our few stumbles along the way were easily answered with a phone call.”

A technical team of two brothers runs the in-house digital lab, Matt and Adam Jones. The daily print jobs include occlusal guards, clear retainers, surgical guides, and provisional restorations including crowns, bridges, and hybrid and full dentures. With the inclusion of the digital dentistry solution, Roc Perio & Implants has not only streamlined patient care in its office, but its digital lab is also able to assist referral dentists with their printing needs. With the success of its first printer, the in-office digital lab has also added some smaller printers to increase productivity.

Strategic Considerations for Seamless Integration of Lab Technicians and Digital Dentistry

Digital dentistry is omnipresent for the production of dental prostheses and appliances beginning with a digital file sent through the Cloud and produced using 3D printing technologies.

Digital dentistry solutions are pivotal for modern dental practices due to their ability to enhance precision, efficiency, and the patient experience. However, these solutions are not one-size-fits-all. When integrating digital dentistry into a clinical setting, here are some tips for a successful endeavor:

• Start with the application in mind – When implementing new digital equipment in your practice, think about the target application or applications for which you want to use it. Consider how it can not only benefit creation of the appliance but also the patient. Start small and build on your successes to expand the applications. To maximize investment and outcomes, partner with a solution provider that not only understands the technology but also has deep expertise in dental applications.
• Post-process for success – Always keep in mind that the parts don’t come out of a 3D printer ready to put into a patient’s mouth. Post-processing of the 3D-printed medical devices is crucial to obtaining biocompatibility and mechanical properties of the final device. There is no cutting corners here. These materials will only work if the manufacturer’s guidelines are followed.
• Realistically leverage your production workflow – Use your equipment and technician to the best of their abilities, but don’t stretch it too far. Your chairside system and team are specialized in efficiently achieving quality provisional restorations. In many cases that means that the direct provided restoration will later be exchanged for a high-end, aesthetic final restoration manufactured by an external lab and a technician specialized in that. They can often start from the same data the in-house technician used.
• Invest in relationships – Operating digital dental equipment requires not only deep dental knowledge but also a good understanding of IT infrastructure including computers, networks, backup systems, cybersecurity… The list keeps expanding. Leaving all these crucial items to your dental assistant who received an hour of training from the company that sold you the solution will likely not get you the intended results. Therefore, it’s imperative to engage in a long-term relationship with the solution provider. Invest in proper training on the systems and make sure to stay up to date. The best maintenance is preventive maintenance. This approach will help mitigate the costs of downtime, patient disappointment, and replanning.

The Opportunities Ahead

In conclusion, the significance of 3D printing in digital dentistry cannot be overstated. It has revolutionized the landscape by providing a platform for enhanced collaboration and elevating the overall patient experience. This technological advancement allows dentists and dental assistants to dedicate more valuable time chairside with their patients, reinforcing the human touch in dental care. Simultaneously, it empowers dental technicians to focus on intricate tasks like making plans, designing, and crafting prosthetic appliances, ensuring precision and excellence in every aspect of dental treatment. Embracing digital dentistry and bringing the lab technician into the dental office opens the door to a whole new realm of possibilities for the convergence of innovation and personalized care.