In recent years, CAD software advances coupled with digital scanning have been able to eliminate some of the production steps in manufacturing products. This is especially true in the manufacture of highly personal products like dental restorations, such as crowns, bridges, fillings, and implants. When it comes to customized design processes, there are few that are more personalized than dental work. Good dental restorations have to be accurate to a minimum of 50 microns.

Traditionally, a dental patient needed to visit the dentist multiple times. First, the patient went for a bite impression with a tray full of goopy material. That hardened impression was sent to a laboratory, which created a positive of the oral environment. Next, a restoration design was waxed up by hand and customized to fit the patient's bite.

The wax pattern was then invested, and the wax was burned away before a molten alloy was introduced to the areas where the wax left a void. After the metal solidified and cooled, it was broken out, adjusted with a bur, and coated with ceramic powder and liquid. After three or four firings in an oven, the restoration was polished, adjusted by hand, and sent back to the dentist. The entire process took about two weeks.

Nowadays, a 3D scan of the patient's mouth can be processed by CAD software to create a virtual design. While modern methods have cut costs and reduced the time to fit the patient with a restoration, there is still the onerous milling process. Enter the FIT system by Illinois.-based Planmeca — a combination of a scanner, CAD software, and an in-office milling device that allows dentists to create and build restorations in the same dental appointment. The combination of technologies isn't new, but Planmeca's solution is said to be the first that is small enough to move from room to room.

According to Gary Severance, a dentist who serves as chief marketing officer for Planmeca technology partner E4D Technologies, after a clinician scans a patient, the information is sent to a design center, where a professional creates a design and then sends it back to the office, where it can be queued on the mill for processing. The PlanMill 40 in the FIT system uses a variety of ceramic-like materials to create dental restorations in minutes. 

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Severance told Design News it's not only about shortening wait times and increasing efficiency for clinicians. It's also about greater restoration quality and raising profit margins - the system allows a dental practice to cut out some of the traditional middlemen.

"The restorations are milled from a solid block of material as opposed to the traditional layering hand-made methodology," he said. "It combines the ability to provide a restoration of the same (if not better) fit, function, and esthetics in a single visit versus the more conventional use of an off-site production facility. It's easiest to explain by comparing it to the revolution that LensCrafters brought to the optical world in 1983. It brings the laboratory to where the patient is."

Planmeca conducts three days of extensive hands-on training for two people on how to use the FIT system (the company recommends that both the clinician and an assistant undergo the training.) The first two days are normally at Planmeca University, and the third day is at the clinician's office overseeing the treatment on patients with the new technology. 

Going forward, Severance told Design News that chairside restoration will grow to include creating a complete digital picture of the patient for diagnostic purposes as well as treatment.

"The benefit of these solutions is their 'openness' in their ability to use all-digital captures — whether 2-D (x-rays), 3-D (cone beam), 3-D photographs of the face or digital impressions — in combination to create a comprehensive approach, or export to other systems if necessary. In addition, storing this information in the the cloud will allow clinicians around the world to view the patient's information (including progression, remission, or changes) over time and choose the best consultative care."

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Tracey Schelmetic graduated from Fairfield University in Fairfield, Conn. and began her long career as a technology and science writer and editor at Appleton & Lange, the now-defunct medical publishing arm of Simon & Schuster. Later, as the editorial director of telecom trade journal Customer Interaction Solutions (today Customer magazine) she became a well-recognized voice in the contact center industry. Today, she is a freelance writer specializing in manufacturing and technology, telecommunications, and enterprise software.