Simplifying the Diagnostic Wax-Up Workflow With 3D Printing
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1 FORMLABS CASE STUDY: Simplifying the Diagnostic Wax-Up Workflow With 3D Printing COMPANY: CMR Dental Lab INDUSTRY: Dentistry PROFILE: A high-end cosmetic reconstructive laboratory in Idaho Falls specializing in large, complex aesthetic and reconstructive cases. Founded in 1979, the family-owned business now employs 18 people with clients across the US. CHALLENGE: Creating diagnostic wax-ups before final restorations is a labor-intensive but low-profit application that limits the lab s scheduling potential per technician. SOLUTION: With 3D printing, CMR can create combined models directly from the digital design design with substantially less labor. RESULTS: Technicians productivity increased by 100%. Turnaround time decreased from 2-3 days to a few hours. Cost per case decreased by 90%.
2 Profile In the business for almost 40 years, Matt Roberts has seen a few revolutions in dentistry. Roberts is the founder CMR Dental Lab, a high-end cosmetic reconstructive laboratory in Idaho Falls specializing in large, complex aesthetic and reconstructive cases. Having realized the potential in digital dentistry, over the last 10 years Roberts has gradually shifted his lab to digitally aided CAD/CAM technologies. A common procedure before final restorations is to create a diagnostic wax-up. In this process, planned restorations are developed in wax on a diagnostic cast to determine optimal clinical and laboratory procedures necessary to achieve the desired aesthetics and function. By replacing manual tasks with 3D printing, CMR Dental has managed to simplify this workflow to save time and costs, and deliver superior products to their clients.
3 Challenge Creating diagnostic wax-ups is a labor-intensive and low-profit process. Traditionally, dental technicians: Collect the anatomical data of a patient s dentition from an intraoral scan, or by scanning a stone model from a physical impression taken by the dentist. Design the ideal aesthetics in dental CAD software. Mill the restorations out of wax. Place the milled restorations on the stone model. Form a silicone matrix from the restoration. This silicone matrix is the final product for the dentist. They can fill it with bis-acryl resin and cure temporaries in the shape of the lab s wax-up design, directly in the patient s mouth. The doctor and patient then inspect the results and, if necessary, make minor adjustments per the patient s request. Between the slow cycle time for milling the wax restorations and the painstaking handiwork required from skilled technicians, it s a time-consuming process, and one prone to error. Wax restorations can break all too easily during the process of forming and removing the silicone matrix, necessitating a lengthy rework. DENTAL LAB Collect anatomical data of the patient s dentition with a manual impression Create a stone model and scan it using a lab scanner Design the ideal aesthetics in dental CAD software Mill restorations out of wax re-mill if restoration is broke n Place milled restorations on the stone model Create a silicone matrix from the restoration Fill the silicon matrix with bis acryl resin and create temporaries in the patient s mouth DENTAL LAB Collect anatomical data of the patient s dentition with a manual impress or intraoral scan. Create a stone model and scan it using a lab scanner Design the ideal aesthetics in dental CAD software 3D print the combined model integrated with the restorations Create a silicone matrix or thermoform the tray onto the 3D model Fill the silicon matrix with bis acryl resin and create temporaries in the patient s mouth
4 Solution Stereolithography (SLA) 3D printing has significantly simplified CMR s diagnostic wax-up workflow. Now, technicians can digitally match the restorations with the model and directly 3D print the combined solid model. This is a substantially process cheaper and faster process than creating stone models and milling from wax. 3D printed models can also be used to create a thermoform tray that is essentially the same as the silicone matrix for the dentist, but more efficient for the lab. 1. Advantages of the new 3D printing workflow: 2. Requires less labor and eliminates mistakes and reworks. 3. Cuts turnaround time from 2-3 days to a few hours. 4. Lowers material and machine costs. 5. Allows the lab to safely ship aesthetically pleasing 3D printed education models directly to dentists. The Standard White Resin is beautiful; our clients love it. We have been creating diagnostic wax-ups for months now, and we haven t heard any negative comment yet, everybody s excited about it. CMR started with a single Form 2 3D printer, but soon grew to four units to meet the volume of jobs coming in. At the Form 2 s accessible price point, Matt could invest in additional units with confidence that it ll be paid off fairly quickly. With multiple printers the lab is able to take on even more cases, and has the flexibility to start a new print job at any time. Technicians design the diagnostic wax-ups at different times of the day, and now they can run multiple prints in parallel and even overnight. Technicians at CMR now design the restorations and digitally match them with the prepared model.
5 Results Now, CMR Dental 3D prints all of their diagnostic wax-ups on four Form 2 SLA 3D printers. We re seeing very accurate models coming out of our diagnostic wax-up process. When we mount the models and re-articulate them, the occlusion comes together very nicely with the opposing model. We do not see any gaps or spaces that would be unexplained. Printing models also makes adjustments very simple if a patient requires any changes. Instead of having to add wax or composite, a technician can just go back to the digital design, slightly move the teeth, and then reprint. Creating wax-ups used to limit our scheduling potential per technician. By printing them on the Form 2, we went from one technician doing 20 cases a week to one technician doing 40 cases a week. We ve increased the productivity of our technicians by 100 percent, thanks to the labor savings. That s really great for our business. Diagnostic Wax-Ups In-House 3D Printing Traditional Milled & Handmade Cost 10X 1X Lead time 3 hours 2 3 days 3D printed models are used to create a thermoform tray that is essentially the same as the silicone matrix for the dentist, but more efficient for the lab. This thermoform tray is the final product for the dentist. They can fill it with bis-acryl resin and cure temporaries in the shape of the lab s wax-up design, directly in the patient s mouth.
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